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Hypopigmented macules in acantholytic disorders

M J Rowley1, L T Nesbitt, P R Carrington

  • 1Department of Dermatology, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.

International Journal of Dermatology
|June 1, 1995
PubMed
Summary
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Disseminated guttate leukoderma, characterized by hypopigmented macules, is now recognized in both Darier's disease and Grover's disease. This finding is particularly noticeable in individuals with darker skin tones.

Area of Science:

  • Dermatology
  • Pathology

Background:

  • Hypopigmented macules are uncommon in Darier's disease patients with darker skin.
  • Previous theories suggested postinflammatory changes or subclinical acantholysis as causes.

Observation:

  • Two cases of disseminated guttate leukoderma in Black patients with acantholytic disorders are presented.
  • Biopsies revealed acantholysis in some lesions and decreased melanin in others.
  • Electron microscopy showed sparse melanocytes and stage IV melanosomes in hypopigmented macules.

Findings:

  • Disseminated guttate leukoderma is observed in both Darier's disease and transient acantholytic dermatosis (Grover's disease).
  • The condition is more noticeable on dark skin due to contrast.
  • The exact cause of this leukoderma remains undetermined.

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Implications:

  • This finding expands the clinical presentation of Darier's disease and Grover's disease.
  • Highlights the importance of considering acantholytic disorders in patients with unexplained hypopigmentation.
  • Further research is needed to elucidate the etiology of disseminated guttate leukoderma in these conditions.