case_images: PMC4763577_01
case_images: (a) Hyperpigmented macules over flexor aspect of forearms. (b) Hyperpigmented macules over dorsum of feet. (c) Hyperpigmented macules over back and dark dot follicles
case_images: IDOJ-7-32-g001.jpg
case_images: PMC4763577_01_IDOJ-7-32-g001.jpg
case_images: F1
case_images: The mucocutaneous examination revealed numerous symmetrical brownish hyperpigmented macules, 1-2 mm in size in axillae, groin, flexor and extensor aspects of both forearms, dorsae of hands and feet, both shins and inner aspects of thighs [Figure 1a and b]. Few darkly pigmented comedo-like papules and few atrophic scars were noticeable over upper back and neck [Figure 1c].
case_images: (a) Elongated and confluent rete ridges with antler-like branching and dilated follicular infundibula x10. (b) Elongated rete ridges with mild perivascular lymphocytic infiltrates x40
case_images: IDOJ-7-32-g002.jpg
case_images: PMC4763577_01_IDOJ-7-32-g002.jpg
case_images: F2
case_images: The tips of rete pegs were hypermelanotic owing to concentrated pigment, which was also scattered within the papillary dermal macrophages [Figure 2a]. Biopsy taken from dorsal aspect of forearm revealed histopathology almost similar to that of biopsy taken from nape of neck except mild perivascular lymphocytic infiltrates [Figure 2b].