Type B pigmentary demarcation lines in a Chinese amenorrheic woman

Abstract

A 51‐year‐old Chinese woman (phototype III) presented to our dermatology clinic with a 3‐month history of asymptomatic pigmented maculae on the lower limbs that developed in the 11th month of amenorrhea. She had noticed no other areas of pigmentary change and denied any inflammatory episode or topical medication before their development. No personal or family history of hormonal imbalance or pigmentary demarcation lines (PDLs) was found. Physical examination revealed broad, band‐like pigmentation symmetrically distributed all over the flexor aspects of the lower limbs (Fig. 1). The medial borders of the pigmented areas were sharply demarcated, but the lateral borders merged imperceptibly into the normal skin. The patient was otherwise healthy. Laboratory examination, including full blood count, liver tests, triiodothyronine (T3), thyroxine (T4), and thyrotropic‐stimulating hormone (TSH), were normal. Hormonal investigations (Table 1) were within normal limits, except that estradiol (E2) was sharply decreased and follicle‐stimulating hormone (FSH) was highly elevated. Ultrasonic B‐mode examination showed a normal uterus and ovaries. No treatment was applied to the lesions. At a follow‐up visit, 16 months after onset, the pigmentary lines had resolved spontaneously. Moreover, the titers of hormones in serum had moved closer to normal values (Table 1).Pigmentary demarcation lines on the buttocks and flexor aspect of the legs. The outer part is darkerimage Hormone investigations on the serum of our patient with pigmentary demarcation lines (PDLs) 3 months after onset 16 months after onset Normal results Abnormal results Normal results Abnormal results 1. Prolactin 1. Estradiol, 12.9 pmol/L Normal, 40.0–100 pmol/L 1. Prolactin 1. Estradiol, 36.46 pmol/L Normal, 40.0–100 pmol/L 2. Luteotropic hormone 2. Follicle‐stimulating hormone, 94.3 U/L Normal, 1.5–33.4 U/L 2. Luteotropic hormone 2. Follicle‐stimulating hormone, 53.2 U/L Normal, 1.5–33.4 U/L 3. Progestone 3. Progestone 4. Total testosterone 4. Total testosterone 5. Free triiodothyronine 5. Free triiodothyronine 6. Free thyroxine 6. Free thyroxine 7. Thyroid‐stimulating hormone 7. Thyroid‐stimulating hormone