Progressive Zosteriform Macular Pigmented Lesion

Hong, Jin Woo; Lee, Ki Yeol; Jeon, Su Young; Ko, Dong Yeob; Song, Ki Hoon; Kim, Ki Ho; Kim, Young Hun

Abstract

A progressive zosteriform macular pigmented lesion (PZMPL) is a chronic pigmentary dermatosis similar to progressive cribriform and zosteriform hyperpigmentation (PCZH), but characteristically accompanied by pruritus as a prodromal symptom and histologic findings, such as pigmentary incontinence. PZMPL was described by Simoes in 1980 and manifests a uniformly tanned macular pigmented lesion in a zosteriform distribution. PZMPL is usually preceded by multiple pruritic macular pigmentation in a part of the dermatome for a period of time. Despite the difficulty in differentiation among other pigmentary disorders with unilateral distribution, such as linear and whorled nevoid hypermelanosis, partial unilateral lentiginosis, and Becker's melanosis, PZMPL can be diagnosed by clinical symptoms and signs, the pattern of lesions, and histologic features. A 6-year-old Korean girl presented with unilaterally located brown macules and patches on the left side of the chest, arm, and back. From childhood, the pigmented macules appeared and coalesced into patches on the left back. The arm and chest lesions extended along the Blaschko's line in a zosteriform distribution. She had no history of previous skin diseases, injuries, or inflammation. The histologic findings revealed increased melanin pigment in the basal layer and focal pigmentary incontinence in the upper dermis. We report a rare case of PZMPL thought to be the same case reported by Simoes.