Department of Dermatology, Oregon Health Sciences University, Portland, Oregon, USA.
Indian J Dermatol Venereol Leprol. 2013 May-Jun;79(3):367-75. doi: 10.4103/0378-6323.110798.
Acquired pigmentary disorders are group of heterogenous entities that share single, most significant, clinical feature, that is, dyspigmentation. Asians and Indians, in particular, are mostly affected. Although the classic morphologies and common treatment options of these conditions have been reviewed in the global dermatology literature, the value of histpathological evaluation has not been thoroughly explored. The importance of accurate diagnosis is emphasized here as the underlying diseases have varying etiologies that need to be addressed in order to effectively treat the dyspigmentation. In this review, we describe and discuss the utility of histology in the diagnostic work of hyperpigmentary disorders, and how, in many cases, it can lead to targeted and more effective therapy. We focus on the most common acquired pigmentary disorders seen in Indian patients as well as a few uncommon diseases with distinctive histological traits. Facial melanoses, including mimickers of melasma, are thoroughly explored. These diseases include lichen planus pigmentosus, discoid lupus erythematosus, drug-induced melanoses, hyperpigmentation due to exogenous substances, acanthosis nigricans, and macular amyloidosis.
获得性色素障碍是一组异质性实体，它们具有单一的、最重要的临床特征，即色素沉着异常。亚洲人和印度人尤其受影响。尽管这些疾病的经典形态和常见的治疗选择已经在全球皮肤科文献中进行了综述，但组织病理学评估的价值尚未得到彻底探讨。这里强调准确诊断的重要性，因为潜在疾病有不同的病因，需要加以解决，以便有效地治疗色素沉着异常。在这篇综述中，我们描述和讨论了组织学在诊断性色素障碍中的应用，以及在许多情况下，它如何能导致更有针对性和更有效的治疗。我们重点介绍了在印度患者中常见的获得性色素障碍以及一些具有独特组织学特征的罕见疾病。面部色素沉着异常，包括黄褐斑的模拟物，也进行了深入探讨。这些疾病包括色素性扁平苔藓、盘状红斑狼疮、药物性色素沉着异常、外源性物质引起的色素沉着过度、黑棘皮病和黄斑淀粉样变。
