Pigmented macules on palms and soles in Puerto Ricans

BACKGROUND

One-third of melanomas in Puerto Ricans occur on the skin of palms and soles. This is a study to define the characteristics of melanocytic nevi in those locations.

METHODS

A sample of 1,039 patients were randomly examined for pigmented macules on the palms and soles. After informed consent, biopsies of these lesions were done on 67 patients.

RESULTS

Among the patients, 13% were found to have pigmented macules on the palms and soles. Volar melanocytic macule was the most frequent lesion.

CONCLUSIONS

Melanocytic nevi occur frequently on volar skin. The criteria for removal of these lesions should not be different from those lesions at other locations.

Eccrine angiomatous hamartoma

This is the case of a 13 year-old female evaluated for a congenital skin lesion on the left buttock. Physical examination revealed a well-defined light brown patch with a 4mm papule on the center. A skin biopsy revealed an increased number of eccrine glands associated to a proliferation of vascular channels, particularly capillaries. These findings are consistent with a diagnosis of eccrine angiomatous hamartoma.

Exogenous ochronosis

Exogenous ochronosis is a condition characterized by hyperpigmentation of the face secondary to the use of hydroquinone-containing bleaching creams. Histopathologically, it presents a collection of yellowish-brown (ochronotic) globules in the papillary dermis. Two cases of exogenous ochronosis are reported, followed by a review of the literature.

Cutaneous drug reactions

Cutaneous drug reactions are among the most common causes of skin eruptions in hospitalized patients. In outpatient clinics, drug eruptions represent a diagnostic and therapeutic challenge to the physician as any drug can cause an adverse cutaneous reaction. These reactions may be mediated by immunologic or nonimmunologic mechanisms. Cutaneous drug reactions may manifest themselves in various clinical morphologic patterns. Factors such as sun-exposure, concomitant drugs or diseases and host immune status can influence the type and morphology of lesions. History taking is one of the most important aspects in the evaluation of these patients and must be oriented so as to provide the information that will lead to the final diagnosis.

Clinicopathologic study on pityriasis alba

Pityriasis alba (PA) is a relatively common skin disorder usually seen in children and young adults characterized by the presence of superficial hypopigmented macules. A clinicopathologic study on pityriasis alba was undertaken which showed an increased occurrence of the disease in preadolescent children with an equal incidence in boys and girls, and a predominance of white over black patients. There was an increased personal history of atopy and the skin lesions were found to occur most frequently in the arms and face followed by the legs and the trunk. Histologic evaluation of biopsy specimens of PA showed consistent spongiosis, follicular spongiosis, focal parakeratosis and acanthosis in the epidermis together with a superficial perivascular lymphocytic infiltrate.