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Erythema dyschromicum perstans: A case report and systematic review of histologic presentation and treatment.

Publication ,  Journal Article
Leung, N; Oliveira, M; Selim, MA; McKinley-Grant, L; Lesesky, E
Published in: Int J Womens Dermatol
December 2018

OBJECTIVE: Erythema dyschromicum perstans (EDP) can be difficult to diagnose and treat; therefore, we reviewed the literature to assess whether histology can be used to differentiate lichen planus pigmentosus (LPP) from EDP and determine which treatments are the most effective for EDP. We also present a case of a patient who was treated successfully with narrow-band ultraviolet B (NB-UVB). METHODS: A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted up to July 2017 using four databases. RESULTS: Histologic analyses from the literature reveal a significant percentage of melanophages, lymphocytic infiltrates, and basal vacuolar degeneration in EDP, and a significant histologic overlap with LPP. The review of the literature on treatment outcomes showed that NB-UVB and tacrolimus were effective with minimal side effects. Clofazimine was effective, but demonstrated significant-to-intolerable side effects. Griseofulvin, isotretinoin, and dapsone provided unsatisfactory results as lesions recurred after discontinuation. Lasers were largely ineffective and may cause postinflammatory hyperpigmentation and fibrosis. CONCLUSION: A diagnosis of EDP should not be based on histologic findings alone. Clinical history, morphology, and distribution should be used to differentiate EDP and LPP. NB-UVB and tacrolimus are promising treatments for EDP with minimal side effects. This is the first report to our knowledge of sustained resolution of EDP after treatment with NB-UVB at long-term follow-up of 4 years. Larger studies are needed to confirm these findings.

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Published In

Int J Womens Dermatol

DOI

ISSN

2352-6475

Publication Date

December 2018

Volume

4

Issue

4

Start / End Page

216 / 222

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Leung, N., Oliveira, M., Selim, M. A., McKinley-Grant, L., & Lesesky, E. (2018). Erythema dyschromicum perstans: A case report and systematic review of histologic presentation and treatment. Int J Womens Dermatol, 4(4), 216–222. https://doi.org/10.1016/j.ijwd.2018.08.003
Leung, N., M. Oliveira, M. A. Selim, L. McKinley-Grant, and E. Lesesky. “Erythema dyschromicum perstans: A case report and systematic review of histologic presentation and treatment.Int J Womens Dermatol 4, no. 4 (December 2018): 216–22. https://doi.org/10.1016/j.ijwd.2018.08.003.
Leung N, Oliveira M, Selim MA, McKinley-Grant L, Lesesky E. Erythema dyschromicum perstans: A case report and systematic review of histologic presentation and treatment. Int J Womens Dermatol. 2018 Dec;4(4):216–22.
Leung, N., et al. “Erythema dyschromicum perstans: A case report and systematic review of histologic presentation and treatment.Int J Womens Dermatol, vol. 4, no. 4, Dec. 2018, pp. 216–22. Pubmed, doi:10.1016/j.ijwd.2018.08.003.
Leung N, Oliveira M, Selim MA, McKinley-Grant L, Lesesky E. Erythema dyschromicum perstans: A case report and systematic review of histologic presentation and treatment. Int J Womens Dermatol. 2018 Dec;4(4):216–222.
Journal cover image

Published In

Int J Womens Dermatol

DOI

ISSN

2352-6475

Publication Date

December 2018

Volume

4

Issue

4

Start / End Page

216 / 222

Location

United States