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Reticulate postinflammatory hyperpigmentation with band-like mucin deposition
1Department of Dermatology, University of Palermo, Policlinico P. Giaccone, Italy.
Background:
Mucinoses of the skin are a group of disorders sharing accumulation of mucin in the skin or hair follicles. Postinflammatory hyperpigmentation, with pigmentary incontinence, is due to loss of melanin from epidermal basal cells and its accumulation in dermal macrophages.
Methods:
We describe clinicopathologic features of two patients presenting with the association of pigmentary incontinence with an unusual diffuse, band-like dermal deposition of mucin, clinically presenting with reticular pigmented macular lesions.
Results:
Two patients were observed with asymptomatic, persistent, reticular, pigmented patches located in the flexures, thighs, neck and back. Histology showed melanophages with a diffuse, band-like dermal deposition of mucin, an increased number of fibroblasts, a slight T-cell infiltrate and scattered mast cells. Blood markers of lupus erythematosus were negative.
Conclusions:
These findings may draw attention to pigmentary disorders such as lichen planus pigmentosus, erythema dyschromicum perstans, pigmentatio maculos eruptiva idiopathica, dermatopathia pigmentosa reticularis, prurigo pigmentosa and frictional melanosis. None of these entities, however, includes mucin deposition among its microscopic features. Macules were not preceded by erythema or any other lesions. We suggest that our cases could belong to group II of Rongioletti and Rebora's classification, i.e. they could be cases of secondary mucin deposition in postinflammatory hyperpigmentation, possibly in an unusual form of lichen planus pigmentosus or, less likely, frictional melanosis.
Insights
Two patients presented with reticular pigmented macular lesions and unusual dermal mucin deposition. This suggests a potential link between pigmentary disorders and mucin accumulation, possibly a variant of lichen planus pigmentosus.
Area of Science:
- Dermatology
- Pathology
Background:
- Mucinoses involve mucin accumulation in the skin.
- Postinflammatory hyperpigmentation results from melanin loss and dermal macrophage accumulation.
Observation:
- Two patients exhibited asymptomatic, persistent, reticular, pigmented patches on flexures, thighs, neck, and back.
- Lesions were characterized by melanophages and diffuse, band-like dermal mucin deposition.
Findings:
- Histology revealed melanophages, diffuse dermal mucin deposition, increased fibroblasts, T-cell infiltrate, and mast cells.
- Negative lupus erythematosus blood markers were noted.
- The macules were not preceded by erythema or other lesions.
Implications:
- These cases highlight a potential association between pigmentary disorders and mucin deposition.
- The findings may represent a variant of lichen planus pigmentosus or frictional melanosis with secondary mucin deposition.
- This presentation expands the understanding of mucinoses and pigmentary disorders.