Pigmentary demarcation lines associated with pregnancy Do not use or distribute without permission. An international study. Topical or systemic corticosteroids and antihistamines may also be useful. This work is published and licensed by Dove Medical Press Limited. Pigmentary demarcation lines are normal boundaries of the skin that represent a transition between darker and lighter melanin pigment distribution corresponding to dermatomal innervation by spinal nerves. official website and that any information you provide is encrypted ODdjYjMyYjNkMGNlOWY0ODhkNDI5ZDI5YWMxZGY4MjViODUwN2ZmYjdhZTI5 Because the facial PDL which mimics Melasma is the major concern of skin of color, we would be focusing on it. It has been reported that CALM may present in a linear configuration.53. Methods: About 4000 consecutive patients, both males and females, attending our skin clinic were examined for the presence of any pigmentary demarcation lines on the face, from October 1998 to February 2000. Disclaimer. Distinct autoimmune syndromes in morphea: a review of 245 adult and pediatric cases, Juvenile localized scleroderma: clinical and epidemiological features in 750 children. Physiologic Pigmentation | SpringerLink . As a library, NLM provides access to scientific literature. The incidence of lower mid-trunk hyperpigmentation (linea nigra) is affected by sex hormone levels. Clipboard, Search History, and several other advanced features are temporarily unavailable. The exact pathogenesis of PDL is unknown. Horizontal curve line patches or plaques in the extremities surrounded by erythematous skin. 2019 Jun;18(3):700-702. doi: 10.1111/jocd.12884. Epidermal nevi most commonly occur as a solitary linear lesion, but they are often seen as multiple unilateral or bilateral linear plaques. Pigmentary demarcation lines (PDL) are symmetric, bilateral, and are present from infancy to adulthood as physiological abrupt transition lines from heavily pigmented areas of the skin to more lightly pigmented areas. While linear hyperpigmentation generally follows Blaschkos lines, this is not universal. YzU2MTY1Yzg4MmE4NTEyMjFmNWU2ZjA2ODg2YTlkNmY2MGVjN2Q3ODNmNjAw The erythematous changes in our patient may have resulted from the alteration of estrogen levels in pregnancy. Neoplasms such as squamous cell carcinoma, basal cell carcinoma, and keratoacanthoma may rarely develop in association with epidermal nevi.38, ConradiHnermannHapple (CHH) syndrome is a rare X-linked dominant disorder that occurs primarily in females. It is important to differentiate normal nail pigmentation from malignant melanocytic proliferations and extraneous pigment deposition. As such, researchers suggested that estrogen or lack of sensitivity of androgen receptors could be an etiological factor.72, Sock line (or mitten line) hyperpigmentation is an infantile skin disorder generally caused by elastic bands that constrict the skin, causing dermal and subcutaneous fat inflammation, which ultimately leads to hyperpigmentation. It can however be managed successfully for long periods of time without relapse. Type B pigmentary demarcation lines in a Chinese amenorrheic woman. Pigmentary demarcation lines over the face. Pediatric morphea (localized scleroderma): review of 136 patients. Facial Pigmentary Demarcation Lines have been seen to respond very well to topical depigmentingproducts and chemical peel sessions, as was used in the before and after above. Mller CSL, Schmaltz R, Vogt T, Pfhler C. Lichen striatus and blaschkitis: reappraisal of the concept of blaschkolinear dermatoses, Progressive cribriform and zosteriform hyperpigmentation, Unilateral nevoid acanthosis nigricans with a submammary location. This is more pronounced in pigmented skin, especially the anterolateral portion of the upper arm. Eight types of PDL (A to H) have been reported.69,70, Pigmentary demarcation lines in newborns present as a rare congenital pigmentation that follows the horizontal abdominal creases. Type B pigmentary demarcation lines of pregnancy involving the anterior thighs and knees Ann Dermatol. Palmar and Plantar Hyperpigmented Macules, Punctate Keratoses of the Palms and Soles, COMMON SKIN DISORDERS SEEN PREDOMINANTLY IN DARKER SKIN, Chest from midthird of clavicle to periareolar skin, Straight or curved convex line on the face. PMC Ocular abnormalities can be seen, most commonly unilateral cataracts, and may be accompanied by microphthalmia or microcornea. Pigmentary demarcation lines represent the normal dorsalventral skin patterning. Furthermore, the involved areas of the anterior thighs and knees in our case do not correspond to the innervation of S1 and S2. 2016 May-Jun;7(3):224-5. doi: 10.4103/2229-5178.182366. However, even without therapy, the cutaneous manifestations are self-limiting and disappear within 68 months.64. Kanwar AJ, Dogra S, Handa S, Parsad D, Radotra BD. Clin Dermatol. To our knowledge, this is the first case of type B PDLs, involving not only the posterior portion of the lower extremities, but also the anterior thighs and knees. It is also important to rule out child abuse in such cases.76, Cryofibrinogenemia is an infrequent cause of non-healing dermal ulcers. In one study, 79% of African American women and 75% of . 2). NjMxOTdiZmRkYTEzODRkYWEwOWQzNWQzZGIyNzhkMmRkNGM5M2EwNWE1YzFl Affected individuals typically have an altered facial appearance characterized by a saddle nose, full everted lips, and frontal bossing, thick and viscous nasal secretions and cerumen, recurrent respiratory tract infections, hoarse or raspy voice, gastroesophageal reflux, and feeding problems.30, Incontinentia pigmenti (IP) (Bloch-Sulzberger syndrome) is a rare X-linked genetic syndrome that affects multiple organ systems. Extracutaneous manifestations include mental retardation, osteopathia striata, hypoplastic teeth, microphthalmia, strabismus, ectopia lentis, and coloboma of the iris and choroid. A 29-year-old female presented with 2 months history of asymptomatic, bilaterally symmetrical, non scaly, pigmented band involving buttocks, thighs and legs upto ankles posteromedially [Figures 1 and 2]. Although there are different morphological presentations, most lesions have a geographic or block-like configuration, and rarely present in a linear pattern; however, it is unclear whether Becker nevus adheres to Blaschkos lines. Otherwise it is hidden from view. Longitudinal melanonychia is a normal pattern of nail pigmentation seen in patients with skin of color. Hence, a cross-sectional study was conducted on consecutive patients of facial PDL to evaluate the hormonal profile . Hyperpigmentation lines may also affect the back and extremities. Melasma: Melasma and PDL are quite similar but the difference is that melasma is usually blotchy or patchy and may also occur at different sites of the face such as the forehead, nose and upper lip. Two cases of lichen planus pigmentosus presenting with a linear pattern, Lichen planopilaris: annual incidence in four hair referral centers in the United States, Lichen Planopilaris: update on diagnosis and treatment. Kanitakis J, Souillet A-L, Butnaru C, Claudy A. Melanocyte stimulation in focal dermal hypoplasia with unusual pigmented skin lesions: a histologic and immunohistochemical study, Linear and whorled naevoid hypermelanosis in a patient with trisomy 4 mosaicism, Linear and whorled nevoid hypermelanosis complicated with inflammatory linear verrucous epidermal nevus and ichthyosis vulgaris. Somani VK, Razvi F, Sita VN. -----END REPORT-----. Seen in darkly pigmented skin from infancy through adulthood as bilateral, symmetric, mostly seen on the anterolateral upper arm and posteromedial thigh. MTY0YTZhODdlM2EyNTE5NjM0Mzc2MjVkY2Q0ZTdkOTczZjk2YTI1YTNhMGFk Pigmentary demarcation lines are normal boundaries of the skin that represent a transition between darker and lighter melanin pigment distribution corresponding to dermatomal innervation by spinal nerves. You may be trying to access this site from a secured browser on the server. Environmental factors: These can include sun and heat exposure following inadequate protective measures. Bakuchiol In Skincare The Natural Retinol Alternative. ODdhZmU3MjY2OWZhMzEwYTdkZmJkNjI5MjBkNmYwODk2NDAwNTAyY2I2NDQ4 Results: The demarcation lines were far more common in women (9%) than in men (0.75%). Physiologic pigmentation of the oral mucosa is commonly seen in patients with skin of color. None in the family had similar pigmentation. Blaszczyk M, Krlicki L, Krasu M, Glinska O, Jablonska S. Progressive facial hemiatrophy: central nervous system involvement and relationship with scleroderma en coup de sabre. Voigt-Futcher pigmentary demarcation lines. ), https://dermatology.mhmedical.com/content.aspx?bookid=2585§ionid=211764446. Figure 1: ZDZiZTQ5OGZiYzQyNDFiYzg2OTZiNzliZTM3ZTJiNDA1NGQ4Y2QzYWRlNGRi Received 2020 Sep 7; Accepted 2020 Nov 24. Before Pigmentary demarcation lines are common, especially in individuals with darker skin types. Sir, Facial pigmentary demarcation lines (PDL) were described by Malakar and Dhar in Indian population and are classified into 3 types F, G, and H. Increased incidence of PDL in females and type B PDL in pregnancy suggests that increased female sex hormones may cause PDL. Usually, PDL affects more women than men. Accessibility Androgens likely play a key role, as the majority of cases appear in late childhood and adolescence. Careers. Okeke LI, George AO, Ogunbiyi AO, Wachtel M. Prevalence of linea nigra in patients with benign prostatic hyperplasia and prostate carcinoma. Linear and whorled hyperpigmentation that spares mucosal surfaces, palms, and soles that becomes apparent within the first year of life. CONCLUSIONS: Pigmentary demarcation lines are fairly common in the Indian population especially amongst the females. Clipboard, Search History, and several other advanced features are temporarily unavailable. Linear and whorled nevoid hypermelanosis. Gupta, Lalit Kumar; Srivastava, Ankita; Khare, Ashok Kumar; Mittal, Asit; Balai, Manisha; Mehta, Sharad, Department of Dermatology, Venereology and Leprology, Rabindra Nath Tagore Medical College, Udaipur, Rajasthan, India, Address for correspondence: Dr. Lalit Kumar Gupta, Department of Dermatology, Rabindra Nath Tagore Medical College, Udaipur - 313 001, Rajasthan, India. Unilateral oval hyperpigmented macules and atrophic band-like skin lesions. Futcher lines: a case report in pregnancy and literature review. Kim BS, Seo S-H, Jung HD, Kwon K-S, Kim M-B. PDLs are asymptomatic, and therefore, may be overlooked by patients and physicians. Ozawa H, Rokugo M, Aoyama H. Pigmentary demarcation lines of pregnancy with erythema Dermatology. In one study, 79% of African American women and 75% of African American men had at least one pigmentary demarcation line. J Cosmet Dermatol. 3). Ciliberto H, Berk D, Salphale P, Bayliss S. Heel-line hyperpigmentation: a variant of sock-line hyperpigmentation after the use of heel-length socks, Sock-line hyperpigmentation: case series and literature review, Mitten-line hyperpigmentation: a reactive process analogous to sock-line hyperpigmentation, Acquired raised bands of infancy: association with amniotic bands, Cryofibrinogenemia-induced cutaneous ulcers: a review and diagnostic criteria, Clinical, Cosmetic and Investigational Dermatology, http://creativecommons.org/licenses/by-nc/3.0/, Pruritic hyperpigmented macules and patches arranged in linear, S-shaped, and whorled patterns (. Type A (Futcher's / Voigt's lines), the most common lines, seen over the dorso-ventral aspect of the arms. Her medical and obstetric history were unremarkable. sharing sensitive information, make sure youre on a federal They have been considered as an atavistic remnant, where the dorsal skin is pigmented more than the ventral to provide better protection from the sun. 2019 Jun;18(3):700-702. doi: 10.1111/jocd.12884. 1989 Apr-Jun;7(2):11-27. doi: 10.1016/0738-081x(89)90053-9. Pigmentary demarcation lines are rare physiologic pigmentations shaped as lines of deeper discoloration with abrupt transition from less pigmented areas. Types of pigmentary demarcation lines Type I Location A Lateral aspect of upper anterior portion of arms, across pectoral area B Posteromedial portion of lower limb C Vertical hypopigmented line in pre- and para- sternal area D Posteromedial ar. Accessibility doi: 10.1111/j.1365-2230.2009.03247.x. 1987 Mar;16(3 Pt 1):584-90. doi: 10.1016/s0190-9622(87)70078-4. Reaching the diagnosis in such presentation is relatively difficult as there is a wide range of differential diagnoses. However, there still may be a relationship between abnormal levels of sex hormones and PDLs. Futcher lines: A case report in pregnancy and literature review Cutis. There are six types of pigmentary demarcation lines based on anatomic location3 [Table 21-1]. Diffuse erythema and edema in photoexposed areas have been observed in patients with shiitake mushroom dermatitis, and fever and malaise are occasionally associated findings.67 Topical corticosteroids and oral antihistamines lead to resolution of symptoms within 18 weeks if the mushrooms are avoided. This type of pigmentary demarcation line occurs in the posterior aspect of the legs, extending from the perineum to the ankle. In males, it presents as generalized hyperpigmentation with small hypopigmented macules. Sil A, Chakraborty S, Panigrahi A, Mondal S. Blaschkoid lichen planus occurring in childhood systemic lupus erythematosus. Inclusion in an NLM database does not imply endorsement of, or agreement with, As linhas de demarcao da pigmentao (LDP), tambm conhecidas como linhas de Futcher, de Voigt, de Fucher-Voigt ou de Ito, so linhas fisiolgicas de transio abrupta entre reas de maior e. Cho E, Lim JH, Kim HS, Park YM, Lee JY, Kim HO. Careers, Unable to load your collection due to an error. Pezzani L, Brena M, Callea M, Colombi M, Tadini G. X-linked reticulate pigmentary disorder with systemic manifestations: a new family and review of the literature, X-linked reticulate pigmentary disorder with systemic manifestations: report of a third family and literature review. Among these phototoxic agents, psoralen or bergamot, which may lead to dermatitis called berloque dermatitis. Unauthorized use of these marks is strictly prohibited. Chapter 21: Normal and Pathological Skin Lesions - McGraw Hill Medical Lichen planus (LP) is an immunological disorder with histologic changes known as lichenoid tissue reactions.7 LP is uncommon in children, constituting only 14% of total LP cases but tends to be more severe. Basal layer pigmentation and dilation of small vessels with moderate perivascular lymphohistiocytic infiltration in the upper dermis (H&E, 100, 400). George AO, Shittu OB, Enwerem E, Wachtel M, Kuti O. Pigmentary demarcation lines: a population survey. We present a case of type B PDLs of pregnancy, with three interesting main features: 1) a relatively early onset at the end of the fourth month of pregnancy, 2) association of erythematous changes, and 3) unique distribution, involving both the anterior and the posterior aspects of the lower extremities. Type B pigmentary demarcation lines in a Chinese amenorrheic woman. Voigt-Futcher pigmentary demarcation lines. ZjkxMDFjMDllNDI0Y2U3ZWM4M2Y5NDYxNjcxMmM1YTcxZDUxMzc0NWZmZjFl Approximately 1025% with LWNH present with extracutaneous findings, which typically become apparent during infancy; neurological conditions such as mental retardation, autism, epilepsy, microcephaly, arhinencephaly, developmental delay, hemiatrophy, psychomotor delay, and deafness; musculoskeletal conditions such as brachydactyly; or (less often) cardiac conditions such as congenital heart diseases.24,25 LWNH is usually diagnosed clinically, although chromosomal analysis of skin fibroblasts from hyperpigmented macules can be diagnostic. The tissue-specific processing of pro-opiomelanocortin. Bethesda, MD 20894, Web Policies Our focus is on the diagnosis and treatment of both cosmetic and and non-cosmetic skin conditions in all ages, and the improvement and enhancement of physical appearance. In the latter case, the hormonal changes were different from the changes in sex hormones during pregnancy. Cutaneous clues associated with linear hyperpigmentation. HHS Vulnerability Disclosure, Help Hyperpigmentation can be congenital or acquired and may be either localized or diffuse. Groups A and C are the most distinct and occur in both Negroes and Japanese. 2008 May;47(5):505-7. doi: 10.1111/j.1365-4632.2008.03308.x. Type B PDL have been reported over the legs during pregnancy, and regress after delivery. Pigmentary demarcation lines associated with pregnancy The image below shows the areas of the face wherewe see the facial subtype F-H. Facial Pigmentary Demarcation Lines appear as symmetrical, non-patchy hyperpigmentation, seen on both sides of the face, extending from thecorners of the eyes to the temples in the pattern of a letter V or W ( refer to the before and after images at the top of this article ), or as a band from the angle of the mouth to the side of the chin. 2. Indian Dermatology Online Journal7(3):224-225, May-Jun 2016. Recently, it was suggested that these lines may occur on the face, and additional categories F, G, and H have been suggested2. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). FOIA This div only appears when the trigger link is hovered over. Short hyperpigmented linear streaks present around the ulcer. They are classified into 5 groups, based on their locations; type A involving the lateral aspect of the upper anterior arms; type B involving the posteromedial portion of the lower extremities; type C involving the hypopigmented lines in pre- and parasternal areas; type D involving the posteromedial area of the spine; and type E involving the bilateral hypopigmented bands on the chest1. Bicknell AB. The medial border of the pigmentary band was sharply demarcated while laterally it merged imperceptibly into the surrounding normal skin. It appears as unilateral round or oval hyperpigmented macules and atrophic band-like skin lesions following Blaschkos lines over the trunk or limbs. Grynszpan R, Niemeyer-Corbellini JP, Lopes MSS, Ramos-e-Silva M. Cortina P, Garrido JA, Tomas JF, Unamuno P, Armijo M. Flagellate erythema from bleomycin. Privacy Policy Please enable it to take advantage of the complete set of features! 4. If your institution subscribes to this resource, and you don't have an Access Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Clinically, the presentation of LP varies depending on the subtype. Int J Dermatol. Epub 2019 Feb 22. Based on history and examination, a diagnosis of type B pigmentary demarcation lines (PDL) associated with pregnancy was made. HHS Vulnerability Disclosure, Help The site is secure. official website and that any information you provide is encrypted Before Finally, it was determined that seven of fifty black women (14%) had the new appearance of type B lines with pregnancy. 8600 Rockville Pike Acute illnesses: Chicken pox, typhoid. An official website of the United States government. Acquired, Idiopathic, Patterned Facial Pigmentation (AIPFP) Including Periorbital Pigmentation and Pigmentary Demarcation Lines on Face Follows the Lines of Blaschko on Face. Case for diagnosis - PubMed Pigmentary Demarcation Lines (PDL), also known as Futcher's or voigt lines, are abrupt physiological transition lines between the areas of darker pigmentation and the areas of lighter, normal pigmentation particularly seen in females and people with darker skin types (Kalasapura et al., 2014; Cho et al., 2012).They are classified into eight types, from A to H, based on the site of occurrence. If you are struggling with Pigmentary Demarcation Lines on any part of your body, all you need to do is call us on 0700SKIN101 or 09086000001 to book an appointment or simply book an appointment https://skin101.ng/appointments/. Cryofibrinogenemia-induced cutaneous ulcers. Other cutaneous anomalies can coexist with Becker nevus, such as hypohidrosis; granuloma annulare; and malignancies such as basal cell carcinoma, malignant melanoma, lymphangioma, and osteoma cutis. 8600 Rockville Pike NjczYjg1YTc0ZjgxOGFlMDIzYTI4M2MzYzc0MTgxNTJlOTU4In0= Hair cycle and hair pigmentation: dynamic interactions and changes associated with aging. The site is secure. BTI Abuja is an internationally recognized college with ITEC and CIDESCO accreditation.Our students hold monthly supervised clinics providing services at very discounted rates. government site. In dark-skinned individuals, LS may present as a hypopigmented lesion. Pigmentary demarcation lines are classified into five groups (types A-E). Pigmentary demarcation lines (PDL) are abrupt lines of transition from deeply pigmented areas to lightly pigmented areas in the skin. Pigmentary demarcation lines are commonly seen in Africans and Japanese and rarely in Caucasians. This small-vessel occlusive vascular disorder is caused by accumulation and precipitation of cryofibrinogens in plasma. This hyperpigmentation is classified as a transient benign cutaneous lesion that can present at birth or a few weeks to months later. Some error has occurred while processing your request. Widespread premature calcifications manifest as stippling (chondrodysplasia punctata) of the long bone epiphyses, tracheal cartilage, and vertebrae. approach, blaschkitis, Blaschkos lines, hyperpigmentation, linear, pigmentary mosaicism, The lines of Blaschko on the head and neck, Blaschkoid lichen planus: not a koebner phenomenon. MWRiMjM0OTU1MTgwZTI4MTgzM2Y5NTEwMzkyOGJmZWY3MmYwMGE3ODVhMjMy In blaschkitis, it commonly presents as inflammatory papules and vesicles on adults trunk.16, There are other few conditions that may present as linear hyperpigmentation following Blaschkos lines without systemic findings. Type B pigmentary demarcation lines (Futcher lines) involve the posterior lower extremities and can be . Linear hyperpigmentation with extensive epidermal apoptosis: a variant of linear lichen planus pigmentosus? The erythroderma resolves substantially, if not completely, within the first weeks or months of life. Lesions occur without atrophy or preceding inflammation. LS is primarily affecting children, while blaschkitis is mainly affecting adults. The lesions had clear boundaries between the hyperpigmentation and adjacent normal skin. Pigmentary demarcation lines (PDLs) are abrupt transition lines between the areas of deeper pigmentation and the areas of lighter, normal pigmentation. An examination of 380 patients was accomplished in order to determine the frequency of occurrence of pigmentary demarcation lines in an unselected population. While there in no consensus on etiology, some researchers suggest that melanocyte accumulation, direct toxicity, and post-inflammatory changes may be causative.30, Bleomycin is an effective chemotherapeutic drug for lymphoma, squamous cell carcinoma, and germ cell tumors.62 Flagellate hyperpigmentation occur in 1020% patients receiving systemic bleomycin.62,63 Clinical features typically begin as an itchy linear pigmentation arranged in a flagellated pattern on the back and chest. Some other reported triggering factors for PDLare acute illnesses such as chicken pox and typhoid. Its distribution follows the Voigt's lines, which define the distribution of peripheral nerves. Clinical Approach to Linear Hyperpigmentation: A Review Article Hypoplasia of the ipsilateral breast, areola, nipple and arm, ipsilateral arm shortening, lumbar spina bifida, thoracic scoliosis and pectus carinatum, and enlargement of the ipsilateral foot. Blisters and erythema followed by linear hyperpigmentation. It is often mistaken for melasma because of its similarities but it is definitely not melasma. to maintaining your privacy and will not share your personal information without Erythematous, edematous scaly papules or papulovesicles that coalesce to form plaques across a single or multiple lines, which are 24 cm wide. It primarily affects women and is caused by a mutation in the NF-kappa essential modulator (NEMO) gene or inhibitor of nuclear factor Kappa-B kinase subunit gamma (IKK-).31,32, The syndrome progresses through four stages. Unable to load your collection due to an error, Unable to load your delegates due to an error. Disclaimer. Pigmentary demarcation lines associated with pregnancy. Pigmentary demarcation lines associated with pregnancy. Clinical approach for linear hyperpigmentation. In one study, 79% of African American women and 75% of . Type B pigmentary demarcation lines : Indian Dermatology Online - LWW Careers. FOIA Your access to this site was blocked by Wordfence, a security provider, who protects sites from malicious activity. government site. Unilateral, block-like (rarely linear) hyperpigmented, often hypertrichotic patch or slightly elevated plaque, mostly on the shoulder of male patients. Pigmentary Demarcation Lines in Pregnancy - PMC - National Center for Accessibility However, dermal PIH is associated with dermatoses characterized by degeneration of the basal layer of the epidermis and inflammation at the dermalepidermal junction, such as lichen planus, lichenoid drug reactions, lupus erythematosus, and fixed drug eruptions.30 In some conditions, like lichen planus, the linear hyperpigmentation may result from koebnerization, which presents as linear hyperpigmentation that is not following Blaschko lines.
When A Guy Wants To Get Drunk With You,
Grayson County Police Department,
Oxford City Schools Calendar,
House For Sale In Harbour View,
4078 Ferrow St, Orlando, Fl 32811,
Articles T
