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Images/Instrument in Dermatology/Dermatosurgery
2022
:2;
64
doi:
10.25259/CSDM_68_2022

Dowling-degos disease

Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Chandigarh, India
Corresponding author: Ankita Tuknayat, Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Chandigarh, India. anku.tuknayat@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Aggarwal K, Tuknayat A, Thami GP. Dowling-degos disease. CosmoDerma 2022;2:64.

A 30-year-old female presented with asymptomatic and brown colored skin lesions over the body for the past 8 years. On examination, there was symmetrical involvement of the neck, flexures [Figure 1a] and trunk in the form of multiple, and brown macules arranged in a reticulated pattern. Along with this, she also had perioral pits [Figure 1b] and few keratotic papules in groin [Figure 1c]. There was no history of similar lesions in the family. Histopathological examination showed filiform downgrowth with papillomatosis and increased pigmentation in the basal layer [Figure 2a], highlighted on Masson Fontana stain [Figure 2b]. Based on these typical clinical and histopathological findings, a diagnosis of Dowling-degos was made.

Figure 1:: (a) Reticulate pigmentation of axilla, (b) Perioral pits, (c) Reticulate pigmentation of groin and Keratotic papules.
Figure 2:: (a) HPE: (On H&E ×200) Epidermis shows filiform downgrowth with papillomatosis and increased pigmentation in the basal layer. Dermis shows minimal periadenexal lymphomononuclear infilterate. (b) Masson Fontana stained basal layer pigmentation (×100).

Dowling-degos disease is a rare genodermatosis with an autosomal dominant inheritance. Common differential diagnosis includes other disorders of reticulate pigmentation such as Reticulate acropigmentation of Kitamura (acral pigmentation, lesional atrophy, and palmar pits), Galli-Galli disease (suprabasal dyskeratotic acantholysis), and Haber syndrome (erythema and telengiectasias on the face, and verrucous papules on the trunk).

There is no definitive treatment available for reticulate pigmentation disorders till date. Topical steroids, hydroquinone, retinoic acids, azelaic acid, and systemic retinoids have been used without definitive success. Among lasers-fractional CO2 or Er: Yag laser has shown some efficacy in the previous case reports.

Declaration of patient consent

Patient’s consent not required as patients identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


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