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Ashy dermatosis: a review.

Khoa Nguyen, Amor Khachemoune1

  • 1Veterans Affairs Medical Center, Brooklyn, NY SUNY Downstate, Department of Dermatology, Brooklyn, NY. amorkh@gmail.com.

Dermatology Online Journal
|June 21, 2019
PubMed
Summary

Ashy dermatosis presents as asymptomatic gray macules, primarily affecting individuals with darker skin tones. Further research is crucial for understanding its unknown causes and establishing effective treatments.

Area of Science:

  • Dermatology
  • Pathology

Background:

  • Ashy dermatosis is a skin condition characterized by asymptomatic, symmetrically distributed gray macules.
  • It predominantly affects individuals with Fitzpatrick phototypes III-V skin.
  • The exact etiology remains unknown, with potential triggers including drugs, infections, and genetics.

Purpose of the Study:

  • To provide a comprehensive review of ashy dermatosis, covering its history, clinical and histopathological features, pathogenesis, differential diagnosis, and management.
  • To highlight the need for increased clinician awareness and further research into the etiology and treatment of this condition.
  • To propose an alternative name, 'macular hyperpigmentation of indeterminate etiology,' reflecting its clinical presentation and uncertain cause.

Main Methods:

  • This review synthesizes existing literature on ashy dermatosis.

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  • It compiles information on clinical presentation, histology, pathogenesis, differential diagnosis, and treatment options.
  • The review also discusses the implications of the condition and suggests a new nomenclature.
  • Main Results:

    • Ashy dermatosis presents with characteristic gray macules on the trunk, neck, face, and extremities.
    • Current treatments lack a gold standard, but clofazimine has shown the most success, with other options including topical tacrolimus, dapsone, phototherapy, and isotretinoin.
    • The condition is mainly a cosmetic concern but can cause significant distress, particularly in individuals with darker skin.

    Conclusions:

    • Ashy dermatosis requires greater clinical recognition and dedicated research to elucidate its etiology and optimize treatment strategies.
    • The proposed name 'macular hyperpigmentation of indeterminate etiology' better reflects the current understanding of the condition.
    • This review serves as a consolidated resource for clinicians managing patients with ashy dermatosis.