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A 12-year-old girl was referred to the outpatient dermatology department at the Hospital Alto Guadalquivir, Andujar, Spain, in April 2015 with a five-month history of asymptomatic dirt-like hyperpigmented plaques on her neck and linea alba [Figure 1]. The patient had been previously treated with adapalene 0.1% cream twice a day for one month after the eruption was diagnosed as pseudoacanthosis nigricans by a general paediatrician. However, no response to treatment was observed. Diabetes mellitus and insulin resistance were ruled out as causative factors and the patient’s medical history was unremarkable. A dermoscopic examination using the Dermlite DL3 (3 Gen Inc, San Juan Capistrano, California, USA) revealed polygonal areas of brownish pigmentation affecting the dermatoglyphs [Figure 2]. Complete and immediate resolution of the plaques was noted after firm rubbing with a 70% isopropyl alcohol swab [Figure 3].Figure 1A u0026 B:Photographs showing asymptomatic dirt-like hyperpigmented plaques on the (A) neck and (B) linea alba of a 12-year-old girl.Figure 2:Dermoscopic image at ×10 magnification showing polygonal areas of brownish pigmentation affecting the dermatoglyphs of a 12-year-old girl with asymptomatic dirt-like hyperpigmented plaques on her neck and linea alba.Figure 3A u0026 B:Photographs of the (A) neck and (B) linea alba of a 12-year-old girl showing the complete resolution of asymptomatic dirt-like hyperpigmented plaques after firm rubbing with a 70% isopropyl alcohol swab.

Dirt-Like Hyperpigmented Plaques on the Neck and Linea Alba of a 12-Year-Old Girl