Clinico-pathological correlation of localised Dowling-Degos disease

Abstract

A 26-years-old young man came with complaints of abnormally dark skin coloring (hyperpigmentation), particularly in the back of the hands and intertriginous folds between digits, progressively spreading since last 5 years without any family history of the same. He was diagnosed with clinical diagnosis of hyper-pigmented disorder under evaluation most probably medication induced. He had no personal and family history of such skin disease or diabetes mellitus. We received a skin biopsy of 0.3 × 0.3 cm which was totally embedded for histopathology reporting. Section studied through skin reveals epidermis, dermis and subcutaneous tissue. Epidermis shows hyperkeratosis, irregular acanthosis with focal filliform down growth of epidermis. Multiple keratin horn cysts were seen in the down growth. The tips of rete ridges showed pronounced hyperpigmentation. Histopathological impression was given as Dowling-Degos disease (DDD). DDD is a rare genetic skin condition without definite cure, although its prevalence is unknown. So we report a DDD case in a young man with clinico-pathological correlation.