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Year : 1996  |  Volume : 62  |  Issue : 4  |  Page : 262-263

Progressive reticulate zosteriform hyperpigmentation

Correspondence Address:
P K Sharma

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Source of Support: None, Conflict of Interest: None

PMID: 20948075

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A 24-year-old healthy Bengali woman presented with progressive, macular tanned lesions in a zosteriform pattern located upon her right upper limb, breast and chest. The biopsy from the tanned lesion showed mild increase in the pigment in the basal layer.

Keywords: Progressive, Reticulate, Zosteriform

How to cite this article:
Sharma P K, Gautam R K, Prasad D, Jain R K, Kar H K. Progressive reticulate zosteriform hyperpigmentation. Indian J Dermatol Venereol Leprol 1996;62:262-3

How to cite this URL:
Sharma P K, Gautam R K, Prasad D, Jain R K, Kar H K. Progressive reticulate zosteriform hyperpigmentation. Indian J Dermatol Venereol Leprol [serial online] 1996 [cited 2019 Sep 15];62:262-3. Available from: http://www.ijdvl.com/text.asp?1996/62/4/262/4412

  Introduction Top

The progressive cribriform and zosteriform hyperpigmentation consits of:(l) Cribriform macular pigmentation in a zosteriform distribution which are uniformally tanned; (2) Gradual extention and onset well after birth; (3) On histopathology, a mild increase in melanin pigment in the basal layer and complete absence of naevus cell; (4) Absence of any causative factor like herpes zoster, injury or inflammation; (5) No other associated cutaneous or internal abnormalities.[1] We are reporting one such case which, to the best of our knowledge, has not been reported earlier in the Indian literature.

  Case Report Top

A healthy 24-year-old Bengali woman born to non-consanguineous parents noticed asymptomatic multiple, small, light brown spots over her right hand about two years ago. These lesions gradually spread on to her right forearm, upper arm, right breast and chest in a linear fashion. She never had any rash or eruptions or injury on these areas. No one in the family suffered from similar or any other pigmentary disorders.

Examination of skin revealed uniformly hyperpigmented, brownish macules in cribriform fashion in a zosteriform pattern. They were distributed over right upper limb in cervical 6 and 7 dermatomes and the chest in thoracic 2nd, 3rd, 4th, 9th and 10th dermatomes. Darier's sign was negative. There was no area of hypertrichosis. Hair, nails and mucous membranes were normal.

A biopsy showed increase in pigmentation at some places in the basal layer on H and E stain. Dermal vessels were normal. No naevus cells were seen. The pigment stained for melanin on Fontanna-Masson's stain.

  Discussion Top

This patient developed uniform, tanned cribriform macular lesions starting from dorsum of right hand and progressing to right forearm, upper arm and right side of chest. The anatomical distribution and involvement of seven dermatomes in our case is at variance to previously reported cases in whom a single dermatome attection was seen over the flanks and lower limbs.[1],[2]

The cases of reticulate hyperpigmentation in a zosteriform distribution have been reported only in younger age group (1.5 months to 6 years). It is a non-progressive condition and has zosteriform pattern which is generalized. Eosinophilia has also been reported in these cases. [3,4]

Other pigmentary disorders like naevus spilus, cafe-au-lait spots, post herpes zoster hyperpigmentation and atypical naevi were ruled out. Thus, the progressive zosteriform hyperpigmentation may involve any site and more than one dermatome over a period of time.

  References Top

1.Rower JM, Carr RD, Lowney ED. Progressive cribriform and zosteriform hyperpigmentation. Arch Dermatol 1978;114:98-9.  Back to cited text no. 1  [PUBMED]  
2.Simoes GA, Pivat N, Sergi PA. Progressive zosteriform macular pigmented lesions. Arch Dermatol 1980;116:20-2.  Back to cited text no. 2    
3.Yoshida M, Tezuka T. A case of reticulate hyperpigmentation distributed in zosteriform fashion. Jpn J Dermatol 1985;95:1519-21.  Back to cited text no. 3  [PUBMED]  
4.lijima S, Naito Y, Natio S, Uyeno K. Reticulate hyperpigmentation distributed in a zosteriform fashion: a new clinical type of hyperpigmentation. Br J Dermatol 1987;117:503-10.  Back to cited text no. 4    


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