pigmentary demarcation lines on legs causes

Copyright McGraw HillAll rights reserved.Your IP address is 2008;47:505-7. This section provides a quick diagnostic and treatment guide in the Federal do Paran, HC-UFPR) Curitiba (PR), Brazil, Endocrinologist Curitibas Diabetes Center Hospital Nossa Senhora das Graas (HNSG) Curitiba (PR), Brazil, Physician Residency in Internal Medicine at Hospital Municipal So Jos (HMSJ) Joinville (SC), Brazil, Text Pityriasis rosea 23.

Arms and legs Eczema - atopic (including facial ecz 12. They have been considered as an atavistic remnant, where the dorsal skin is pigmented more than the ventral, providing better protection from the sun. Arch Dermatol.

2002;138:127-8. Arch Dermatol. Comments on: Nonsegmental vitiligo follows, Nonsegmental vitiligo follows Blaschko's lines and, Pigmented linear discoid lupus erythematosus following the. .switcher .selected a:hover {background:#fff} The patient underwent tightening of the os uteri during the first trimester for a patulous os and had a threatened abortion. We could not come across a description of type B pigmentary demarcation line in the Indian literature. - how to use, THE CUNLIFFE (TP) GENERAL DERMATOLOGY images for use on the website. Rash arises periodically lasting days-weeks London. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. 1. If you would like to donate, please use this Arch Dermatol. These are most often observed in darker races and are considered to be normal variants of pigmentation. Longitudinal melanonychia is a normal pattern of nail pigmentation seen in patients with skin of color. In male black individuals, type B lines have already been observed; however, in white individuals, they are present only in women.33. spots (syn. Taylor and Kelly's Dermatology for Skin of Color, 2e. 1987;16:584-90. Itch Type B pigmentary demarcation lines in a Chinese amenorrheic woman. College of General Practitioners, The All Hyperchromia in the axillae and groin, which had appeared earlier in the pregnancy, were concurrent complaints. use, THE CUNLIFFE (TP) SKIN LESION DIAGNOSTIC TABLE, Trunk (chest, abdomen, back) / buttocks / axillae / groin, Leg & Other training in dermatology. Linhas de demarcao pigmentar so linhas fisiolgicas que correspondem a transies abruptas entre reas mais escuras e mais claras. Ulceration / necrosis (black non-viable skin) Pigmentary Demarcation Lines (PDL), also known as Futchers or voigt lines, are abrupt physiological transition lines between the areas of darker pigmentation and the areas of lighter, normal pigmentation particularly seen in females and people with darker skin types (Kalasapura et al., 2014; Cho et al., 2012). Seborrhoeic eczema 29. Arch Dermatol. Pigmentary demarcation lines are normal boundaries of the skin that represent a transition between levels of melanin pigment in the skin corresponding to dermatomal innervation.

She also had generalized cutaneous hyperemia that blanched completely on diascopy. Lips J Am Acad Dermatol 1987;16:584-90. Accessibility 2008;47:505-7. Hands James WD, Carter JM, Rodman OG. Macules (small flat lesions) / papules (small raised lesions) Photosensitive rashes (rashes made wo Peeling skin Scabies 28. A histopathological examination was performed on the basal layers of hyper-pigmented and hypo-pigmented areas. Drug (or chemical) related Hyperchromic axillae and prominent linea alba were also seen. Bonci A, Patrizi A. Pigmentary demarcation lines in pregnancy. Associated with medical conditions We also use third-party cookies that help us analyze and understand how you use this website. British Association of Dermatologists, The Royal Face and neck Lability of pigment in the darker-skinned population causes dramatic changes in skin color after inflammatory processes of the skin. This website is non-profit and holds the images for educational purposes only. Ma HJ, Zhao G, Dang YP. 2002;138:127-8. Although type B PDL are transitory, they may persist in some patients as seen in our case. I shall book again and already shared with colleagues [4], Five naturally occurring PDLs, labeled A-E, have been described:[1],[4], [5].

Malakar and Dhar (2000) were the first to report pigmentary demarcation lines over face in Indian population and labeled them as type F PDL. Skin lesion algorithm - common benign 4. solar keratosis), Fordyce 1. Type E, periareolar hypopigmented macules. Some cases were accompanied or preceded by an overlapped erythematous component, and the fact that the erythema and pigmentation disappeared soon after delivery supports this hypothesis.33. Pruritis ani 25. Its distribution is bilateral and symmetrical and separates the more deeply pigmented skin of the outer surfaces from the lighter inner surfaces. 55. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

.switcher .selected a {border:1px solid #ccc;color:#666;padding:3px 5px;width:151px;} Dermatologist Specialization in Cosmetic and Dermatologic Surgery Clinics Hospital Federal University of Parana (Hospital de Clnicas Universidade Eczema - discoid eczema 11. eczema, Other guidelines - The British Charity No. Erythema dyschromicum perstans is seen more often in people with skin of color. There is smooth lightening of the hyperchromia as it reaches the anterior aspect of the legs. All rights reserved. She was slightly concerned that she had experienced a similar temporary pigmentation during her previous pregnancy that spontaneously resolved 6 months after delivery. These lesions fall into pigmentary and nonpigmentary categories.2, Pigmentary demarcation lines are normal boundaries of the skin that represent a transition between darker and lighter melanin pigment distribution corresponding to dermatomal innervation by spinal nerves. They can be seen on the limbs, face, and sometimes the trunk. Unwell with eg fever / malaise given and further information. Protection Policy. Anyhow, type B PDLs should be considered a physiological pigmentary alteration related to pregnancy.33. They are considered to be associated with the distribution of cutaneous peripheral nerves and pigmentary differences due to neurogenic inflammation. The videos used in this section have kindly been produced by a 3. J Am Acad Dermatol. Sua fisiopatogenia incerta. link for the society's contact details. There are six types of pigmentary demarcation lines based on anatomic location3 [Table 21-1]. Eyelids conditions, Other useful tools for patients and She had also received progesterone injections for 3 months. Arunachalam M, Bruscino N, Bassi A, Difonzo E. Type A and B pigmentary demarcation lines in a white, pregnant woman - a rare observation? Pain / tenderness (sore to touch) Eur J Dermatol. consent form, Website Privacy Effective treatment of Futcher's lines with Q-switched Alexandrite laser. This finding may be explained by the possible presence of a local trigger factor occurring only in some pregnancies or during some periods of the same pregnancy.33. Regression occurs spontaneously from 6 to 12 months after delivery; hence, treatment is not required. Physical examination revealed demarcation lines from the perineum to the posteromedial portion of the thighs extending to the ankles through the popliteal fossae, bilaterally and symmetrically, in the interface between a hyperchromic lateral portion and a lighter medial portion (Figures 1 and 2). Stay informed of issues for this journal through your RSS reader, Resumo Int J Dermatol. Pregnancy-related email the declaration of consent form with the images to pcds@pcds.org.uk. Notice and credit must be given to the PCDS or other named contributors. 2011; 21: 787-8. Statement Policy In a study involving 380 patients, although PDL were reported to occur typically during childhood which supports the former theory, seven of fifty black women (14%) were noted to have the new appearance of type B lines with pregnancy (James et al., 1987). Type B, which appear during pregnancy on the lower limbs and regress after delivery. (2009) 19 cases of type B PDL were reported to have resolved within a year of delivery. save the web address in the browser as one of your favourites then #selected_lang_name {float: none;} [3] The PDL were seen with a much higher frequency in women (9%) than in men (0.75%). 2002;138:127-8. The change from darker to lighter pigment occurs at the junction of the extensor to flexor surface of the arm. 2011;50:863-5. James WD, Caster JM, Rodman OG. [3] We report a pregnant woman, who presented with type B pigmentary demarcation lines and generalized cutaneous hyperemia. Fordyce's granules), Adult [2] Subsequently, a few more patterns of pigmentary demarcation lines on the face, types F, G and H have also been described in Indian subjects. Data This category only includes cookies that ensures basic functionalities and security features of the website. Small vessels were dilated and there was perivascular lymphocytic infiltration in the papillary dermis (Fig. 3. Hair Successful use of Q-switched Alexandrite 755nm has been reported. According to Selmanowitz and Krivo (1975), PDL are streaks of melanocyte accumulation along the embryological axial line but not along the Blaschkos lines as in type A PDL. Dermatology 2000;200:85-6. Palmar and Plantar Hyperpigmented Macules, Punctate Keratoses of the Palms and Soles, COMMON SKIN DISORDERS SEEN PREDOMINANTLY IN DARKER SKIN, Chest from midthird of clavicle to periareolar skin, Straight or curved convex line on the face. 5. Psychological This chapter, which provides a brief overview of PDL, is set out as follows: Please refer to notes on image rights at bottom of the page with regards to individual image (English), https://doi.org/10.1590/abd1806-4841.20131764. 2011; 21: 787-8. .l_name {float: none !important;margin: 0;} Sharona Yashar; Jennifer Haley; Leslie Robinson-Bostom; Nianda Reid. Estas se localizam nas linhas de Voigt que so o trajeto dos nervos perifricos. Psoriasis 26. 5. Scalp Type C, which are mid sternal, extending from the clavicle to the inferior border of the sternum. - 2011;50:863-5. Normal to low hormonal levels have been reported. Genitalia, Diagnosis based on morphology White / pale areas 3. Type B pigmentary demarcation lines in a Chinese amenorrheic woman. Fourteen percent of black women have type B PDLs during pregnancy.22. The skin can provide diagnostic evidence of either local or systemic disease.

Happle (1993) also suggested that the familial pattern and female predominance led to the hypothesis of cutaneous mosaicism pigmentary pattern by paternal X chromosome lyonization. Translate this page into: The patient was diagnosed with type B; PDL based on her medical history, physical examination and histopathological findings. She did not report similar pigmentation or hyperemia in her previous pregnancy. Pityriasis versicolor 24. Pigmentary demarcation lines are abrupt demarcation lines between the light and dark pigmentation areas that usually occur on the upper and lower limbs. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. .switcher .option a:hover {background:#fff;} Int J Dermatol. PDL are abrupt transition lines from areas of deeper pigmentation to areas with less pigmentation. Zhang R, Zhu W. Coexistence of pigmentary demarcation lines types C and E in one subject. They are rare examples of streaks of melanocytes, otherwise inapparent. Fungal infections (tinea) 15. Eur J Dermatol. Pigmentary demarcation lines. Trunk (chest, abdomen, back) Expectant treatment is used, and good results have been reported with the use of Q-switched Alexandrite laser. There are eight types of pigmentary demarcation lines. They neither correspond to the lines of Blaschko that mark the distribution of linear nevoid conditions, nor to the dermatomal lines. Br J Dermatol 1975;93:371-7. Ears [5] The PDL and generalized cutaneous hyperemia in our patient could possibly be due to the progesterone therapy received during early pregnancy.

.switcher .option::-webkit-scrollbar-thumb {border-radius:5px;-webkit-box-shadow: inset 0 0 3px rgba(0,0,0,.3);background-color:#888;}. Referral pathways 2. The medial borders of the pigmented areas were sharply demarcated while the lateral borders merged imperceptibly into the normal skin. However, due to miscegenation, it is probable that PDLs are common in Brazil, but that they are underdiagnosed. James WD, Meltza MS, Giml MA, Berger TG, Rodman OG. Bukhari IA. The reason for this recurrence has to be further investigated through clinical studies. Warts, Consent Forms: The PCDS always needs good Delmonte et al. Molluscum contagiosum 19. Actinic (solar) keratosis 3. Type A lines, also termed Voigt (Futcher) lines, are sharply demarcated, frequently bilateral lines of pigmentation found at the anterolateral junction of the upper arms [Figure 21-1]. [5] Genetic and hormonal influences have also been suggested. Bonci A, Patrizi A. Pigmentary demarcation lines in pregnancy. Eczema - atopic (including facial ecz 16. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Malakar S, Dhar S. Pigmentary demarcation lines over face. .switcher .selected {background:#fff linear-gradient(180deg, #efefef 0%, #fff 70%);position:relative;z-index:9999;} Type B PDL involve the posterior medial portion of the lower extremities and are more commonly associated with pregnancy and often show spontaneous resolution after delivery (Peck and Cusack, 2013). 88 Int J Dermatol. Structural - firm or weak areas of skin, Head and neck Trunk (chest, abdomen, back) / buttocks / axillae / groin Arms and legs Hands Feet Nails Genital conditions. PDL are more commonly reported in Japanese people and black skin, and rarely in white skin. 1. Therefore, when evaluating pigmentation, it is important to understand and recognize normal variants.1 Knowledge of normal variations in skin is crucial in the evaluation and management of patients with skin of color because there are a number of skin lesions that represent physiologic variants. By clicking Accept, you consent to the use of ALL the cookies. Este tipo de linha de demarcao pigmentar ocorre na face posterior dos membros inferiores estendendo-se do perneo ao tornozelo. Its distribution follows the Voigt's lines, which define the distribution of peripheral nerves. These cookies do not store any personal information. Eczema - hand (and foot) 14. and health professionals, Up to 30% of GP consultations have some element of skin, but yet there is limited 4. carers, this 1109376 Lead Author - Dr Tim Cunliffe. A 30-year-old second gravida who was 8 month spregnant presented at the skin outpatient department with asymptomatic, broad, band-like pigmentation over the posterior aspect of both legs and thighs [Figure - 1], extending from the heel to the gluteal crease, that was present since 4 months. UK Tel: 0333 939 0126 Email: pcds@pcds.org.uk, Website Privacy Download, The Arunachalam M, Bruscino N, Bassi A, Difonzo E. Type A and B pigmentary demarcation lines in a white, pregnant woman - a rare observation? 1b) although she completely denied the presence of any post-inflammatory hypopigmentation. .switcher .selected a:after {height:16px;display:inline-block;position:absolute;right:5px;width:15px;background-position:50%;background-size:7px;background-image:url("data:image/svg+xml;utf8,");background-repeat:no-repeat;content:""!important;transition:all .2s;} These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Would recommend it to other GPs." The exact cause of pigmentary demarcation lines is still an enigma. 2a). 2005;4:27-8. If you simply .switcher a img {vertical-align:middle;display:inline;border:0;padding:0;margin:0;opacity:0.8;} You also have the option to opt-out of these cookies. These lines may be present at birth, arise later in life, or occur during pregnancy.4. Other common types of PDL are; type A that mostly occurs in the lateral aspect of the upper anterior portion of the arms across the pectoral area and type C that consists of a vertical hypo pigmented line in the presternal and parasternal areas (Peck and Cusack, 2013; Gupta et al., 2005; Somani et al., 2004).

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