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Congenital curvilinear palpable hyperpigmentation
Y Isabel Zhu1, James E Fitzpatrick, William L Weston
1isabel.zhu@uchsc.edu
Insights
Two infant boys presented with rare congenital hyperpigmentation on their legs, mimicking abuse. These lesions may indicate potential neurologic and developmental issues.
Area of Science:
- Dermatology
- Pediatrics
- Medical Genetics
Background:
- Congenital hyperpigmentation in infants can present diagnostic challenges.
- Distinguishing between congenital lesions and signs of abuse is critical in pediatric cases.
Observation:
- Two male infants presented with bilateral, posterior leg hyperpigmentation appearing shortly after birth.
- The curvilinear, palpable lesions initially mimicked child abuse (looped cord) or postinflammatory changes.
Findings:
- Histopathology revealed lentiginous melanocytic hyperplasia.
- One infant exhibited severe global developmental delay and abnormal brain MRI findings.
Implications:
- These cases describe a novel form of congenital hyperpigmentation, termed "congenital curvilinear palpable hyperpigmentation."
- The association with neurologic and developmental abnormalities suggests these lesions may serve as markers for underlying systemic issues, despite not following Blaschko lines.
Abstract:
We report two cases of congenital curvilinear palpable hyperpigmentation on the posterior aspect of bilateral legs in male infants. These lesions appeared shortly after birth and mimicked child abuse with looped cord or postinflammatory hyperpigmentation. Histopathologic features showed lentiginous melanocytic hyperplasia. One of the boys also had severe global developmental delay with abnormal findings from magnetic resonance imaging of the brain. We believe that these lesions represent a new type of congenital hyperpigmentation that we termed "congenital curvilinear palpable hyperpigmentation." Although these lesions do not follow the lines of Blaschko, they may also be associated with neurologic and developmental abnormalities.
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