PMC5726689_01
A. Multiple black-colored, hyperpigmented patches without
scaling, atrophy and telangiectasias on the trunk. B.
Patches with surrounding erythema
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f1
Similar hyperpigmented patches developed and progressed on her chest and flank over half a year (Figure 1). Some of the pigmented patches had become surrounded with erythema two weeks prior to presentation (Figure 1).
A. Histopathology showing epidermotropism, atypical
lymphocytes aligning along the basal layer and perivascular space with
melanophages in the dermis (Hematoxylin & eosin, X200).
B. High power view demonstrating atypical small to
medium-sized hyperchromatic lymphocytes (Hematoxylin & eosin,
X400)
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f2
The histology of lesional skin from a hyperpigmented patch and surrounding erythema both showed prominent epidermotropism and atypical lymphocytes (small to medium-sized hyperchromatic indented nuclei) aligning along the basal layer and perivascular space with dermal melanophages (Figure 2).
A. Regression of hyperpigmented patches. B. The
patch with surrounding diminished erythema after 8-week treatment of
PUVA
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f3
A therapy with oral 8-methoxypsoralen three times a week along with a potent topical corticosteroid agent (clobetasol propionate). After 8 weeks of treatment, the erythematous lesions regressed with no development of new lesions, and the involved pigmented area had reduced from 10% to 6% of the total body surface area (Figure 3).