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May 1988

Asymptomatic Progressive Hyperpigmentation in a 16-Year-Old Girl

Author Affiliations

Baylor College of Medicine, Houston

Arch Dermatol. 1988;124(5):769-770. doi:10.1001/archderm.1988.01670050113036

REPORT OF A CASE  A 16-year-old girl presented with a four-year history of asymptomatic, hyperpigmented, macular eruptions initially arising on the upper extremities and then slowly progressing to involve the entire body, sparing only the scalp, palms, soles, and mucous membranes. The lesions reportedly first appeared as small hyperpigmented macules with a palpable, erythematous border. The macules would enlarge slowly by peripheral extension and coalescence. The patient reported extensive areas, especially on the upper extremities, of erythematous, annular, raised borders that would disappear within days. Once pigmented lesions appeared, they persisted. The patient's general health was excellent, and there was no family history of cutaneous disease.Physical examination revealed uniformly bluishgray macules of varying intensity, ranging in size from small macules to large polycyclic patches (Fig 1). Lesions involved the face, neck, trunk, and extremities, sparing only the palms, soles, mucous membranes, and scalp. On the upper extremities, some of

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