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What Causes Persistent Skin Pigmentation?
Question: Hi doctor...this is xxxxx XXXXXXX ..in continuation to our earlier discussion of LPP disease. You have recommended to use Hydroxycloroquin tablets under doctor's supervision to to stop spread of this skin pigmentation. So I visited a near by general physician for baseline liver & eye tests. However, that doctor suggested to comeup with a written prescription. So I visited another skin specialist at Continental Hospital and I explained the complete background. She identified this skin issue as "Aconthosis nigricans / Erythema Dyschromicum Perstans". I'm attaching her prescription for your ref...however she is not suggesting Hydroxycloroquin. But recommended couple of blood tests. She asked to continue to use momate cream and use Antoxid tabs for 2 months, I dont see attachment option to attach the prescription here..but i'm bit confused state now...please help me as I'm struggling with this pignemtation issue for several years and feeling uncomfort as this is mainly effecting on face..
Brief Answer:
Erythema dyschromicum perstans can be a possibility
Detailed Answer:
Hi. Thank you for writing back to me.
Its fine if she thinks about these possibilities. Lichen planus pigmentosus, erythema dyschromicum perstans are quite similar in presentation and its not surpising that she had kept EDP as one of the differential diagnosis. Though I don't go with her on the possibility of acanthosis nigricans and her treatment too does'nt seem to suggest that she considers this as a possibility. Her treatment is more or less complies with LPP and EDP.
Hydroxychloroquin is one of the treatment modalities for LPP but it is not a substitute for topical treatment and some doctors may be of the opinion that only topical treatment would suffice for limited disease. Hydroxychloroquin may produce variable results and is more often prefered for widespread involvement. Therapy is long term in either case, whether it is oral+topical Or topical alone.
Therefore, I suggest you to follow her prescription and follow up regularly every month.
Regards
Erythema dyschromicum perstans can be a possibility
Detailed Answer:
Hi. Thank you for writing back to me.
Its fine if she thinks about these possibilities. Lichen planus pigmentosus, erythema dyschromicum perstans are quite similar in presentation and its not surpising that she had kept EDP as one of the differential diagnosis. Though I don't go with her on the possibility of acanthosis nigricans and her treatment too does'nt seem to suggest that she considers this as a possibility. Her treatment is more or less complies with LPP and EDP.
Hydroxychloroquin is one of the treatment modalities for LPP but it is not a substitute for topical treatment and some doctors may be of the opinion that only topical treatment would suffice for limited disease. Hydroxychloroquin may produce variable results and is more often prefered for widespread involvement. Therapy is long term in either case, whether it is oral+topical Or topical alone.
Therefore, I suggest you to follow her prescription and follow up regularly every month.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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