Back issues No.1 - 2013 / Resident Forum  

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Mottled hyperpigmentation on the face and neck of a woman 35 years of age
Chih-Tsung Hung, Hong-Wei Gao, Bai-Yao Wu, Chien-Ping Chiang

A Taiwanese woman 35 years of age presented with asymptomatic, mottled hyper- and hypopigmented macules on her neck and face, which had presented in the last 2 years. Spotted macules were first noted on her neck and had slowly progressed to involve her face as time went by. Her medical history was unremarkable. She did not have photosensitivity or any other systemic or cutaneous diseases before the onset of the lesions. There were no family members with similar cutaneous presentations. Examination revealed diffuse hyperpigmentation with numerous and varying sizes of hypopigmented spots over her neck and face (Figure 1). There were no apparent erythemas, blisters, telangiectasia, atrophy, or papular lesions. Her mental and developmental milestones were normal.
A skin biopsy specimen was obtained from her neck. The histopathologic evaluation revealed that mildly hyperkeratotic epidermis and amorphous eosinophilic masses were deposited in the papillary dermis (Figure 2). There were no alternations in the reticular dermis. Congo red staining was positive for eosinophilic materials (Figure 3).

Amyloidosis cutis dyschromica-like macular amyloidosis on the face and neck.

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