Two of our three cases presented to obstetricians initially. Vollum DI. HI does not represent a single genetic/chromosomal disorder, but is a cutaneous phenotype and has been associated with many different genetic abnormalities, including chromosomal translocations, insertions, aneuploidy, and microdeletions, often leading to chromosomal mosaicism. PDL on the face are fairly common in the Indian population especially among the females. When on the society site, please use the credentials provided by that society. The melanisation process in dark skin is protective against sun damage, but melanisation in white skin (for example after sunburn) is much less protective. I have this problem since 10yrs does laser treatment helps me get rid of those pigments permenantly or is there any other ways to get rid except glutathione therapy .. pigmentary demarcation lines respond well with laser but will require maintenance therapy to keep them light. 1965;4:45-7. Narrow-band ultraviolet B and PUVA (topical or systemic psoralens followed by ultraviolet [UV] A exposure) therapy twice weekly is effective treatment for extensive disease. Some skin diseases and conditions result in generalised or localised hyperpigmentation (increased skin colour, hypermelanosis), hypopigmentation (reduced skin colour, hypomelanosis), or depigmentation (absent skin colour,leukoderma). Published: April 2012 I hv pigmentary demarcation lines on my face. This div only appears when the trigger link is hovered over. Decreased or absent pigment makes the skin appear lighter or white, known as hypomelanosis or hypopigmentation (Box 2). [8] Pigmentation has neural control and differences in pigmentation noted across these lines may correspond to the absence of overlap between neural territories controlled by different homoeobox genes. Large areas of hyperpigmented can be associated with McCune-Albright syndrome (polyostotic fibrous dysplasia with endocrinopathies such as precocious puberty). This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Affected patients can have circulating autoantibodies, including antithyroglobulin, antimicrosomal antibodies, and antiparietal cell antibodies. Pigmentary demarcation lines (PDL) are sharp demarcation lines present over the different parts of the body. Somani VK, Razvi F, Sita VN. ND is an uncommon congenital hypomelanosis of the skin that is often characterized as being nonprogressive and having serrated borders and needs to be distinguished from other hypopigmented skin conditions. Indian journal of dermatology, venereology and. Currently many experts feel that the diagnosis of HI should be reserved for individuals who have the characteristic patterned hypopigmentation and neurologic abnormalities, and should not be given to those who only have the skin manifestations. [11] We speculate that Type B PDL also may not be rare in Indian skin type and large population-based surveys are required. Grimes PE: New insights and new therapies in vitiligo. Pigmentary demarcation lines, also known as Futcher's lines or Voigt's lines, are physiological lines which correspond to borders of abrupt transitions between deeply pigmented surfaces and lighter surfaces. Methods: Patients attending the Outpatient Department for various complaints were examined for the presence of pigmentary demarcation lines, and those with pigmentary demarcation lines were analysed further. Pigmentary demarcation lines over the face - PubMed Melasma and facial pigmentary demarcation lines (FPDL) are common causes of patterned facial pigmentation that may mimic each other. Note that this may not provide an exact translation in all languages, Home Pigmentary demarcation lines are mainly a cosmetic problem. Erythema dyschromicum perstans is seen more often in people with skin of color. National Library of Medicine Bukhari IA. Any inflammatory condition in the skin (e.g., eczema, psoriasis), especially in dark-skinned patients, can lead to postinflammatory hyperpigmentation. Dermatol Int. All Rights Skin research and technology : official journal. Conclusions: The most common type of PDL observed in our study was Type A PDL, followed by Type C PDL. Click the account icon in the top right to: Oxford Academic is home to a wide variety of products. PDF IJDVL Sept 07 - ResearchGate In pregnancy, increase in hormones such as melanocyte-stimulating hormone may trigger the inconspicuous melanocytes more in some of these demarcated areas supplied by specific peripheral nerves leading to prominence of PDL (including Type A and B as in our case).[3]. A hitherto undescribed pigmentary demarcation line is also described along with this study. Vitiligo often follows trauma, with disease common on extensor sites, such as the hands, elbows, and knees. Taylor and Kelly's Dermatology for Skin of Color, 2e. There was no history of similar pigmentary alteration during previous pregnancy. These lesions fall into pigmentary and nonpigmentary categories.2, Pigmentary demarcation lines are normal boundaries of the skin that represent a transition between darker and lighter melanin pigment distribution corresponding to dermatomal innervation by spinal nerves. glutathione do not work for these lines. Physiologic pigmentation of the oral mucosa is commonly seen in patients with skin of color. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. [1] There may be a loss or reduction, which may be related to loss of melanocytes or the inability of melanocytes to produce melanin or transport melanosomes correctly. Causes of Pigmentary Demarcation Lines government site. The https:// ensures that you are connecting to the How common is pigmentary mosaicism? : Dr Takekuni Nakama, Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 8300011, Japan. Children with any red flags warrant subspecialty referral, and all children deserve close clinical follow-up with their primary care physician to ensure they meet all of their developmental milestones. Do not use an Oxford Academic personal account. The melanocytes of dark-skinned people produce more melanin than those of people with light skin. Arunachalam M, Bruscino N, Bassi A, Difonzo E. Type A and B pigmentary demarcation lines in a white, pregnant woman- a rare observation? The disorders can be genetic or acquired. Pigmentary demarcation lines - SELMANOWITZ - 1975 - Wiley Online Library Pigmentary demarcation lines (PDLs), also known as Futcher or Voigt lines, present as an abrupt transition between areas of light and dark pigmentation. Hypopigmented areas of SegPD are also commonly named nevoid hypomelanosis or segmental nevus depigmentosus . Maleville J, Taeb A. Pigmentary demarcation lines as markers of neural development. The site is secure. 2004;70:336-41. Pigmentary demarcation lines (PDL) are abrupt lines of transition from deeply pigmented areas to lightly pigmented areas in the skin. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. Pigmentary Demarcation Lines - I Have This Problem Since 10Yrs - Practo [9] As per the axialneural theory by Maleville, PDL may become apparent only when subtle variation in pigmentation is apparent between two contiguous dermatomes originating from noncontiguous dorsal roots. An official website of the United States government. On examination, there were well-demarcated areas of hyperpigmentation on the flexoral aspect of both lower limbs which were diagnosed as Type B PDL [Figure 1]. Probably many different types of genetic aberrations can lead to pigmentary mosaicism. Capillaritis Dermatol. If you see Sign in through society site in the sign in pane within a journal: If you do not have a society account or have forgotten your username or password, please contact your society. Updated September 2014. Blackwell; 2010: 15-17. International Journal of Research in Dermatology. Bleaching agents with hydroquinone (a hydroxyphenolic compound that inhibits the conversion of dopa to melanin), in concentrations of 2% to 4%, can help to minimize (lighten) the pigmentation. Books about skin diseasesBooks about the skin Don't already have a personal account? Krivo JM. DermNet provides Google Translate, a free machine translation service. Pigmentary demarcation lines (PDLs) are areas of an abrupt transition from hyper into subtypes has been described. Type A lines, also termed Voigt (Futcher) lines, are sharply demarcated, frequently bilateral lines of pigmentation found at the anterolateral junction of the upper arms [Figure 21-1]. Melanin is the major color determinant and is responsible for variations in skin color. JAMA 2005;293:730-735. Generalised hyperpigmentation or hypermelanosis may rarely arise from excessive circulating melanocyte-stimulating hormone (MSH) when it often has a bronze hue. Background: Pigmentary demarcation lines (PDL) correspond to a border of abrupt transition between the more deeply pigmented skin of the outer surfaces and the lighter inner surfaces. [4] Thus far, six demarcation lines have been described and given names If your institution subscribes to this resource, and you don't have an Access Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. [2] [3] PDL is a common finding in dark-skinned women. Arch dermatol. The melanocytes (pigment cells) are located at the base of the epidermis and produce the protein melanin. Dr. Sandeep Gupta Dermatologist 19 yrs exp Delhi Consult Now Nothing works permanently in pigmentary demarcation lines Answered 3 years ago 1 /1 people found this helpful Was this answer helpful? Pigmentary demarcation lines are rare physiologic pigmentations shaped as lines of deeper discoloration with abrupt transition from less pigmented areas. However, this relatively high percentage likely represents a reporting bias, because cases that have no karyotype abnormality may be underreported. Pigmentary demarcation lines: A population survey. Pallor is much more frequently due to blood loss or anaemia. Background: Pigmentary demarcation lines (PDL) correspond to a border of abrupt transition between the more deeply pigmented skin of the outer surfaces and the lighter inner surfaces. Women are more commonly affected. On the basis of their location they have been classified into eight types, type A to type H. The present study is an attempt to obtain a better understanding of the clinical types of pigmentary demarcation lines . Pigmentary demarcation lines are abrupt transition lines between the areas of deeper pigmentation and the areas of lighter, normal pigmentation. Dermatol Clin 2005;23:208-226. There are six types of pigmentary demarcation lines based on anatomic location 3 . The terms pigmentary mosaicism or patterned dyspigmentation describe a spectrum of clinical findings that range from localized areas of dyspigmentation with no systemic findings to widespread dyspigmentation with associated neurologic, musculoskeletal, and cardiac abnormalities, and other sequelae that can lead to early demise. Topics AZ The various types of pigmentary demarcation lines seen were Type A (38%), Type B (14%), Type C (24%), Type F (22%), Type G (4%), Type H (4%). The change from darker to lighter pigment occurs at the junction of the extensor to flexor surface of the arm. Enter your library card number to sign in. If a genetic error leads to a distinct set of cells that has a darker or lighter phenotype, Blaschkos lines become visible as a line of darker or lighter pigmentation along that cell and its progenys migration path. Other cutaneous signs of tuberous sclerosis include facial angiofibromas (adenoma sebaceum), fibrous plaques on the forehead, periungual fibromas (Koenens tumors), and connective tissue nevi (shagreen patches). [1] We are reporting a case with PDL related to pregnancy in Indian skin. Eight different types are described in the literature. Abnormalities in karyotype can be detected in 30% to 60% of patients with HI or LWNH. Otherwise it is hidden from view. A genetic abnormality is not always found. We have also observed that the lateral margins of the perioral pigmentation roughly follow the nasolabial fold in the upper part and the . Melanin is the major color determinant and is responsible for variations in skin color. Pigmentation disorders | DermNet Pituitary failure resulting in lack of MSH rarely results in acquired generalised hypomelanosis. Whether mosaicism is the cause of the patterned pigmentation in all patients is unknown. Treatment is not necessary. SegPD that is hyperpigmented is often called nevoid hypermelanosis or segmental caf au lait . The Groupto hypopigmented or normal skin color. All types were more common in females with the exception of Type C, which was observed only in males. Hypopigmentation SegPD with hypopigmentation can also be differentiated from disorders such as vitiligo, which lead to depigmented areas that appear more starkly white and highlight distinctly with a Woods lamp examination. The diagnosis is usually straightforward. 1952;56:1-2. [1], Most pigmentation disorders involve the underproduction or overproduction of melanin. In one study, 79% of African American women and 75% of . Hence, the role of genetic factors in the development of disease needs to be further studied. The variability in the clinical presentation is likely from the large number of distinct genetic abnormalities that can lead to the same clinical phenotype of streaky hypopigmentation. Diffuse lentiginosis This term was originally described by Metzker and colleagues. Pigmentary demarcation lines are normal boundaries of the skin that represent a transition between darker and lighter melanin pigment distribution corresponding to dermatomal innervation by spinal nerves. Oval (ash leaf) hypopigmented macules are the earliest cutaneous sign of tuberous sclerosis. Suntan in dark skin [3,7], Miura described PDL to correspond to axial lines of Sherrington. Blaschko's lines are more wavy and whorled than the straight bands of dermatomes, which follow the distribution of cutaneous sensory nerves. Some societies use Oxford Academic personal accounts to provide access to their members. Issue Section: Clinical dermatology Concise reports 2009 British Association of Dermatologists [1] There may be a loss or reduction, which may be related to loss of melanocytes or the inability of melanocytes to produce melanin or transport melanosomes correctly. Methods: Pigmentary demarcation lines (PDL) are abrupt lines of transition from deeply pigmented areas to lightly pigmented areas in the skin. As you start to approa Pigmentary demarcation lines are normal boundaries of the skin that represent a transition between levels of melanin pigment in the skin corresponding to dermatomal innervation. Approximately 30% to 40% patients have a family history of vitiligo, and disease has occurred in monozygotic twins. The natural pigmentary demarcation boundaries of the skin can be classified as: Group A lines along the upper limb with variable transpectoral extension; Group Blines along the lower limb; Group Cpaired lines in median or paramedian course on the chest with midline abdominal extension; and Group Ebilaterally symmetrical, obliquely oriented hypopigmented macules on thechest. 2000;200:856. Pigmentary demarcation lines are rare physiologic pigmentations shaped as lines of deeper discoloration with abrupt transition from less pigmented areas. Lability of pigment in the darker-skinned population causes dramatic changes in skin color after inflammatory processes of the skin. Read more, Hyper pigmentation is divided into two types:1. See below. Read more, Chemical peeling agents are used to improve the texture of the skin. Language links are at the top of the page across from the title. Pigmentation disorders are disturbances of human skin color. Pigmentary demarcation lines (PDL) are symmetric, bilateral, and are present from infancy to adulthood as physiological abrupt transition lines from heavily pigmented areas of the skin to more lightly pigmented areas. James WD, Meltzer MS, Guill MA, Berger TG, Rodman OG. J Am Acad Dermatol. Although there have only been 29 cases of pigmentary demarcation lines associated with pregnancy reported to date, before ours, we experienced 3 cases within 3 months, therefore it is possible that many such cases are overlooked. Post-sclerotherapy staining. A family history of PDL was present in 5 (10%) and all were females. The skin can provide diagnostic evidence of either local or systemic disease. These lines are known and seen by dermatologists in the skin of African, Indian, and Japanese patients, usually females. Pigmentary Demarcation Lines - Patient Care Online Pigmentary demarcation lines are mainly a cosmetic problem.
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