PDF(Pubmed)
Abstract：
Acquired dermal macular hyperpigmentation (ADMH) is a recently coined term to encompass lichen planus pigmentosus (LPP), erythema dyschromicum perstans (EDP), and Riehl\'s melanosis. Here we report a 60 -year- old female, with an insignificant past medical history, who presented to the dermatology clinic, with slightly itchy skin lesions on her body. The lesions were slowly increasing in number over the last 10 years. The patient was otherwise healthy and was not taking any medications. A review of systems was unremarkable. There was no similar case in the family and the parents did not show consanguinity. Skin examination revealed multiple well-defined non-scaly brownish macules scattered on her body. In addition, bilateral macules and papules were present in the inframammary folds. There were no skin lesions in the axillae, groin, and intergluteal folds. Differential diagnoses include Dowling Degos Disease (DDD), LPP, and EDP. A 4 mm punch skin biopsy was taken from skin lesions under the breast. It revealed hyperkeratosis, hypergranulosis, and acanthosis. The dermis showed a band-like infiltrate of mononuclear histiocytic cellular infiltrate with basal layer degeneration. According to the above clinicopathological findings, the diagnosis of lichen planus was made. The patient was reassured. She was started on hydroxychlorquine 200 mg tab bid, a topical steroid, and topical calcineurin inhibitors, and was asked to follow up regularly in the dermatology clinic.
摘要：
获得性真皮黄斑色素沉着（ADMH）是最近创造的一个术语，包括色素性扁平苔藓（LPP），紫癜性红斑（EDP），还有Riehl的黑变病.这里我们报道了一位60岁的女性，过去的病史微不足道，他被送到皮肤科诊所，身上有轻微的皮肤瘙痒.在过去的10年中，病变的数量缓慢增加。患者在其他方面是健康的并且没有服用任何药物。对系统的审查并不引人注目。家庭中没有类似的情况，父母也没有血缘关系。皮肤检查显示，她身上散布着多个清晰的非鳞片状褐色斑疹。此外,双侧斑疹和丘疹存在于乳房下褶皱中。腋窝没有皮肤损伤,腹股沟,和臀间褶皱。鉴别诊断包括道林德戈斯病（DDD），LPP,和EDP。从乳房下的皮肤损伤处进行4mm穿孔皮肤活检。显示角化过度,高颗粒症,和棘皮病.真皮显示单核组织细胞浸润的带状浸润，基底层变性。根据上述临床病理发现,诊断为扁平苔藓。病人放心了。她开始服用羟氯喹200毫克，一种局部类固醇,和局部钙调磷酸酶抑制剂，并被要求在皮肤科诊所定期随访。
