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HYPOPIGMENTED MACULES IN ACANTHOLYTIC DISORDERS
Author(s) -
ROWLEY MATTHEW J.,
NESBITT LEE T.,
CARRINGTON PATRICK R.,
ESPINOZA CARMEN G.
Publication year - 1995
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4362.1995.tb04438.x
Subject(s) - acantholysis , dermatology , medicine , hypopigmentation , etiology , pathology , darier disease , melanosome , pemphigus , disease , melanin , autoantibody , biology , antibody , immunology , genetics
Background . Widespread hypopigmented macules are rarely seen in heavily pigmented patients with Darier's disease. Previous hypotheses concerning the cause of decreased pigmentation suggest it is a postinflammatory phenomenon or that the hypomelanosis is evidence of sub‐clinical acantholysis. Patients . This report presents 2 patients: a new case of disseminated guttate leukoderma in a black patient with Darier's disease and the first such case in a patient with transient acantholytic dermatosis (Grover's disease). Direct immunofluorescence and electron‐microscopic studies were carried out on lesional biopsies. Observations . Numerous small hypopigmented macules were observed in two black patients followed for acantholytic disorders. Three biopsies of the hypopigmented macules revealed acantholysis, while one showed only decreased melanin. Direct immunofluorescence studies were negative. Electron‐microscopic studies of the leukodermic macules showed sparse melanocytes and melanosomes that were mostly pigmented stage IV melanosomes. Conclusions . Disseminated guttate leukoderma can occur in transient acantholytic dermatosis, as well as in Darier's disease. It is readily apparent on darkly pigmented skin because of contrast. The etiology of this phenomenon is still unknown.