Psoralen plus ultraviolet A irradiation-induced lentigines arising in vitiligo: involvement of vitiliginous and normal appearing skin

Clinical and Experimental Dermatology
M B Abdel NaserS El Shiemy

Abstract

Psoralen plus ultraviolet A irradiation (PUVA therapy) is commonly used for the management of vitiligo in which perifollicular repigmentation is the usual response pattern. However, excessive PUVA therapy may be associated with adverse effects. We report a case of generalized vitiligo that has been extensively treated with topical and systemic PUVA therapy for several years with the development of extensive and widespread stellate and irregularly shaped black and brown macules (lentigines). Interestingly, the lentigines were observed not only in the normally pigmented skin but also within the depigmented lesions that were lacking the perifollicular response pattern. The lesions developed in the exposed and unexposed skin areas. No evidence of skin malignancy was observed clinically and no melanocyte atypia was detected histopathologically. Cryotherapy may be used in the management of the lentigines; however, because of the extent of lesions this was impractical in our case.

References

Dec 1, 1996·The British Journal of Dermatology·D LeroyS Louvet
Mar 31, 1999·Journal of Dermatological Science·D BetheaF P Gasparro
Aug 5, 2000·The Journal of Pathology·D J TobinK U Schallreuter

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Citations

Aug 16, 2011·Journal of the American Academy of Dermatology·Lesley M FelstenVesna Petronic-Rosic
May 24, 2006·Clinical and Experimental Dermatology·M B Abdel-NaserM A Habib
Nov 28, 2008·The British Journal of Dermatology·D J GawkrodgerUNKNOWN Vitiligo Society
Jul 28, 2011·Journal of the European Academy of Dermatology and Venereology : JEADV·R FriedlandE Hodak
Oct 31, 2009·Clinical and Experimental Dermatology·D DeU N Saikia
Apr 13, 2010·Italian Journal of Pediatrics·Laura FolgoriAndrea Finocchi
Jul 23, 2013·Journal of the American Academy of Dermatology·Janyana M D DeonizioJoan Guitart
Dec 1, 2012·Anais Brasileiros De Dermatologia·Shyam Bhanushankar Verma, Uwe Wollina
Aug 24, 2013·Clinical Medicine Insights. Pediatrics·Irene Lara-CorralesPerla Lansang
Jan 31, 2016·The American Journal of Dermatopathology·Claudia Ramos-RodríguezCarlos Mendoza-Chaparro
Aug 22, 2006·Autoimmunity Reviews·Kepa Oyarbide-ValenciaI Caroline Le Poole

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