Jennifer Nicole Harb, MD, Kiran Motaparthi, MD JAAD Case Reports

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Presentation transcript:

Clinicopathologic findings of guttate leukoderma in Darier disease: A helpful diagnostic feature Jennifer Nicole Harb, MD, Kiran Motaparthi, MD JAAD Case Reports Volume 4, Issue 3, Pages 262-266 (April 2018) DOI: 10.1016/j.jdcr.2017.09.021 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A, Chest and abdomen with multiple 1-4 mm discrete and coalescing hypopigmented macules. B, Subungual hyperkeratosis and V-shaped scalloping of the fingernails. JAAD Case Reports 2018 4, 262-266DOI: (10.1016/j.jdcr.2017.09.021) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 A and B, Back with multiple hypopigmented macules admixed with multiple hyperkeratotic brown papules. JAAD Case Reports 2018 4, 262-266DOI: (10.1016/j.jdcr.2017.09.021) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 A and B, Verrucous epidermal hyperplasia, acantholytic dyskeratosis, and relationship to the follicular infundibulum are demonstrated in a keratotic papule from the sacrum. C, Basket-weave stratum corneum, papillomatosis without acanthosis, thinned epidermis, and maintained basilar pigmentation at the ends of rete ridges are observed in guttate leukoderma. D, Basilar pigmentation is retained within a normal epidermis in the patient's adjacent, nonlesional skin. (A-D, Hematoxylin-eosin stain; original magnifications: A, C, D: ×100; B: ×200.) JAAD Case Reports 2018 4, 262-266DOI: (10.1016/j.jdcr.2017.09.021) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 A, Immunostaining for SOX-10 within a hypopigmented macule demonstrates an overall reduction in the number of melanocytes at the dermoepidermal junction, with preservation of melanocytes at the base of rete ridges and acrosyringium and absence within the epidermis overlying dermal papillae. B, A corresponding near absence of melanization is also demonstrated between rete ridges, while basilar pigment is preserved at the ends of rete ridges and the acrosyringium. Pigment incontinence is absent. C and D, For comparison, the patient's adjacent nonlesional skin features a normal complement of melanocytes and complete melanization. (A and C, SOX-10 stain; B and D, Fontana Masson stain; original magnification: ×100.) JAAD Case Reports 2018 4, 262-266DOI: (10.1016/j.jdcr.2017.09.021) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions