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3 children&#41;&#46; She also had a stable congenital lesion on her back and right hemithorax&#46; Examination revealed symmetrical lentiginous pigmentation on the dorsum of the hands&#44; the anterior aspect of the wrists&#44; the eyelids&#44; and the area around the lips&#44; together with palmoplantar pits and interrupted palmar creases &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A blue-grayish plaque was observed on her back and right hemithorax and arm &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Analysis of a biopsy specimen from the hand revealed lentiginous epidermal hyperplasia with hyperpigmented bulbous projections of the epidermal rete ridges&#59; in the case of the dorsum&#44; it revealed dendritic melanocytes in the dermis &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; These findings led us to diagnose the patient&#39;s condition as RAPK and nevus of Ito&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Reticulate pigmentary disorders comprise a group of congenital and acquired conditions with reticulate or freckle-type hyperpigmentation and occasional hypopigmentation&#46; There is some confusion in the literature with respect to definitions and terminology&#46; Hereditary forms are unusual and have variable inheritance patterns&#44; although they are generally autosomal dominant&#44; with possible associated abnormalities&#46; They include dyskeratosis congenita&#44; Dowling-Degos disease&#44; RAPK&#44; Haber syndrome&#44; reticulate acropigmentation of Dohi&#44; Naegeli-Franceschetti-Jadassohn syndrome&#44; X-linked reticulate pigmentary disorder&#44; and dyschromatosis universalis hereditaria&#46; In the acquired forms&#44; the lesions are usually larger and include confluent and reticulate papillomatosis &#40;Gougerot-Carteaud&#41;&#44; prurigo pigmentosa&#44; lichen planus pigmentosus&#44; Riehl melanosis&#44; erythema ab igne&#44; cutis marmorata&#44; livedo reticularis&#44; and postinflammatory pigmentation&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">RAPK is an uncommon disorder&#44; with approximately 130 reported cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;7</span></a> While more common in Japan&#44; it can be found throughout the world&#46; The inheritance pattern is autosomal dominant&#44; although nonhereditary cases occur sporadically&#46; It first appears during the first or second decade of life&#44; with reticulate or freckle-like hyperpigmented macules that measure 1 to 5<span class="elsevierStyleHsp" style=""></span>mm&#46; The lesions are initially atrophic and are found on the dorsum of the hands and feet and can extend proximally with progressive darkening aggravated by exposure to sunlight&#46; They rarely affect the face and are accompanied by palmoplantar pits and interrupted palmar creases&#44; and there have been isolated reports of localized alopecia and absence of the distal phalanges of the toes&#46; Dermoscopy shows the pigmentation to have a fine network of nonspecific reticulate brown pigment and the palmoplantar pits to have brown spots&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Histopathology reveals atrophy of the epidermis&#44; elongation&#44; and increased melanin on the interpapillary ridges&#44; with scarce perivascular lymphocytic infiltrate&#44; and an increased number of DOPA-positive basal melanocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">There is some debate over whether RAPK&#44; Dowling-Degos disease&#44; Haber syndrome&#44; and reticulate acropigmentation of Dohi are variants of the same disease&#44; since their clinical and histologic characteristics overlap to some extent&#44; mainly in Dowling-Degos disease and RAPK&#46; The exception is Galli-Galli disease&#44; in which suprabasal acantholysis can be observed&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a> Dowling-Degos disease is autosomal dominant&#44; more commonly affects adult women&#44; and manifests with reticulate pigmentation and brown hyperkeratotic papules mainly on flexures and the trunk&#46; It may be accompanied by comedones on the face and neck&#44; perioral pitting&#44; and facial scars&#44; and even epidermal cysts&#44; suppurative hidradenitis&#44; seborrheic keratosis&#44; pilonidal cysts&#44; and tumors such as keratoacanthoma and squamous cell carcinoma&#46; Histologically&#44; it is similar to RAPK&#44; although with more pronounced follicular involvement&#46; Recent genetic studies indicate that they are different disorders&#44; although this issue remains unresolved&#46; In Dowling-Degos disease&#44; there have been reports of mutations in the keratin 5 gene &#40;<span class="elsevierStyleItalic">KRT5</span>&#41; and&#44; subsequently&#44; in the protein O-fucosyltransferase 1 gene &#40;<span class="elsevierStyleItalic">POFUT1</span>&#41; and protein O-glucosyltransferase 1 protein gene &#40;<span class="elsevierStyleItalic">POGLUT1</span>&#41;&#44; which overlaps clinically with RAPK&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> In 2013&#44; several mutations were detected in the <span class="elsevierStyleItalic">ADAM10</span> gene in Japanese families with RAPK&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> and&#44; more recently&#44; in other cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a><span class="elsevierStyleItalic">ADAM10</span> codes for a disintegrin and metalloprotease&#44; a member of the a disintegrin and metalloprotease family&#44; which has numerous biologic functions and is expressed in the human epidermis&#44; melanoma cells&#44; and keratinocytes&#46; In mice&#44; its mutation is associated with freckle-like pigmentation&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Furthermore&#44; dermal melanocytosis comprises a group of benign congenital and&#8212;less frequently&#8212;acquired disorders characterized by the presence of dendritic melanocytes in the dermis&#46; They are more common in Asian and African women and are unusual in white individuals&#46; They comprise nevus of Ota&#44; nevus of Ito&#44; Mongolian spots&#44; and dermal melanocytic hamartoma&#46; Dermal melanocytosis rarely becomes malignant&#44; with barely 4 cases of nevus of Ito&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Moreover&#44; a case of Dowling-Degos disease and metastatic amelanotic melanoma has been reported&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> To date&#44; RAPK has not been reported to occur alongside other melanocytic disorders&#46; There is no proof that RAPK and nevus of Ito are related&#44; since&#44; although both are pigmentation disorders&#44; they are different&#46; Thus&#44; in dermal melanocytosis there is a proliferation of dermal melanocytes&#44; whereas in RAPK&#44; electron microscopy reveals an increase in the number of melanosomes in lesional melanocytes and keratinocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> The <span class="elsevierStyleItalic">ADAM10</span> mutation has not been studied to date in dermal melanocytosis&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We present a case of RAPK and nevus of Ito in a white woman&#46; This association has not previously been reported&#46; Both conditions are more common in Asian individuals&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Garc&#237;a-Arpa M&#46; Acropigmentaci&#243;n reticulada de Kitamura y nevus de Ito&#46; Actas Dermosifiliogr&#46; 2017&#59;108&#58;675&#8211;677&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lentiginous brown mottled pigmentation on the dorsum of the hands &#40;A&#41; and on the anterior aspect of the wrists &#40;B&#41;&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A&#44; Findings from a biopsy specimen taken from the wrist&#46; Note the lentiginous epidermal hyperplasia with hyperpigmented bulbous projections of the epidermal rete ridges and increased basal melanocytes &#40;hematoxylin-eosin &#91;H-E&#93;&#44; original magnification &#215;10&#59; detail &#40;inset&#41;&#44; original magnification &#215;40&#41;&#46; B&#44; Findings from a biopsy specimen taken from the back&#46; Notice the dendritic melanocytes in the reticular and papillary dermis and hyperpigmentation of the basal layer of the epidermis &#40;H-E&#44; original magnification &#215;20&#41;&#46;</p>"
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        "texto" => "<p id="par0045" class="elsevierStylePara elsevierViewall">We are grateful to Dr&#46; Juan Luis Santiago S&#225;nchez-Mateos for his help in this study&#46;</p>"
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Case and Research Letter
Reticulate Acropigmentation of Kitamura and Nevus of Ito
Acropigmentación reticulada de Kitamura y nevus de Ito
M. García-Arpaa,
Autor para correspondencia
mgarciaa73@yahoo.es

Corresponding author.
, M. Franco-Muñoza, M.A. Flores-Terrya, C. Ramos-Rodríguezb
a Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
b Servicio de Anatomía Patológica, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Reticulate acropigmentation of Kitamura &#40;RAPK&#41; is an uncommon genodermatosis that is classed as a congenital reticulate pigmentary disorder&#46; It is characterized by acral lentiginous pigmentation and mainly affects Japanese individuals&#46; Nevus of Ito is a congenital dermal melanocytosis that is congenital and affects the deltoid and acromioclavicular region&#44; more commonly in Asian women&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 47-year-old woman &#40;phototype III&#41; with no clinical history of interest who consulted for progressively slow-growing asymptomatic darkening of the skin on the dorsum of the hands and on the face that began during adolescence&#46; She reported that her mother had similar pigmentation on the hands&#44; although other family members did not &#40;2 maternal aunts&#44; 2 siblings&#44; 3 children&#41;&#46; She also had a stable congenital lesion on her back and right hemithorax&#46; Examination revealed symmetrical lentiginous pigmentation on the dorsum of the hands&#44; the anterior aspect of the wrists&#44; the eyelids&#44; and the area around the lips&#44; together with palmoplantar pits and interrupted palmar creases &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A blue-grayish plaque was observed on her back and right hemithorax and arm &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Analysis of a biopsy specimen from the hand revealed lentiginous epidermal hyperplasia with hyperpigmented bulbous projections of the epidermal rete ridges&#59; in the case of the dorsum&#44; it revealed dendritic melanocytes in the dermis &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; These findings led us to diagnose the patient&#39;s condition as RAPK and nevus of Ito&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Reticulate pigmentary disorders comprise a group of congenital and acquired conditions with reticulate or freckle-type hyperpigmentation and occasional hypopigmentation&#46; There is some confusion in the literature with respect to definitions and terminology&#46; Hereditary forms are unusual and have variable inheritance patterns&#44; although they are generally autosomal dominant&#44; with possible associated abnormalities&#46; They include dyskeratosis congenita&#44; Dowling-Degos disease&#44; RAPK&#44; Haber syndrome&#44; reticulate acropigmentation of Dohi&#44; Naegeli-Franceschetti-Jadassohn syndrome&#44; X-linked reticulate pigmentary disorder&#44; and dyschromatosis universalis hereditaria&#46; In the acquired forms&#44; the lesions are usually larger and include confluent and reticulate papillomatosis &#40;Gougerot-Carteaud&#41;&#44; prurigo pigmentosa&#44; lichen planus pigmentosus&#44; Riehl melanosis&#44; erythema ab igne&#44; cutis marmorata&#44; livedo reticularis&#44; and postinflammatory pigmentation&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">RAPK is an uncommon disorder&#44; with approximately 130 reported cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;7</span></a> While more common in Japan&#44; it can be found throughout the world&#46; The inheritance pattern is autosomal dominant&#44; although nonhereditary cases occur sporadically&#46; It first appears during the first or second decade of life&#44; with reticulate or freckle-like hyperpigmented macules that measure 1 to 5<span class="elsevierStyleHsp" style=""></span>mm&#46; The lesions are initially atrophic and are found on the dorsum of the hands and feet and can extend proximally with progressive darkening aggravated by exposure to sunlight&#46; They rarely affect the face and are accompanied by palmoplantar pits and interrupted palmar creases&#44; and there have been isolated reports of localized alopecia and absence of the distal phalanges of the toes&#46; Dermoscopy shows the pigmentation to have a fine network of nonspecific reticulate brown pigment and the palmoplantar pits to have brown spots&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Histopathology reveals atrophy of the epidermis&#44; elongation&#44; and increased melanin on the interpapillary ridges&#44; with scarce perivascular lymphocytic infiltrate&#44; and an increased number of DOPA-positive basal melanocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">There is some debate over whether RAPK&#44; Dowling-Degos disease&#44; Haber syndrome&#44; and reticulate acropigmentation of Dohi are variants of the same disease&#44; since their clinical and histologic characteristics overlap to some extent&#44; mainly in Dowling-Degos disease and RAPK&#46; The exception is Galli-Galli disease&#44; in which suprabasal acantholysis can be observed&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a> Dowling-Degos disease is autosomal dominant&#44; more commonly affects adult women&#44; and manifests with reticulate pigmentation and brown hyperkeratotic papules mainly on flexures and the trunk&#46; It may be accompanied by comedones on the face and neck&#44; perioral pitting&#44; and facial scars&#44; and even epidermal cysts&#44; suppurative hidradenitis&#44; seborrheic keratosis&#44; pilonidal cysts&#44; and tumors such as keratoacanthoma and squamous cell carcinoma&#46; Histologically&#44; it is similar to RAPK&#44; although with more pronounced follicular involvement&#46; Recent genetic studies indicate that they are different disorders&#44; although this issue remains unresolved&#46; In Dowling-Degos disease&#44; there have been reports of mutations in the keratin 5 gene &#40;<span class="elsevierStyleItalic">KRT5</span>&#41; and&#44; subsequently&#44; in the protein O-fucosyltransferase 1 gene &#40;<span class="elsevierStyleItalic">POFUT1</span>&#41; and protein O-glucosyltransferase 1 protein gene &#40;<span class="elsevierStyleItalic">POGLUT1</span>&#41;&#44; which overlaps clinically with RAPK&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> In 2013&#44; several mutations were detected in the <span class="elsevierStyleItalic">ADAM10</span> gene in Japanese families with RAPK&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> and&#44; more recently&#44; in other cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a><span class="elsevierStyleItalic">ADAM10</span> codes for a disintegrin and metalloprotease&#44; a member of the a disintegrin and metalloprotease family&#44; which has numerous biologic functions and is expressed in the human epidermis&#44; melanoma cells&#44; and keratinocytes&#46; In mice&#44; its mutation is associated with freckle-like pigmentation&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Furthermore&#44; dermal melanocytosis comprises a group of benign congenital and&#8212;less frequently&#8212;acquired disorders characterized by the presence of dendritic melanocytes in the dermis&#46; They are more common in Asian and African women and are unusual in white individuals&#46; They comprise nevus of Ota&#44; nevus of Ito&#44; Mongolian spots&#44; and dermal melanocytic hamartoma&#46; Dermal melanocytosis rarely becomes malignant&#44; with barely 4 cases of nevus of Ito&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Moreover&#44; a case of Dowling-Degos disease and metastatic amelanotic melanoma has been reported&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> To date&#44; RAPK has not been reported to occur alongside other melanocytic disorders&#46; There is no proof that RAPK and nevus of Ito are related&#44; since&#44; although both are pigmentation disorders&#44; they are different&#46; Thus&#44; in dermal melanocytosis there is a proliferation of dermal melanocytes&#44; whereas in RAPK&#44; electron microscopy reveals an increase in the number of melanosomes in lesional melanocytes and keratinocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> The <span class="elsevierStyleItalic">ADAM10</span> mutation has not been studied to date in dermal melanocytosis&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We present a case of RAPK and nevus of Ito in a white woman&#46; This association has not previously been reported&#46; Both conditions are more common in Asian individuals&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Garc&#237;a-Arpa M&#46; Acropigmentaci&#243;n reticulada de Kitamura y nevus de Ito&#46; Actas Dermosifiliogr&#46; 2017&#59;108&#58;675&#8211;677&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lentiginous brown mottled pigmentation on the dorsum of the hands &#40;A&#41; and on the anterior aspect of the wrists &#40;B&#41;&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Noninfiltrated bluish macular plaque with no nodules and irregular borders and peripheral brown areas on the center of the back &#40;13&#46;5<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#41; &#40;A&#41; and with less evident grayish-blue coloring on the right hemithorax &#40;B&#41;&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A&#44; Findings from a biopsy specimen taken from the wrist&#46; Note the lentiginous epidermal hyperplasia with hyperpigmented bulbous projections of the epidermal rete ridges and increased basal melanocytes &#40;hematoxylin-eosin &#91;H-E&#93;&#44; original magnification &#215;10&#59; detail &#40;inset&#41;&#44; original magnification &#215;40&#41;&#46; B&#44; Findings from a biopsy specimen taken from the back&#46; Notice the dendritic melanocytes in the reticular and papillary dermis and hyperpigmentation of the basal layer of the epidermis &#40;H-E&#44; original magnification &#215;20&#41;&#46;</p>"
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        "identificador" => "xack297047"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0045" class="elsevierStylePara elsevierViewall">We are grateful to Dr&#46; Juan Luis Santiago S&#225;nchez-Mateos for his help in this study&#46;</p>"
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Información del artículo
ISSN: 15782190
Idioma original: Inglés
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