| Dermatosis | Clinical manifestations | Onset | Pathophysiology | Inheritence | Alcohol Test | Treatment | ||||||
| Dermatosis Neglecta | Brown, adherent, cornflake-like scaling in areas of indaeqate frictional scrubbing | Any age | Lack of friction produces improper exfoliation of the stratum corneum | Acquired | Complete clearance | Frictional cleansing, alcohol based preparations, and epidermolytic emollients | ||||||
| Terra Firma Forme | Dirt-like brown patches, typically involving the neck, occasionally neck and arms | Children, adolesent, young adult | ? involvment of Pityrosporum. ? incomplete squame maturation with retention of melanin | Acquired | Complete clearance | Alcohol-based preparation | ||||||
| X-linked Icthyosis | Fine to large scaling prominent over extensor surfaces, comma-shaped corneal opacities, increased migration of B- lipoproteins on electrophoresis | Birth/infancy | Steroid sulfatase deficiency producing improper cholesterol metabolism and desquamation | X-linked recessive | Unresponsive | Emolients, keratolytics, topical retinoids, or Vitamin D | ||||||
| Confluent and reticulated papillomatosis of Gougerot and Carteaud | Persistant hyperpigmented papules and plaques localized to the central trunk | Any age | ? Abnormal reponse to infection - Pityrosporum | Acquired | Unresponsive | Keratolytics, Vitamin A & D derivatives, antimicrobials, &/or systemic antibiotics | ||||||
| Acanthosis Nigricans | Gray-Brown plaques of the axiillae, neck, external genitalia, groin, facer, inner thighs, antecubital and popliteal fossae, umbilicus, and perianal area, beginning as a dirty appearance associated with hyperkeratosis, increased sking markings, and papillomatosis | Any age | Insulin resistance stimulating ILGF promoting celluar proliferation. Humoral factor produced by neoplastic cells promoting cellular proliferation | Acquired | Unresponsive | Treat the underlying cause | ||||||
| Atopic dermatitis | Brown-black ripple pigmentation predominantly on the anterior neck in an atopic patient | Any age | Unknown. Long standing interface dermatitis producing post inflamatory hyperpigmentation. Amyloidosis | Acquired | Unresponsive | Topical steroids, avoid irritants, moisturizers | ||||||
| Postinflammatory hyperpigmentation | Hyperpigmented plaques in areas of resolved inflamation | Any age | Melanocytes drop to the dermis after dermal epidermal junction disturbance | Acquired | Unresponsive | Reassurance. Treat primary process.Bleaching agents. | ||||||
| Frictional Asymptomatic Darkening of Extensor Surfaces (FADES) | Hyperpigmented plaques involving areas of friction &/or pressure, predominantly on the knees and elbows | Any age | Friction and pressure prouducing hyperpigmented scaling | Acquired | Unresponsive | Avoid pressure and friction | ||||||