Back issues No.4 - 1994 / Case Report  

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Reticulate Pigmented Anomaly of The Flexures (Dowling - Degos Disease) - A Case Report -
Yu-Ling Kuo, Hsiu-Chin Chen, Yung-Fa Chao, Chien-Chung Lai, Hsin-Yi Su
Dermatol Sinica 12: 209-216, 1994

Reticulate pigmented anomaly of the flexures is a rare genodermatosis that usually has its onset in adulthood. The clinical characteristics are reticulated brownish macules symmetrical distribution over the flexure areas of the body and usually combined with pitted scars around the angles of the mouth and dark-dot comedo-like papules occurring around the axillary folds, at the base of the neck, and below the angles of the mouth. Sun exposure and friction at pressure sites may be factors inducing pigmentation. The pathological characteristic is irregular elongation of thin branching rete ridges, with a concentration of melanin at the tips, extending out from the epidermis and follicular walls. Horn pseudocysts and large keratotic follicular plugs were also noted. In this article, we report a 66-year-old woman with the similar clinical and pathological features of reticulate pigmented anomaly of the flexures and discuss the differential diagnosis of the disease.

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