10.5826/dpc.1202a106
text/xml
2160-9381
1931
en
Slobodanka Mitrović
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
A Case of Erythema Dyschromicum Perstans
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-05-02
2021-07-31
2022-05-02
2022-05-24
e2022106
Dermatol Pract Concept
Slobodanka Mitrović
2022/05/02
10.5826/dpc.1202a106
e2022106
Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Department of Pathology, University Clinical Center Kragujevac, Kragujevac, Serbia
2160-9381
en
e2022106
Sasidharanpillai S, Govindan A, Ajithkumar K, , et al. Histological evaluation of acquired dermal macular hyperpigmentation. Indian Dermatol Online J. 2019;10(5):542-546. DOI: 10.4103/idoj.IDOJ_426_18. PMID: 31544073. PMCID: PMC6743398.
A Case of Erythema Dyschromicum Perstans
https://dpcj.org/index.php/dpc/article/download/1931/1577
                    Dermatology Practical & Conceptual


          A Case of Erythema Dyschromicum Perstans
    Ana Ravić Nikolić1,2, Vesna Miličić1,2, Bojana Jovović Dagović2, Slobodanka Mitrović3,4


1 Department of Dermatovenereology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
2 Department of Dermatology, University Clinical Center Kragujevac, Kragujevac, Serbia
3 Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
4 Department of Pathology, University Clinical Center Kragujevac, Kragujevac, Serbia



Citation: Ravić Nikolić A, Miličić V, Jovović Dagović B, Mitrović S. A Case of Erythema Dyschromicum Perstans.
Dermatol Pract Concept. 2022;12(2):e2022106. DOI: https://doi.org/10.5826/dpc.1202a106
Accepted: November 4, 2021; Published: April 2022
Copyright: ©2022 Ozarslan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Ana Ravić Nikolić, MD, PhD, Department of Dermatovenereology, Faculty of Medical Sciences, University of
Kragujevac, Kragujevac, Serbia. E-mail: anaravic74@gmail.com




Case Presentation                                                        significant clinical, histological and dermoscopic similarities
                                                                         between EDP and other acquired dermal macular hyperpig-
A 66-year-old male presented with pigmented lesions that he              mentations-pigmented contact dermatitis and lichen planus
had for a few months. Diagnosis of erythema dyschromicum                 pigmentosus [1]. Viney et al reported that severity of pigmen-
perstans was made based on clinical appearance (asymptom-                tation by dermoscopy is comparable with severity of clinical
atic, blue-grayish patches of varying sizes, some with ery-              and histological findings but there are no specific dermo-
thematous borders, distributed on the face, arms, shoulders              scopic differences to differentiate these diseases [1,2]. Four
and trunk) (Figure 1 A-D), histopathology (atrophic epider-              dermoscopic grades were observed: 1) discrete pigment dots
mis, superficial and perivascular lymphocytic infiltrate and             without any pattern; 2) pigment dots and globules arranged
pigment incontinence in the dermis) (Figure 1E) and dermos-              in broken net pattern; 3) pigment dots and globules in a well-
copy (gray-bluish small dots over a bluish base) (Figure 1F).            formed net-like pattern and 4) diffuse pigment dots, globules
                                                                         and blotches, sparing only gland openings [1]. According to
                                                                         the given classification, first grade corresponds to our case.
Teaching points
                                                                         Presence of dots, globules and blotches in EDP differs from
In everyday practice and for every skin lesion, the use of der-          other hyperpigmentations, such as melasma where pseu-
moscopy as a supportive tool is highly recommended. In a                 do-reticular network is observed or in the case of nevus Ota
case of erythema dyschromicum perstans (EDP), there are                  where slate-gray structureless areas are present [1].




Image Letter | Dermatol Pract Concept. 2022;12(2):e2022106                                                                            1
Figure 1. (A- D). Blue-grayish patches of varying sizes, some with erythematous borders localized on the face, arms, shoulders and trunk. (E)
Atrophic epidermis, superficial and perivascular lymphocytic infiltrate and pigment incontinence in the dermis (H&E x100). (F) Dermoscopic
image: gray-bluish small dots over a bluish base (Dermatoscope Heine Delta 20 Led Plus).



References                                                               2. Sasidharanpillai S, Govindan A, Ajithkumar K, et al. Histologi-
                                                                            cal evaluation of acquired dermal macular hyperpigmentation.
 1. Vinay K, Bishnoi A, Kamat D, Chatterjee D, Kumaran MS,                  Indian Dermatol Online J. 2019;10(5):542-546. DOI: 10.4103/
    Parsad D. Acquired dermal macular hyperpigmentation: An update.         idoj.IDOJ_426_18. PMID: 31544073. PMCID: PMC6743398.
    Indian Dermatol Online J. 2021;12(5):663-673. DOI: 10.4103/
    idoj.IDOJ_881_20. PMID: 34667751. PMCID: PMC8456249.




2                                                                              Image Letter | Dermatol Pract Concept. 2022;12(2):e2022106
