By Thierry Passeron, Jean-Paul Ortonne
The epidermis is coloured by way of a mix of pigments, which shape a part of a fancy and hugely regulated technique. Pigmentary defects regularly current with dyschromia and will be brought on by genetic defects, systemic sickness, inflammatory tactics, metabolic defects, infections, tumors, or poisonous or iatrogenic motives. This atlas is an intensive textual content written via key opinion leaders inside of dermatology, it has a accomplished structure that courses the reader throughout the epidemiology, pathophysiology, prognosis, therapy, and differential analysis of either universal and infrequent pigmentary problems. It illustrates the analysis and popularity of pigmentary problems with a variety of images.
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The lesions are asymptomatic. Localization: penis, scrotum, vulva, vagina. • Laugier disease and other genital lentiginosis. • Genital nevus. • Melanoma. KEY REFERENCES • Barnhill RL, Albert LS, Shama SK et al. Genital lentiginosis: a clinical and histopathologic study. J Am Acad Dermatol 1990; 22:453-60. • Breathnach AS, Balus L, Amantea A. Penile lentiginosis. An ultrastructural study. Pigment Cell Res 1992; 5:404-13. EXTRACUTANEOUS SIGNS None. 45 GENITAL MELANOSIS ASSOCIATED WITH LOCALIZED DEPIGMENTATION Genital melanosis of the penis with white depigmented macules.
Are the second most frequent localization. • Lichen amyloidosis: Flesh-colored papules which coalesce into flat-topped, mildly keratotic plaques. • Nodular amyloidosis: Unique or few flesh-colored or yellowish papules or nodules. Localization: Face, scalp and extremities. Constant and severe pruritus. PATHOPHYSIOLOGY Amyloid deposits could come from the transformation of necrotic epidermal cells into amyloid by dermal macrophages. One other explanation could come from a secretion of amyloid by disrupted basal epidermal cells.
One other explanation could come from a secretion of amyloid by disrupted basal epidermal cells. Those amyloid deposits then bind to antikeratin antibodies. Constant friction and rubbing with brush or towel may cause macular amyloidosis (also called friction amyloidosis). CLINICAL DERMATOLOGICAL PRESENTATION The two most common types of cutaneous amyloidosis are macular and lichen amyloidosis. • Macular amyloidosis: Brown to reddish-brown small macules with poorly defined borders. Asymptomatic to severe pruritus.