Erythema dyschromicum perstans

    Article Contributors: 
    Sean Klepper M.D.
    Stephen Lyle, M.D., ...

    Also known as: ashy dermatosis

    Clinical Features:

    • Considered by some to be a macular variant of lichen planus, based on the fact that the diseases sometimes coexist, and both have the same immunofluorescence findings
    • Lesions are often widespread, although there is a predilection for the trunk.
    • Presents as slowly progressive ash-colored to brown macular areas of hyperpigmentation
    • Reported associations with paraphenylenediamine and HIV
    • Lichen planus pigmentosus is considered by some to represent the same disease. 

    Histologic Features:

    • Lichenoid lymphocytic infiltrate, much more sparse than in lichen planus, and may extend deeper into the dermis than in lichen planus
    • Prominent melanin incontinence, which may be the only change in older lesions
    • Basal vacuolar change
    • Occasional Civatte bodies
    • Immunofluorescence, as in lichen planus, shows IgM, IgG and complement deposition on dermal colloid bodies.
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    Cases associated with this book:

  • Erythema dyschromicum perstans
    Author: Stephen Lyle, M.D., Ph.D.

    Conference: Teaching Collection