ASHY DERMATOSIS

By Gary M. White, MD Ashy Dermatosis
Multiple blue macules and patches on the back of a teenager.


Also known as erythema dyschromicum perstans, ashy dermatosis is an unusual dermatosis that shows a strong geographic preference for Mexico and Central and South America.

Clinical

Clinically, one sees bluish-gray macules and patches scattered on the trunk, arms, and face. Erythema may occur at the border early in the course of the disease. Most patients are less than 30 years of age. There are anecdotal reports of it being associated with various medications, e.g., ethambutol for Tb, and omeprazole.

Diagnosis

For proper diagnosis, it is important to biopsy the edge of a lesion. Taking skin from the center may miss the active area that provides the characteristic histologic picture. As part of the differential diagnosis, lichen planus pigmentosus should be considered.

Treatment

Topical steroids may be tried, especially if there seems to be an inflammatory component. Clofazamine was used with benefit [AD 1997;133;325]. It was given either 100 mg every other day to patients weighing less than 40 kg or 100 mg every day to patients weighing more than 40 kg. It was continued for 3 months, then reduced to 200 mg/wk and 400 mg/wk, respectively. Other anecdotal treatments include hydroxychloroquine, dapsone, and sunscreen use.

Low dose, isotretinoin at 0.25 mg/kg/day for 4 months improved one patient by 90% [JAMADerm 2016;152;842].

Additional Pictures

Ashy Dermatosis Ashy Dermatosis Ashy Dermatosis

RegionalDerm

Homepage | FAQs | Contact Dr. White


It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.