All cases in Pigmentary Disorders

Black hairy tongue

Black hairy tongue
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A 28-year-old male presented with an asymptomatic blackish-brown pigmentation on the dorsal surface of the tongue of few months duration. The patient is smoker and has used to get large doses of oral antibiotics for dental problem.  The pigmentation can’t be rubbed off with tooth brush. The patient was instructed to avoid smoking , stop the current antibiotics, together with H2O2 mouth wash.

The case is presented by Dr. Ayman Abdelmaksoud, MD (Egypt).

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Multiple halo nevi

Multiple halo nevi
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A 16-year-old male presented with many depigmented oval patches surrounding central melanocytic nevi on the back of six months duration. The patient noticed that a small pigmented nevus usually appear and then whitish patches develop within a matter of 1-2 months. The patient has no family history of vitiligo or halonevi.

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Halo nevus

Halo nevus

An asymptomatic, solitary, depigmented oval patch about 5 x 2.5 centimeters in diameters involves the upper part of the chest of 6 months duration. As the usual history, there was a central small pigmented compound melanocytic nevus. Few linear depigmented lesions were also seen due to koebnerization.

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Melasma

Melasma

A 32-year-old multiparous woman with history pf brownish hyperpigmented patches involving the butterfly region of the face since first pregnancy  After each of the four previous pregnancies the rash improved spontaneously but partially. Now, one year after the last pregnancy the rash persisted didn’t improved. She has been put on combination of hydroquinone 4% cream plus mometasone furoate 0.1% cream once application at night.

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Acral vitiligo

Acral vitiligo

A 35-year-old male presented with depigmented patches confined to the dorsal surface of both hands of more than one year duration. No other body site was involved and family history of vitiligo or other autoimmune disease was negative. Acral vitiligo is one of the most difficult-to-treat type of vitiligo.

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Melasma

Melasma
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History

         A 36-year-old lady presented with more than two years history of hyperpigmentation involved the butterfly area of the face that had not respond to hydroquinon, topical corticosteroid and topical adapaline used singly and in combination. The patient claimed that 3 sessions of Nd-YAG laser have exacerbated her melasma.
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