Dermatopathology Clues in Pigmentary Disorders

  • Riti Bhatia
  • M. Ramam
Chapter
Part of the Updates in Clinical Dermatology book series (UCD)

Abstract

Pigmentary disorders are a group of diseases characterized by a reduction, increase or alteration of pigment in the skin. On biopsy, hypopigmented lesions typically show a reduction of melanin in basal epidermal cells with an accompanying reduction in the number of melanocytes in some conditions. Hyperpigmented lesions show an increase in basal layer melanin with some melanophages in the upper dermis. However, these findings are shared by many different disorders and are not of much diagnostic value.

The focus in this chapter is on histopathological clues that can help make a diagnosis. These clues fall into three groups. There may be abnormalities related to components of the pigment system (melanocytes, melanin) as seen in dermal melanocytosis, vitiligo, carbon baby syndrome and hereditary melanosome transfer disorders. The second group includes pigmentary disorders with non-melanin pigment in the skin such as tattoos, pigmented purpuric dermatoses, talon noir, argyria, drug-induced pigmentation and ochronosis. The third and largest group consists of disorders with findings not related to the pigmentary system but distinctive enough to allow a diagnosis. These include lichen planus pigmentosus, connective tissue disorders, lichen sclerosus, Dowling-Degos disease, epidermodysplasia verruciformis, indeterminate leprosy and clear cell papulosis, among others.

Keywords

Dermatopathology clues Melanocytosis Melanocytes Melanin Melanophages Hyperpigmentation Hypopigmentation Skin pigmentation 

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© Government of India 2018

Authors and Affiliations

  • Riti Bhatia
    • 1
  • M. Ramam
    • 1
  1. 1.Department of Dermatology and VenereologyAll India Institute of Medical SciencesNew DelhiIndia

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