ACROMELANOSIS
-------------------------------------------------



I've seen in my Pediatric Dpt an 40 days old baby, male, caucasian, with 
a brownish hyperpigmentation of the last part of the all the 10 fingers 
(only periungueal surface,the nails are normal).The hyperpigmentation is 
in each finger exactly and only in the last phalangis.
The baby in this days was in therapy whit amoxicillin & clavulanic acid 
for a persistent rhinitis.  No other dermatological problem.
Can you help me with an idea ?. 

Mario Cutrone MD
----------------


I would question if this is superficial epidermal necrosis which might be
seen following a drug or viral eruption or in other situations, possibly
following a step infection.  This, if it was the case, would evolve and
desquamate over days.

Charles Swanson MD
------------------


This sounds to me like  "Distal Digital Hyperpigmentation" , a benign and not
too uncommon finding in dark skinned children.  I will try to find you a
reference for it.                
                                        
Jeffrey N. Thompson
-------------------

It sounds like your patient has diffuse acromelanosis, described on page 974
of Fitzpatrick's text.It will probably persist and may extend up his fingers.
Many years ago, I presented a young white man to the Brooklyn Derm Society
because of  hyperpigmentation of his distal phalanges which developed in
childhood.  He said that such hyperpigmentation ran in his family.

Yelva Lynfield, MD
------------------