Synonyms: Postinflammatory pigmentary change.
Clinical Presentation (Fig. 11A):
■ Pigmented macules and patches
■ Sites of a previous dermatitis
■ More prominent in dark-skinned individuals
■ Fading gradually over months or years
Histopathology (Figs. 11B and C):
■ Little or no infiltrate of lymphocytes around venules of the superficial plexus and along the dermoepidermal junction
■ Hints of vacuolar alteration sometimes
■ Melanophages in the papillary dermis and in the upper part of the reticular dermis range from few to many
■ Papillary dermis thickened sometimes by subtle fibroplasia
■ Hyperpigmentation in mycosis fungoides (parakeratosis variegata) is accompanied by features typical of mycosis fungoides, that is, lymphocytes are accompanied by scant spongiosis in the epidermis.
■ Lymphocytes of an inflammatory process, nearly always of an interface type destroy keratinocytes of the basal layer; melanin comes to be situated in the dermis, where it is ingested by macrophages.
1. Pandya AG, Guevara IL. Disorders of hyperpigmentation. Dermatol Clin 2000; 18(1):91-98, ix.
2. Ruiz-Maldonado R, Orozco-Covarrubias ML. Postinflammatory hypopigmentation and hyperpigmentation. Semin Cutan Med Surg 1997; 16:36-43.
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