Exploring reticulate pigmentary disorders - A case series highlighting 5 distinctive types

• Author Details:   
• Devaraj Yogesh ^*
• Richin Anna Johnson
• Shubhashree Panigrahi
• Harshitha K Reddy
• Ron Thomas
• Karthick Korvanagundhi Shantha Kumar
• Namratha Govindaraju
• Jayaprakash Hosmani1

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The term "reticulate pigmentary disorders" is used in a broad sense to refer to a heterogenous group of acquired and congenital dermatosis because of their clinical pattern of presentation. Presentations range from the "freckle-like" hyper- and hypopigmented macules that are typically only seen in the true genetic "reticulate" pigmentary disorders to the reticular or net-like pattern. Clinically, the reticulate pigmentary disorders can be classified based on the extent and distribution into acral, flexural, and generalized. They can also be divided on the basis of age of presentation (infancy, childhood, adolescent, adult). In this case series, five distinct types of Reticulate pigmentary disorders, are reported. The first two cases are that of father and daughter diagnosed as dyschromatosis universalis hereditarian. The father was a 47-year-old man who presented with mottled hypo and hyperpigmented macules over face, trunks and limbs present since birth. The second case was his daughter who had similar lesions over dorsum of hands and dorsum of left foot. The third case was a 13-year-old girl who presented with a 2-month history of mottled hyperpigmented macules and few hyperpigmented papules over the axilla, groin along with few pits over forearms and was diagnosed as Dowling Degos disease. The fourth and fifth cases were that of young male patients with reticulated hyperpigmented macules over the neck, upper chest and arms, occurring on and off for 2 years. They were clinically diagnosed with Confluent and reticulated papillomatosis. The sixth case was a 65-year-old woman who presented with multiple flat lesions over left upper limb and clinically diagnosed with macular amyloidosis. The final case is of a 29-year-old male diagnosed with Darier’s disease. This case series is being reported to highlight different reticulate pigmentary dermatosis of varied aetiologies. 

Keywords: Reticulate pigmentation, Darier’s disease, Dowling- Degos disease