Metelitsa Andrei I, Nguyen Gia-Khanh, Lin Andrew N
Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada.
J Cutan Med Surg. 2005 Dec;9(6):341-5. doi: 10.1007/s10227-005-0139-7.
Patients who present with facial pigmentation can be a diagnostic challenge.
The goal of this study was to discuss the diagnosis and management of imipramine-induced facial pigmentation.
We describe a patient with facial pigmentation of 26 years' duration that was associated with imipramine treatment for depression. We discuss light and election microscopic findings and review 11 previously reported cases of imipramine-induced skin pigmentation.
Examination showed blue-gray facial pigmentation. Light microscopy showed perivascular pigment granule deposits in the upper dermis that stained positively with Fontana-Masson stain and negatively with Prussian blue stain. Electron microscopy showed electron-dense bodies within histiocytes without clearly identifiable melanin granules, consistent with drug-induced pigmentation. Six weeks after switching to sertraline the patient reported a slight improvement of her cutaneous pigmentation.
Imipramine is a rare cause of gray-blue facial pigmentation. Light microscopy consistently shows granular dermal deposits that stain positively with Fontana-Masson stain but negatively with iron stain.
出现面部色素沉着的患者可能是一个诊断难题。
本研究的目的是探讨丙咪嗪所致面部色素沉着的诊断和处理。
我们描述了一名有26年面部色素沉着病史的患者，其与丙咪嗪治疗抑郁症有关。我们讨论了光镜和电镜检查结果，并回顾了11例先前报道的丙咪嗪所致皮肤色素沉着病例。
检查显示面部呈蓝灰色色素沉着。光镜检查显示真皮上层血管周围有色素颗粒沉积，Fontana-Masson染色呈阳性，普鲁士蓝染色呈阴性。电镜检查显示组织细胞内有电子致密体，但无明显可识别的黑色素颗粒，符合药物性色素沉着。改用舍曲林六周后，患者报告其皮肤色素沉着略有改善。
丙咪嗪是蓝灰色面部色素沉着的罕见病因。光镜检查始终显示真皮有颗粒状沉积物，Fontana-Masson染色呈阳性，但铁染色呈阴性。
