Year: 2019 I Volume: 2 I Issue: 3 I Page: 94-95

Idiopathic Eruptive Macular Pigmentation

JNU Medical College ,Jaipur

Corresponding Author:
Dr Kailash Sharma
JNU Medical College ,Jaipur

How to cite this article:
Mathur D, Sharma K. Idiopathic eruptive macular pigmentation. JDA Indian Journal of Clinical Dermatology. 2019;2:94-95.


Idiopathic eruptive macular pigmentation (IEMP) is an rare, rather under reported disease entity of the pediatric age characterized by asymptomatic, brownish hyperpigmented macules involving the neck and trunk with no preceding inflammation or exposure to drug. Here we report this case to increase awareness of this entity among dermatologists, dermatopathologists and pediatricians. A 23 years old healthy female presented with brown-gray to dark, discrete, pruritic macules on the , trunk, neck and limbs (face is spared)of insidious onset. Histopathologic examination showed acanthosis,melanophages, mild perivascular lymphohistiocytic infiltrate in the papillary dermis and papillomatosis. The natural course of the disease is spontaneous remission without treatment, which was not seen in our patient. IEMP is a benign entity with an excellent prognosis as it exhibits spontaneous resolution. It falls into the differential diagnoses of asymptomatic hyperpigmentatory disorders in pediatric population. Awareness of the entity leads to avoidance of unnecessary aggressive damaging treatment.

Key words: Idiopathic eruptive macular pigmentation, papillomatosis


Idiopathic eruptive macular pigmentation (IEMP) is a pigmentary disorder of unknown etiology. It was first reported by Degos et al.,[1] in 1978. Knowledge and familiarity of this entity is minimal. Less than 30 cases of IEMPhave been reported in the literature so far, reflecting unfamiliarity with the entity.[2]

Case Report:

This is a case report of a 23 years healthy girl who presented with pruritic brown to dark lesions over the neck, trunk and proximal extremities of 8 years duration. They appeared spontaneously without any preceding lesions or topical therapy. The lesions started insidiously and gradually progressed over a duration of 3 month.

Figure 1 : Hyperpigmented macules present over back length of forearm.

Click here to view

On Cutaneous examination, multiple brownish gray to dark, discrete, round to oval macules ranging from 0.3 to 1 cm in diameter were seen [Figures 1]. On back, there was a large capillary hemangiom, measuring 10×8 cm [Figures 2].The lesions on the lower abdomen had a velvety texture. Face ,Palms and soles were spared. Darier’s sign was negative. Other general physical examination were unremarkable. Hematological investigations were normal.

Figure 2 : Large size capillary hemangioma present over back since birth

Click here to view

Biopsy showed moderate irregular acanthosis, papillomatosis [Figure 3], basal layer hyperpigmentation And upper dermis showed sparse superficial lymphohistiocytic infiltrate [Figure 4]. Few melanophages were seen in the papillary dermis. The mast cell number was normal [Figure 5]. The final diagnosis was IEMP. Patient is treated with topical steroid and oral

Figure 3 : Histopathology shows acanthosis,papillomatosis and sparse superficial lymphohistiocytic infiltrate in upper dermis. (HxE(4x))

Click here to view

antihistaminics.Patient show excellent response within 15 days . Topical Timolol is also advised to patient for capillary hemangioma which show no satisfactory response.


IEMP is a rare and under diagnosed condition. Although it clinically resembles to lichen planus pigmentosus, erythema dyschromicum perstans, fixed drug eruption and mastocytosis. Therefore the only way to differentiate is by histopathological examination. The youngest and oldest case reported in the literature is that of a 1-year-old and a 50-year-old.[3,4] Though most cases have been reported in the young; it has also been reported in a 31-year-old female.[5] Astudy by Sanz de Galdeano et al.[6] gave the criteria for diagnosis in 1996, namely: (a) Eruption of brownish, non-confluent, asymptomatic macules

Figure 4 : HXE showing papillomatosis (HxE(4x))

Click here to view

Figure 5 : HXE showing mast cells.

Click here to view

involving the trunk, neck and proximal extremities in children and adolescents (b) absence of preceding inflammatory lesions (c) no previous drug exposure (d) basal layer hyperpigmentation of the epidermis and prominent dermal melanophages without visible basal layer damage or lichenoid inflammatory infiltrate (e) normal mast cell count. The present case fulfilled all the above mentioned criteria and very few cases of similar nature have been reported[2,7] among Indians.

The histopathological finding,`pigmented papillomatosis` is characteristic feature which was seen in the present case as well. IEMP is self-resolving and has been reported to disappear spontaneously in months to years. The largest series of ten cases have been described by Jang et al.[3]

This case is reported for its rarity , as most cases of IEMP shows spontaneous resolution but this case did not show spontaneous resolution. Most of the cases of IEMP are asymptomatic clinically but this case shows significant itching which shows excellent response with topical steroid and antihistaminics.


1. Degos R, Civatte J, Belaïch S. Idiopathic eruptive macular pigmentation (author’s transl). Ann Dermatol Venereol 1978;105:177-82.

2. Grover S, Basu A. Idiopathic eruptive macular pigmentation: Report on two cases. Indian J Dermatol 2010;55:277-8.

3. Jang KA, Choi JH, Sung KS, Moon KC, Koh JK. Idiopathic eruptive macular pigmentation: Report of 10 cases. J Am Acad Dermatol 2001;44:351-3.

4. Mantovani L, Minghetti S, Ricci M, Zauli S, Marzola A, Corazza M. Idiopathic eruptive macular pigmentation in a 50-year-old man. Eur J Dermatol 2010;20:633-4.

5. Milobratovic D, Djordjevic S, Vukicevic J, Bogdanovic Z. Idiopathic eruptive macular pigmentation associated with pregnancy and Hashimoto thyroiditis. J Am Acad Dermatol 2005;52:919-21.

6. Sanz de Galdeano C, Léauté-Labrèze C, Bioulac-Sage P, Nikolic M, Taïeb A. Idiopathic eruptive macular pigmentation: Report of five patients. Pediatr Dermatol 1996;13:274-7.

7. Verma S, ThakurBK. Idiopathic eruptive macular pigmentation with papillomatosis. Indian Dermatol Online J 2011;2:101-3.

117 comments on “Idiopathic Eruptive Macular Pigmentation

  1. гостевой дом дача алушта санатории урала с бассейном и лечением
    hotel welcome inn великий новгород отели выборга с бассейном и сауной курорт береговой алушта
    парк отель морская даль головинка отель бекасово дим коктебель

  2. отель корона витязево отзывы голден крым
    гостиница в обухово лучезарный николаевка нерехта гостиница
    пансионаты подмосковья с бассейном пансионат селен пансионат юпитер евпатория официальный

  3. грейс горизонт анапа забронировать гостиницу
    отель эллас в адлере отзывы отдых в анапа кисловодск семашко
    сосны удп рф официальный сайт уехать жить в сочи с собакой кохма городок

  4. конгресс отель малахит ул труда 153 челябинск ibis budget панфиловская
    ибис центр бахрушина одиссея санаторий сочи крым санаторий айвазовский официальный сайт
    палас отель ялта дома отдыха управления делами президента рф все родина отель стандарт абхазия новый афон

  5. гостиница в ступино московской области санаторий саянская благодать официальный сайт
    петрово пансионат заря официальный сайт кумысолечебница в башкирии алушта ривьера
    отели в крыму недорого удельная раменский район официальный сайт отель гагра

  6. святой шарбель отзывы людей скайпарк апарт отель
    курсовки в санатории анапы санаторий газпрома в анапе гостиница пантера арзамас
    металлург шелехов грегори дизайн отель москва сосновый бор васильево санаторий официальный сайт

  7. санаторий заполярье сочи фото территории отдых в россии и снг все включено
    гостиница спорт железноводск официальный сайт либерти флай томск хостел
    санаторий колос брестская область официальный сайт челюскинцев 100 г кисловодск санаторий долина нарзанов стоимость путевки

  8. коктебель гостиница ас эль ресторан шведский стол казань
    арктика салехард гостиница степана злобина 2 геленджик отель с бассейном у моря
    новый афон отель грифон вологда гостиница атриум гостиница в кижах

  9. пансионат на истре гостиницы алушты на берегу моря недорого
    озерки парк отель самара официальный грибоедова 33 санкт петербург гостиница эспланада пермь
    хостел сова казань пешков нижний новгород евпатория гостевые дома с бассейном у моря

  10. олеся отель 3 сочи адлер арго геленджик официальный сайт
    санаторий белые ночи в лоо туто коовее анапа малая бухта фото
    белокуриха санатории цены на путевки 2021 туры в анапу все включено театральный отель ростов на дону

  11. санатории лоо цены на 2021 год санаторий красные камни в кисловодске
    ritz carlton москва цены на номера ольгинка апартаменты санаторий в новоаннинском районе волгоградской области
    молния ямал небуг официальный сайт цены отели в лазаревской ташир ялта

  12. санаторий айвазовский крым санаторий гурзуфский официальный сайт
    парк отель солнечный подмосковье сан пятигорье пятигорск муром отель есенин
    аксай гостиница гостиница стрелец goosi lebedi wellness centre

  13. отели абхазии на берегу летний отдых с детьми в россии
    дель арт санкт петербург джемете пансионат фея 2 официальный сайт бамбора гудаута абхазия
    белокуриха благодать официальный сайт уват гранд отель англетер гостиница санкт петербург адрес

  14. новогодние туры 2022 из краснодара спас деменск гостиница
    маршала крылова 13 пенза спа отдых на алтае отель алия даховская
    отель в медведково расписание руза дорохово санаторий сестрорецкий курорт скидки

  15. микроуролитиаз что это такое как лечить отель чайка хабаровск
    долфин официальный сайт гостиницы и отели анапы прибрежный квартал сочи официальный сайт
    богатырь адлер туапсе отдых цены гостиницы в приозерске ленинградской области

  16. Chemotherapy may be used alone or in combination Staging and grading must be done to determine the extent with other treatment modalities such as surgery or radia to which a cancer has invaded the body cialis with dapoxetine However, if you take medicines that trigger fluid retention, you may want less Ask your healthcare supplier about the appropriate amount of water wanted to keep your blood sugar ranges in the regular vary Measuring your A1C is a substitute for measuring fasting blood glucose Keep your blood sugar levels close to normal to avoid many of these complications The American Diabetes Association s goals for blood sugar control Normal Blood Sugar Levels Chart it regulates blood sugar levels in folks with diabetes are 70 to a hundred thirty mg dL before meals, and less than 180 mg dL after meals Diabetes influences the way in which that the body creates and utilizes insulin, and it could immediate totally different manifestations leading to unwanted studying in an otherwise normal blood sugar ranges chart

  17. com 20 E2 AD 90 20Viagra 20Tanpa 20Efek 20Samping 20 20Jual 20Viagra 20Asli 20Di 20Bekasi jual viagra asli di bekasi The only way to achieve that is through vaccination and I urge parents whose children have not received two doses of MMR to ensure that they speak to their GP immediately to arrange this quick, safe and effective vaccine buy priligy generic Inpatient treatment is one of the most common ways to initiate treatment for alcoholism

  18. Take every effort to stretch the muscle to cool down shortly after you exercise, and make an effort to incorporate stretching into your routine wherever limitations appear buy cheap lasix online 4 Referral in accordance with Article 31 of Directive 2001 83 EC 3

  19. 50 No Deposit Free Spins – Use the Promo Code “allgemcasinos50” An existing customer can take advantage of bonus free spins too. Online casinos want to reward active players like any other businesses and offering free spins without a deposit is the best way of doing that. Once again, the bonus spins you get are completely free of charge and ready to use: you can keep all your winnings, which is the main benefit of this bonus. There is no single way to claim, but most of the time, such free spins bonuses will be a part of the loyalty program. Casinos offering free spins also have loyalty programs, and it is possible to unlock exclusive offers after gaining enough levels. If you thought casino bonuses or Free Spins no deposit promos were an easy way to win real money, we have bad news. Unfortunately, most casinos set a threshold for maximum bonus winnings, so you’re effectively capped on how much you can cash out.
    Blackjack is a game with a strategy component. By learning the basic strategy for classic 21, you’ll be able to make optimal plays on each hand. This won’t assure a victory and it won’t weight the odds in your favor, but it helps reduce the house edge to under 1/2 of 1%, in many cases. This makes blackjack one of the best games in the casino. You will be able to Double Down during your Multi Hand Classic Blackjack Gold game when the two initial cards total 9, 10, or 11, and these numbers will be hard ones. You will also be able to Split if you wish to, but can only do so once. Game Description – Blackjack Classic We are growers and wholesalers of the highest quality horticultural products, including flower bulbs and perennial plants. We deliver real value and the best service in the industry to our customers in Canada.

  20. 1xBet является одной из самых известных на рынке. Огромный выбор спортивных и киберспортивных событий, десятки открытых линий, высочайшие коэффициенты. Кроме того, БК имеет широкий функционал и немногие дает возможность совершать ставки по уникальным промокодам. Используя их, вы можете получить настоящие деньги, не внося абсолютно никаких средств. Это реально! Узнать последний промокод вы можете сейчас же, однако использовать его необходимо в соответствии с условиями и инструкциями, которые приведены ниже.

  21. O Connell F, Thomas VE, Pride NB, Fuller RW 1994 Capsaicin cough sensitivity decreases with successful treatment of chronic cough buy cialis online overnight shipping This testing and treatment usually requires the help of a physician skilled and knowledgeable in nutritional and natural medicine, who can also help with monitoring thyroid function

  22. I have read your article carefully and I agree with you very much. So, do you allow me to do this? I want to share your article link to my website:

  23. Your article gave me a lot of inspiration, I hope you can explain your point of view in more detail, because I have some doubts, thank you.

  24. Your article gave me a lot of inspiration, I hope you can explain your point of view in more detail, because I have some doubts, thank you.

  25. 539開獎


    ### 539彩券,那是什麼來頭?


    ### 539開獎,是場視覺盛宴!


    ### 跟我一起玩539?


    ### 539開獎,那刺激的感覺!


    ### 最後說兩句


Leave a Reply

Your email address will not be published. Required fields are marked *