Australas J. Dermatol 1992; 33: 56-59
AUSTRALIAN DERMATOPATHOLOGY SOCIETY A PECULIAR PRURIGINOUS DERMATOSES WITH GROSS RETICULAR PIGMENTATION PRESENTED BY H . ROTSTEIN, DERMATOLOGIST AND G.H. MASON, PATHOLOGIST
Melbourne
A twenty-two year old female of Indonesian origin presented with a three month history of an itchy rash on the nape of the neck and the interscapular region of the back (Figure 1). The patient was otherwise well. She had noted that papules resolved to leave pigmentation after approximately one week, and that new papules were still appearing in regions where papules had been. The rash had not responded to topical steroid application or to oral Oucloxacillin. The rash was seen to consist of small 3-5 mm diameter red papules that were intensely pruritic. The papules coalesced to form linear arrangements organised into a reticulate network and occasional small plaques. This was admixed with reticulate macular pigmentation (Figure 2).
Histology of a papule was reported on as a spongiotic dermatitis with a superficial perivascular mononuclear infiltrate (Figures 3 & 4). Melanin stain revaled patchy pigmentary incontinence (Figure 5). Treatment with dapsone 50 mg per day caused disappearance of itch within 24 hours and disappearance of all papules with a few days. By one week all that remained was asymptomatic reticulate macular pigmentation (Figure 6). With continued treatment the pigmentation took many months to disappear and eventually the patient was able to cease treatment, with no recurrence of the rash one year later.
FIGURE 1
FIGURE 2
56
AUSTRALIAN DERMATOPATHOLOGY SOCIETY
FIGURE 3 — ( H & E X 13.2)
I
^'{.
•^"•' • . - •
,
.
- •
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} FIGURE 4 — ( H & E X 66)
FIGURE 5—(Schmorl stain x 33)
j FIGURE 6
57
AUSTRALIAN DERMATOPATHOLOGY SOCIETY A PECULIAR PRURIGINOUS DERMATOSES WITH GROSS RETICULAR PIGMENTATION PRESENTED BY H . ROTSTEIN, DERMATOLOGIST AND G.H. MASON, PATHOLOGIST
Melbourne
A twenty-two year old female of Indonesian origin presented with a three month history of an itchy rash on the nape of the neck and the interscapular region of the back (Figure 1). The patient was otherwise well. She had noted that papules resolved to leave pigmentation after approximately one week, and that new papules were still appearing in regions where papules had been. The rash had not responded to topical steroid application or to oral Oucloxacillin. The rash was seen to consist of small 3-5 mm diameter red papules that were intensely pruritic. The papules coalesced to form linear arrangements organised into a reticulate network and occasional small plaques. This was admixed with reticulate macular pigmentation (Figure 2).
Histology of a papule was reported on as a spongiotic dermatitis with a superficial perivascular mononuclear infiltrate (Figures 3 & 4). Melanin stain revaled patchy pigmentary incontinence (Figure 5). Treatment with dapsone 50 mg per day caused disappearance of itch within 24 hours and disappearance of all papules with a few days. By one week all that remained was asymptomatic reticulate macular pigmentation (Figure 6). With continued treatment the pigmentation took many months to disappear and eventually the patient was able to cease treatment, with no recurrence of the rash one year later.
FIGURE 1
FIGURE 2
56
AUSTRALIAN DERMATOPATHOLOGY SOCIETY
FIGURE 3 — ( H & E X 13.2)
I
^'{.
•^"•' • . - •
,
.
- •
.'. - > '
} FIGURE 4 — ( H & E X 66)
FIGURE 5—(Schmorl stain x 33)
j FIGURE 6
57
