Dowling Degos disease (reticulated pigmented anomaly of the flexures) is an autosomal dominant condition caused by the loss of function mutation in Keratin-5 gene leading to alterations in transfer of melanin from melanocytes to keratinocytes. A 37-year-old male presented with progressive, mildly itchy, pigmented macules in the axillae and groin for the past 15 years. Few lentigo like lesions over chest and pitted perioral scars were seen on examination. There was history of similar lesions in his father. Histopathology shows increased pigmentation of the basal layer, and finger-like elongation of the rete ridges with suprapapillary thinning giving rise to an “antler like” pattern. There is no effective treatment, but the condition does not cause significant morbidity.
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