Presenter: Christopher Buckley, DO; Marcus Goodman, DO; Allison Schwedelson, DO; Angela Combs, DO; Matthew Elias, DO; Emily Rubenstein, DO; Carlos Gomez-Meade, DO; Julian Moore, DO; Rupa Reddy, DO
Dermatology Program: NSUCOM/Broward General Medical Center
Program Director: Stanley Skopit, DO
Submitted on: Dec 23, 2009
CHIEF COMPLAINT: 58 year old Hispanic male with complaints of darkish discoloration of skin involving the back, neck, and upper arms. The discoloration was ongoing for several years.
Signs and symptoms: No associated pruritus, pain or previous skin lesions. No new medications.
Previous Treatment: None
Other information: Hypertension, not on medication
Hyperpigmented blue-gray macular eruption coalescing into patches on the anterior shoulders, neck, upper extremities, back and mid-chest. No overlying scale or erythema.
CBC, CMP, thyroid were within normal limits.
mild basal cell layer vacuolar degeneration overlying an upper dermis with a mild perivascular mononuclear cell infiltrate and increased melanophages
1. Exogenous ochronosis
2. Lichen planus pigmentosa
3. Erythema dyschromicum perstans
4. Drug-induced hyperpigmentation
5. Contact dermatitis