Joshi Rajiv
P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India.
Indian J Dermatol Venereol Leprol. 2007 Nov-Dec;73(6):402-5. doi: 10.4103/0378-6323.37058.
Nine patients, seven males and two females aged 6-14 years, presented with extensive, asymptomatic, brown-black macules and mildly elevated, pigmented lesions of a few months' duration. The sites affected were the face, trunk and proximal extremities. The skin lesions were discrete and individual lesions were less than 2 cm in size. The clinical diagnoses rendered by the referring physicians were lichen planus pigmentosus, urticaria pigmentosa, erythema dyschromicum perstans and postinflammatory hyperpigmentation. Histology in all nine cases showed papillomatosis of the dermis with prominent pigmentation of the basal layer (pigmented papillomatosis) without any significant dermal inflammation. Two cases had spores of Pityrosporum ovale in the thickened horny layer, one of which also had, in addition, bacterial colonies in the stratum corneum. The pigmentation resolved on its own over several months. This presentation is similar to the previously described idiopathic eruptive macular pigmentation with the additional histological finding of papillomatosis that is being described for the first time and may be nosologically related to acanthosis nigricans and confluent and reticulate papillomatosis.
9名患者，7名男性和2名女性，年龄在6至14岁之间，表现为广泛的、无症状的棕黑色斑疹以及持续数月的轻度隆起的色素沉着性损害。受累部位为面部、躯干和近端肢体。皮肤损害为散在性，单个损害大小小于2厘米。转诊医生做出的临床诊断为色素性扁平苔藓、色素性荨麻疹、持久性色素异常性红斑和炎症后色素沉着。所有9例的组织学检查均显示真皮乳头瘤样增生，基底层色素沉着显著（色素性乳头瘤样增生），无明显的真皮炎症。2例在增厚的角质层中有卵圆形糠秕孢子菌孢子，其中1例在角质层中还存在细菌菌落。色素沉着在数月内自行消退。这种表现类似于先前描述的特发性发疹性黄斑色素沉着，伴有首次描述的乳头瘤样增生这一额外组织学发现，可能在病因学上与黑棘皮病及融合性网状乳头瘤病相关。
