Category Archives: Pigmentary Disorders

Pigmentary disorders

Black hairy tongue

History

          A middle-aged heavy smoker man presented with a blackish hyperpigmented patch on the dorsal surface of the tongue of many years duration. The patient has been advised to quit smoking and to brush the lesion with a teeth brush daily to scrub the hyperpigmented patch.

Longitudinal melanonychia

History

        An asymptomatic linear band of brown-black discoloration extending from the base of the fifth fingernail to the distal end of an about one and half year duration in a 22-year-old female. Biopsy of the nail matrix at the site of pigmentation revealed a benign melanocytic nevus.

Nevus of Ota

History

         A 35-year-old female presented with a slate-grey to bluish hyperpigmented patch affected the right side of the face mainly the area supplied by the maxillary branch of the trigeminal nerve was noticed since birth. The conjunctiva, sclera and the skin surrounding the eye were not involved.

A puzzling black lesion

History

          A very interesting and puzzling case referred from another dermatologist of a 6-year-old girl presented with an asymptomatic, oval, blackish patch/plaque about 2×1 cm in greatest diametetrs involved the middle portion of the palm of six months duration. We put three differential diagnoses according to lesion’s morphology: Benign melanocytic nevus, pigmented BCC and malignant melanoma. An excisional biopsy was done and benign melanocytic nevus was the final diagnosis.

Post-lichen planus hyperpigmentation

Post-lichen planus hyperpigmentation2

History

         A 28-year-old lady with classical LP involved mainly the extremities specially the acral parts of more than six months duration. Two months after commencement of treatment with Hydroxychloroquine 200 mg per day plus topical potent corticosteroids most lesions have gone with residual brownish hyperpigmentation.

Vitiligo

vitiligo back

History

          A 20-year-old female presented with asymptomatic, depigmented patches variable in sizes and shapes involved the trunk of two years duration. Many foci of resumed pigmentation had been induced through treatment with topical psoralen plus sun (UVL) exposure.