Atopic Dirty Neck or Acquired Atopic Hyperpigmentation ? An Epidemiological and Clinical Study from the National Skin Centre in Singapore

作者：Seghers Amelie C^*; Lee Joyce S S; Tan Chuen Seng; Koh Yun Pei; Ho Madeline S L; Lim Yen Loo; Giam Yoke Chin; Tang Mark B Y

来源：Dermatology, 2014, 229(3): 174-182.

DOI：10.1159/000362596

• Acquired atopic hyperpigmentation
• Atopic dirty neck
• Rippled pigmentation
• Reticulate pigmentation
• Poikiloderma-like lesions
• Atopic dermatitis

Background: 'Atopic dirty neck' is a poorly understood acquired hyperpigmentation in patients with atopic dermatitis (AD). Objective: To report a single-centre experience with synthesis of this entity's features. Methods: All patients with AD with dirty neck seen over a 5-month period at the National Skin Centre were invited to participate. Results: Out of 544 AD patients examined, 78(14.3%) had acquired pigmentation of the neck. The majority had moderate-to-severe underlying eczema. Histopathology showed increased epidermal melanin and dermal melanophages, a thickened basement membrane and a dense superficial perivascular infiltrate. Conclusion: Acquired atopic hyperpigmentation has a high prevalence, particularly in adolescent Asian males. Clinico-pathological correlation suggests it results from both frictional melanosis and post-inflammatory hyperpigmentation. The rippled appearance and the onset in adolescence are probably due to accentuation of the juxta-clavic-ular beaded lines. Optimal control of eczema may improve and potentially prevent the development, which is of importance considering the psychosocial impact of the condition.

• 出版日期2014