Pigmentary Disorders Flashcards
pathology of vitiligo
loss of functional melanocytes
pathology of postinflammatory hypopigmentation
dysfunction in melanocyte-keratinocyte interactions
decreased melanocyte function
decreased melanin synthesis
pathology of melasma
excess deposition of melanin into the epidermis or dermis
pathology of solar lentigines
proliferation of basal melanocytes and subsequent increase in melanization
pathology of ephelides
increased melanin production
pathology of PIH
increased release / production of melanin
proposed etiologies of vitiligo
- genetic
- environmental
- auto-immune
- oxidative stress
- melanocyte detachment
Clinical presentation of progressive macular hypomelanosis
non scaly
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Pathophysiology of progressive macular hypomelanosis
C acnes
Wood’s lamp of progressive macular hypomelanosis
orange to red follicular fluorescence
clinical presentation of postinflammatory hypopigmentation
ill defined
clinical presentation of chemical/medication induced leukoderma
confetti-like
medications that cause leukoderma
- plaquenil
- methylphenidate (ADHD)
- topical steroids
- IL TAC
- immune checkpoint inhibitors
- EGFR inhibitors
- Azelaic acid
- Imiquimod
- Optic preparations
treatment for confluent/reticulated papillomatosis
minocycline 50-100mg BID 1-3 months
azithromycin 250-500mg three times weekly x 3-4 weeks
there is a rare malignant form of acanthosis nigricans associated with ______ malignancy
GI
-onset in middle age/adult
-unusual locations on the body
drugs that cause acanthosis nigricans
Oral contraceptives
Testosterone
Insulin
Niacin
risk factors for melasma
- Hormone replacement therapy
- Pregnancy
- Oral contraceptives
- UVR
- Photosensitizing meds
Pattern of clinical presentation of melasma
- centrofacial
- malar
- mandibular
major difference clinically between solar lentigines and ephelides
lentigines:
-DO NOT FADE IN WINTER
ephelides:
-FADE IN WINTER
etiology of exogenous ochronosis
most commonly associated with prolonged use of hydroquinone or other lightening agents in combo with UV exposure
may not resolve
drug known to cause drug-induced hyperpigmentation
minocycline
what is erythema ab igne
hyperpigmentation due to prolonged exposure to heat (laptops, heating pads, electric heaters)
reticular pattern
spontaneously resolves after weeks-months removal of heat source
