Pigmentary Lines Research Articles

Transient pigmentary lines of the newborn

Transient pigmentary lines of the newborn

新生儿一过性线状色素沉着一例

新生儿一过性线状色素沉着一例

Voight-Futcher pigmentary demarcation lines

Pigmentary demarcation lines are physiological abrupt transition, between two areas of skin, one more pigmented and one less pigmented. These pigmentary lines are currently classified into eight types according to location (A to H). The most common is type A affecting the arms. We report a new observation through which we stress the importance of recognizing the different presentations of this pigmentary disorder, as well as differential diagnoses, thus reassuring patients about its physiological nature and avoiding over-medication. A concern of an aesthetic nature may lead to proposing some solutions.

Transient pigmentary lines of the newborn

Transient pigmentary lines of the newborn

Transient Pigmentary Lines of the Newborn

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, and must not exceed two pages of text including references. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.

Type B pigmentary demarcation lines in a Chinese amenorrheic woman

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

Suprachoroidal hemorrhage during cataract surgery in a vitrectomized eye

We report a case of surprachoroidal hemorrhage (SCH) that occurred during cataract surgery in a previously vitrectomized eye. The only sign of SCH was a progressive shadow obscuring the red reflex. There was no increase in intraocular pressure (IOP), shallowing of the anterior chamber, or iris prolapse. Postoperatively, the SCH gradually resolved without complications, leaving a series of subretinal pigmentary lines. Surgeons should be aware that the signs normally expected in SCH may not develop in vitrectomized eyes. Obscuration of the red reflex may be the only sign of the hemorrhage, and when this happens, it may be prudent to keep the IOP elevated and suture the incision at the end of the procedure.

How Common Is Pigmentary Mosaicism?

In an article on lines of Blaschko,¹the authors referred to a study of pigmentary lines by Selmanowitz and me²and pointed out that we thought that those lines did not correspond to lines of Blaschko. We did say that in the article; however, after looking at the diagrams provided by Bolognia et al,¹it is clear to me that these pigmentary lines did indeed follow Blaschko lines. Also, this same correction applies to a study by Selmanowitz and me³on hypopigmented markings in blacks. These pigmentary variations represent a common form of mosaicism most easily visible in dark-skinned people. In a recent article, Nehal et al⁴show that pigmentary mosaicism in certain clinical patterns was associated with extracutaneous abnormal features in 30% of their patients. If one were to study dark-skinned people with pigmentary demarcation lines, mediosternal lines, or hypopigmented chest macules as examples

How Common Is Pigmentary Mosaicism?-Reply

In reply Pigmentary lines of demarcation are indeed a common phenomenon, especially evident in dark-skinned people, and the descriptions by Selmanowitz and Krivo referred to in Krivo's letter are classics in the field. There is no evidence, however, that these lines of demarcation represent genetic mosaicism even of the somatic type. That is to say, there is no reason to believe that there is a genetic difference between the cells on the dark, posterior side of a line of demarcation vs the light, anterior side. Indeed, the presence of a lighter ventrum is a common phenomenon in the animal kingdom, readily evident not only in darkly pigmented humans, but also in other mammals, reptiles, and amphibians. Recent evidence suggests that these differences may be due to the normal function of genes that affect embryonic patterning, such as the product of the agouti locus. 1 Since the lines of Blaschko presumably

Pigmentary lines of the newborn

We report three cases of infants born with extensive linear and retiform pigmentation on the trunk and extremities. In none of these cases was there an associated underlying medical disorder, and in all cases the pigmentation resolved by 6 months of age. It appears that the treatment of choice for this transient disorder is reassurance.

Pigmentary Changes in Acquired Retinoschisis

We reviewed retrospectively the records of patients referred for retinal examination and found 375 eyes (233 patients) with acquired retinoschisis. Of the 375 eyes, 85 had outer layer retinal breaks, 27 had retinal detachments, and 29 had pigmentary lines. Twenty-five of the 29 pigmentary lines (86.2%) demarcated either retinal detachment or outer retinal layer breaks.