Angel Tiffany A, Stalkup Jennifer R, Hsu Sylvia
Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA.
Int J Dermatol. 2002 Jun;41(6):327-9. doi: 10.1046/j.1365-4362.2002.01479.x.
A 72-year-old white woman presented with progressively increasing slate-gray pigmentation of the face and extensor aspect of the forearms, which she had been suffering from for 8 years. She had been taking imipramine for approximately 30 years. Her other medications included ranitidine and anacin. Physical examination revealed slate-gray hyperpigmentation of the skin photodistributed on the face (Figs 1, 2) and extensor aspects of the forearms. Relative sparing of the skin folds, mucous membranes, sclerae, teeth, and nails was noted. The remainder of the physical examination revealed no abnormalities. Skin biopsy specimens from the right cheek and right forearm were obtained. Histologic examination revealed collections of variably sized, round to ovoid, yellow-brown globular deposits in the upper and mid dermis (Fig. 2). The deposits were identified within macrophages and free within the dermis. The epidermis was unremarkable and free of deposits. The deposits stained for melanin with a Fontana-Masson stain, but did not stain for iron.
一名72岁的白人女性，面部和前臂伸侧出现逐渐加重的蓝灰色色素沉着，这种情况已持续8年。她服用丙咪嗪约30年。她的其他药物包括雷尼替丁和阿司匹林。体格检查发现，面部（图1、2）和前臂伸侧皮肤有光分布性蓝灰色色素沉着。注意到皮肤褶皱、黏膜、巩膜、牙齿和指甲相对未受累。体格检查的其余部分未发现异常。取右侧脸颊和右侧前臂的皮肤活检标本。组织学检查显示，真皮上部和中部有大小不一、圆形至椭圆形的黄褐色球状沉积物聚集（图2）。沉积物存在于巨噬细胞内，也游离于真皮中。表皮无异常，无沉积物。沉积物经Fontana-Masson染色显示为黑色素，但铁染色阴性。
