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Pigmentary Development of East Asian Skin

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Pediatric Skin of Color

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Abstract

East Asians have a large range of skin types and different cultural beliefs.Knowledge about normal variations in skin color and common pigmentary disorders among East Asians is essential to avoid overdiagnosis.Although most pigmentation disorders are benign or non specific, some pigmentation disorders present cosmetic or psychological challenges to the patient, necessitating systematic evaluation and treatment.Pigmentary disorders are broadly classified into three groups:

  1. 1.

    Hypopigmentation or depigmentation

  2. 2.

    Hyperpigmentation

  3. 3.

    Mixed

These disorders can be further subcategorized based on their age of onset, pattern and distribution. i.e., Hypomelanosis of lto is categorized under early onset patterned hypopigmentary disorder.

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References

  1. Liu W, Lai W, Wang XM, Li L, Tian Y, Lu Y, Wu YY, Li Y, Zhang P, Wu Y, Chen L. Skin phototyping in a Chinese female population: analysis of four hundred and four cases from four major cities of China. Photodermatol Photoimmunol Photomed. 2006;22(4):184–8.

    Article  CAS  PubMed  Google Scholar 

  2. Holbrook KA, Underwood RA, Vogel AM, Gown AM, Kimball H. The appearance, density and distribution of melanocytes in human embryonic and fetal skin revealed by the anti-melanoma monoclonal antibody, HMB-45. Anat Embryol (Berl). 1989;180:443.

    Article  CAS  Google Scholar 

  3. Selmanowitz VJ, Krivo JM. Pigmentary demarcation lines. Comparison of Negroes with Japanese. Br J Dermatol. 1975;93(4):371–7.

    Article  CAS  PubMed  Google Scholar 

  4. Xu AE, Huang B, Li YW, Wang P, Shen H. Clinical, histopathological and ultrastructural characteristics of naevus depigmentosus. Clin Exp Dermatol. 2008;33(4):400–5.

    Article  PubMed  Google Scholar 

  5. Lee HS, Chun YS, Hann SK. Nevus depigmentosus: clinical features and histopathologic characteristics in 67 patients. J Am Acad Dermatol. 1999;40(1):21–6.

    Article  CAS  PubMed  Google Scholar 

  6. Olsson MJ, Juhlin L. Leucoderma treated by transplantation of a basal cell layer enriched suspension. Br J Dermatol. 1998;138:644–8.

    Article  CAS  PubMed  Google Scholar 

  7. Glover MT, Brett EM, Atherton DJ. Hypomelanosis of Ito: spectrum of the disease. J Pediatr. 1989;115(1):75–80.

    Article  CAS  PubMed  Google Scholar 

  8. Pascual-Castroviejo I. Hypomelanosis of Ito. Neurologia. 1997;12:300–5.

    CAS  PubMed  Google Scholar 

  9. Ruiz-Maldonado R, Toussaint S, Tamayo L, Laterza A, Del Castillo V. Hypomelanosis of lto: diagnostic criteria and report of 41 cases. Pediatr Dermatol. 1992;9:1–10.

    Article  CAS  PubMed  Google Scholar 

  10. Fleury P, de Groot WP, Delleman JW, et al. Tuberous sclerosis: the incidence of sporadic cases versus familial cases. Brain Dev. 1980;2:107–17.

    Article  CAS  PubMed  Google Scholar 

  11. Roach ES, Delgado MR. Tubereous sclerosis. Dermatol Clin. 1995;13:151–61.

    Article  CAS  PubMed  Google Scholar 

  12. Osborne JP, Fryer A, Webb D. Epidemiology of tuberous sclerosis. Ann N Y Acad Sci. 1991;615:125–7.

    Article  CAS  PubMed  Google Scholar 

  13. Hong CH, Darling TN, Lee CH. Prevalence of tuberous sclerosis complex in Taiwan: a national population-based study. Neuroepidemiology. 2009;33:335–41.

    Article  PubMed  Google Scholar 

  14. Jóźwiak S, Goodman M, Lamm SH. Poor mental development in patients with tuberous sclerosis complex: clinical risk factors. Arch Neurol. 1998;55:379–84.

    Article  PubMed  Google Scholar 

  15. Kim SK, Kang HY, Lee ES, Kim YC. Clinical and histopathologic characteristics of nevus depigmentosus. J Am Acad Dermatol. 2006;55:423–8.

    Article  PubMed  Google Scholar 

  16. Webb DW, Clarke A, Fryer A, Osborne JP. The cutaneous features of tuberous sclerosis: a population study. Br J Dermatol. 1996;135:1–5.

    Article  CAS  PubMed  Google Scholar 

  17. Salido R, Garnacho-Saucedo G, Cuevas-Asencio I, Ruano J, Galan-Gutierrez M, Velez A, et al. Sustained clinical effectiveness and favourable safety profile of topical Sirolimus for tuberous sclerosis associated facial angiofibroma. J Eur Acad Dermatol Venereol. 2012;26(10):1315–8.

    Article  CAS  PubMed  Google Scholar 

  18. Giebel LB, Spritz RA. Mutation of the KIT (mast/stem cell growth factor receptor) protooncogene in human piebaldism. Proc Natl Acad Sci U S A. 1991;88:8696–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Cooke JV. Familial white skin spotting (piebaldness) with white forelock. J Pediatr. 1952;41:1–12.

    Article  CAS  PubMed  Google Scholar 

  20. Chang T, McGrae JD, Hashimoto K. Ultrastructural study of two patients with both Piebaldism and Neurofibromatosis type 1. Pediatr Dermatol. 1993;10:224–34.

    Article  CAS  PubMed  Google Scholar 

  21. Tay YK. Neurofibromatosis type 1 and Piebaldism: a case report. Dermatology. 1998;197:401–2.

    Article  CAS  PubMed  Google Scholar 

  22. Shah KN, Dalal SJ, Desai MP, et al. White forelock, pigmentary disorder of the irides, and long segment Hirschsprung disease; possible variant of Waardenburg syndrome. J Pediatr. 1981;99:432–5.

    Article  CAS  PubMed  Google Scholar 

  23. Inagaki K, Suzuki T, Shimizu H, Ishii N, Umezawa Y. Oculocutaneous albinism type 4 is one of the most common types of albinism in Japan. Am J Hum Genet. 2004;74(3):466–71.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Liza AF, Aziah AM. Albinism and lung fibrosis in a young man – the first case of adult Hermansky-Pudlak Syndrome reported in Malaysia. Med J Malaysia. 2012;67(6):620–1.

    CAS  PubMed  Google Scholar 

  25. King RA, Summer CG. Albinism. Dermatol Clin. 1988;6:217–27.

    CAS  PubMed  Google Scholar 

  26. Ramsay M, Colman MA, Steven G, et al. The tyrosine positive oculocutaneous albinism locus maps to chromosome 15q11.2-q12. Am J Hum Genet. 1992;51:879–84.

    PubMed Central  CAS  PubMed  Google Scholar 

  27. Toyofuku K, Valencia JC, Kushimoto T, et al. The etiology of oculocutaneous albinism (OCA) type 2: the pink protein modulates the processing and transport of tyrosinase. Pigment Cell Res. 2002;15:217–24.

    Article  CAS  PubMed  Google Scholar 

  28. Boissy RE, Zhao H, Oetting WS, et al. Mutation in and lack of expression of Tyrosinase related protein 1 (TRP-1) in melanocytes from an individual with brown oculocutaneous albinism: new subtype of albinism classified as “OCA3”. Am J Hum Genet. 1996;58:1145–56.

    PubMed Central  CAS  PubMed  Google Scholar 

  29. Kobayashi T, Urabe K, Winder A, et al. Tyrosinase related protein-1 (TRP-1) functions as a DHICA oxidase in melanin biosynthesis. EMBO J. 1994;13:5818–25.

    PubMed Central  CAS  PubMed  Google Scholar 

  30. Newton JM, Cohen-Barak O, Hagiwara N, et al. Mutation in human orthologue of the mouse underwhite gene (UW) underlie a new form of oculocutaneous albinism, OCA4. Am J Hum Genet. 2001;68:981–8.

    Article  Google Scholar 

  31. Menasche G, Fischer A, de Saint Basile G. Griscelli syndrome type 1 and 2. Am J Hum Genet. 2002;71:1237–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Menasche G, Pastural E, Feldmann J, et al. Mutations in RAB27A cause Griscelli syndrome associated with hemophagocytic Syndrome. Nat Genet. 2000;25:173–6.

    Article  CAS  PubMed  Google Scholar 

  33. Menasche G, Ho CH, Sanal O, et al. Griscelli syndrome restricted to hypopigmentation results from a melanophilin defect (GS3) or a MYO5A F-exon deletion ( GS1). J Clin Invest. 2003;112:450–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  34. Vinton NE, Dahlstrom KA, Strobel CT, Ament ME. Macrocytosis and pseudoalbinism: manifestations of selenium deficiency. J Pediatr. 1987;111:711–7.

    Article  CAS  PubMed  Google Scholar 

  35. Durán-McKinster C, Rodríguez-Jurado R, Ridaura C, Orozco-Covarrubias ML, Tamayo-Sánchez L, Ruiz-Maldonado R. Elejade syndrome: a melanolysosomal neurocutaneous syndrome: clinical and morphological findings in 7 patients. Arch Dermatol. 1999;135:182–6.

    Article  PubMed  Google Scholar 

  36. Peterson J, Drolet BA, Esterly NB. Menkes’ Kinky-hair syndrome. Pediatr Dermatol. 1998;15:137–9.

    Article  CAS  PubMed  Google Scholar 

  37. Fox H. Partial depigmentation: chiefly on the face in Negro children. Arch Dermatol Syphilol. 1923;7:268–9.

    Google Scholar 

  38. Tay YK, Kong KH, Khoo L, Goh CL, Giam YC. The prevalence and descriptive epidemiology of atopic eczema in Singapore school children. Br J Dermatol. 2002;146:101–6.

    Article  PubMed  Google Scholar 

  39. Rigopoulos D, Gregoriou S, Charissi C, et al. Tacrolimus ointment 0.1% in pityriasis alba: an open label, randomised controlled study. Br J Dermatol. 2006;155:152–5.

    Article  CAS  PubMed  Google Scholar 

  40. Fujita WH, McCormick CL, Parneix-Spake A. An exploratory study to evaluate the efficacy of pimecrolimus cream 1% for the treatment of pityriasis alba. Int J Dermatol. 2007;46:700–5.

    Article  CAS  PubMed  Google Scholar 

  41. Crespo Erchiga V, Delgado Florencio V. Malassezia species in skin diseases. Curr Opin Infect Dis. 2002;15:133–42.

    Article  PubMed  Google Scholar 

  42. Ryan EA, Sanderson KV, Bartak P, Samman PD. Can mycosis fungoides begin in the epidermis? A hypothesis. Br J Dermatol. 1973;88:419–29.

    Article  CAS  PubMed  Google Scholar 

  43. Clayton R, Warin A. Pityriasis lichenoides chronica presenting as hypopigmentation. Br J Dermatol. 1979;100(3):297–302.

    Article  CAS  PubMed  Google Scholar 

  44. Agar NS, Wedgeworth E, Crichton S, Mitchell TJ, Cox M, Ferreira S, Robson A, Calonje E, Stefanato CM, Wain EM, Wilkins B, Fields PA, Dean A, Webb K, Scarisbrick J, Morris S, Whittaker SJ. Survival outcomes and prognostic factors in mycosis fungoides/Sézary syndrome: validation of the revised International Society for Cutaneous Lymphomas/European Organisation for Research and Treatment of Cancer staging proposal by Nita Sally Agar et al. J Clin Oncol. 2010;28:4730–9.

    Article  PubMed  Google Scholar 

  45. Ezzedine K, Diallo A, Léauté-Labrèze C, Mossalayi D, Gauthier Y, Bouchtnei S, Cario-André M, Seneschal J, Boralevi F, Jouary T, Taieb A. Multivariate analysis of factors associated with early-onset segmental and nonsegmental vitiligo: a prospective observational study of 213 patients. Br J Dermatol. 2011;165(1):44–9.

    Article  CAS  PubMed  Google Scholar 

  46. Chun WH, Hann S-H. The progression of nonsegmental vitiligo: clinical analysis of 318 patients. Int J Dermatol. 1997;36:908–10.

    Article  CAS  PubMed  Google Scholar 

  47. Lepe V, Moncada B, Castanedo-Cazares JP, et al. Double-blind randomized trial of 0.1% tacrolimus vs 0.05% clobetasol for treatment of childhood vitiligo. Arch Dermatol. 2003;139:581–5.

    Article  CAS  PubMed  Google Scholar 

  48. Weismann K, Lorentzen HF. Dermoscopic color perspective. Arch Dermatol. 2006;142:1250.

    Article  PubMed  Google Scholar 

  49. Landau M, Krafchik B. The diagnostic value of café au lait spot. J Am Acad Dermatol. 1999;40:877–90.

    Article  CAS  PubMed  Google Scholar 

  50. Hogeling M, Frieden IJ. Segmental pigmentation disorder. Br J Dermatol. 2010;162:1337–41.

    Article  CAS  PubMed  Google Scholar 

  51. Jacob A. Birthmarks. Pediatr Ann. 1976;5:743–58.

    Google Scholar 

  52. Crowe FW, Schull WJ. Diagnostic importance of cafe au lait spots in neurofibromatosis. Arch Intern Med. 1993;91:758–66.

    Article  Google Scholar 

  53. Cordova A. The Mongolian spot: a study of ethnic differences and literature review. Clin Pediatr. 1981;20:714–9.

    Article  CAS  Google Scholar 

  54. Jacobs A. The incidence of birthmarks in the neonate. Pediatrics. 1976;58:218–22.

    CAS  PubMed  Google Scholar 

  55. Hanson M, Lupski JR, Hicks J, et al. Association of dermal melanocytosis with lysosomal storage disease: clinical features and hypotheses regarding pathogenesis. Arch Dermatol. 2003;139:916–20.

    Article  PubMed  Google Scholar 

  56. Mehta V, Vasanth V, Balachandran C, Mathew M. Linear and whorled nevoid hypermelanosis. Int J Dermatol. 2011;50(4):491–2.

    Article  PubMed  Google Scholar 

  57. Metta AK, Ramachandra S, Sadath N, Manupati S. Linear and whorled nevoid hypermelanosis in three successive generations. Indian J Dermatol Venereol Leprol. 2011;77(3):403.

    Article  PubMed  Google Scholar 

  58. Di Lernia V. Linear and whorled hypermelanosis. Pediatr Dermatol. 2007;24:205–10.

    Article  PubMed  Google Scholar 

  59. Hassab-El-Naby HMM, Alsaleh QA, Fathallah MA. Linear and whorled hypermelanosis: report of a case associated with cerebral palsy. Pediatr Dermatol. 1996;13:148–50.

    Article  CAS  PubMed  Google Scholar 

  60. Schepis C, Siragusa M, Alberti A, et al. Linear and whorled nevoid hypermelanosis in a boy with mental retardation and congenital defects. Int J Dermatol. 1996;35:654–5.

    Article  CAS  PubMed  Google Scholar 

  61. Verghese S, Newlin A, Miller M, et al. Mosaic trisomy 7 in a patient with pigmentary abnormalities. Am J Med Genet. 1999;87:371–4.

    Article  CAS  PubMed  Google Scholar 

  62. Alrobaee AA, Alsaif F. Linear and whorled nevoid hypermelanosis associated with developmental delay and generalized convulsions. Int J Dermatol. 2004;43:145–7.

    Article  PubMed  Google Scholar 

  63. Ment L, Alper J, Sirota RL, et al. Infant with abnormal pigmentation, malformation and immune deficiency. Arch Dermatol. 1978;114:1043–4.

    Article  CAS  PubMed  Google Scholar 

  64. Hartmann A, Hofmann UB, Hoehn H, et al. Postnatal confirmation of prenatally diagnosed trisomy 20 mosaicism in a patient with linear and whorled nevoid hypermelanosis. Pediatr Dermatol. 2004;2:636–41.

    Article  Google Scholar 

  65. Legius E, Schrander-Stumpel C, Schollen E, et al. PTPN 11(SH 2) mutations in LEOPARD syndrome. J Med Genet. 2002;39:571–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  66. Gorlin RJ, Anderson RC, Moller JH. The Leopard syndrome revisited. Birth Defects Orig Artic Ser. 1971;7:110–5.

    CAS  Google Scholar 

  67. Arnsmeier SL, Paller AS. Pigmentary anomalies in multiple lentigines syndrome: is it distinct from LEOPARD syndrome? Pediatr Dermatol. 1996;13:100–4.

    Article  CAS  PubMed  Google Scholar 

  68. Nordlund JJ, Lerner AB, Braveman IM, et al. The multiple lentigines syndrome. Arch Dermatol. 1973;107:259–61.

    Article  CAS  PubMed  Google Scholar 

  69. Marceshi L, Naldi L, Di Landro A, et al. Segmental lentiginosis with “lentigo” histologic pattern. Am J Dermatopathol. 1992;14:323–7.

    Google Scholar 

  70. Carney JA, Gordon H, Carpenter PC, et al. The complex of myxomas, spotty pigmentation and endocrine over reactivity. Medicines (Baltimore). 1985;64:270–83.

    CAS  Google Scholar 

  71. Odeibat H. Transient neonatal pustular melanosis: a retrospective review. Middle East J Intern Med. 2013;6(5):44.

    Article  Google Scholar 

  72. Robbins JH. Xeroderma pigmentosum. Defective DNA repair causes skin cancer and neurodegeneration. JAMA. 1988;260:384–8.

    Article  CAS  PubMed  Google Scholar 

  73. Fernandez FM, Martinez Soto MI, Fernandez Lorenzo JR, et al. Peutz Jegher syndrome in a neonate. J Pediatr. 1995;126:965–7.

    Article  Google Scholar 

  74. DeDavid M, Orlow SJ, Provost N, Marghoob AA, Rao BK, Wasti Q, Huang CL, Kopf AW, Bart RS. Neurocutaneous melanosis: clinical features of large congenital melanocytic nevi in patients with manifest central nervous system melanosis. J Am Acad Dermatol. 1996;35(4):529–38.

    Article  CAS  PubMed  Google Scholar 

  75. Caplan RM. The natural course of urticaria pigmentosa. Analysis and follow up of 112 cases. Arch Dermatol. 1963;87:146–57.

    Article  CAS  PubMed  Google Scholar 

  76. Ramirez CO. Los cenicientos: Problema Clinica. Memoria del Primer Congreso Centroamericano de Dermatologia. 1957; p. 122–30.

    Google Scholar 

  77. Silverberg NB, Herz J, Wagner A, Paller AS. Erythema dyschromicum perstans in prepubertal children. Pediatr Dermatol. 2003;20(5):398–403.

    Article  PubMed  Google Scholar 

  78. Piquero-Martín J, Pérez-Alfonzo R, Abrusci V, Briceño L, Gross A, Mosca W, Tapia F, Convit J. Clinical trial with clofazimine for treating erythema dyschromicum perstans. Evaluation of cell-mediated immunity. Int J Dermatol. 1989;28(3):198–200.

    Article  PubMed  Google Scholar 

  79. Gönül M, Kiliç A, Cakmak SK, Gül U, Ekiz OD, Ergül G. Juvenile generalized acanthosis nigricans without any systemic disease. Pediatr Int. 2009;51:595–7.

    Article  PubMed  Google Scholar 

  80. Gao M, Wang PG, Yang S, et al. Two frameshift mutations in the RNA-specific adenosine deaminase gene associated with dyschromatosis symmetrica hereditaria. Arch Dermatol. 2005;141:193–6.

    Article  CAS  PubMed  Google Scholar 

  81. Urabe K, Hori Y. Dyschromatosis. Semin Cutan Med Surg. 1997;16:81–5.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia

    Kin Fon Leong M.B.B.S. (UM), MRCPCH (Edinburg)

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  1. Kin Fon Leong M.B.B.S. (UM), MRCPCH (Edinburg)
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Correspondence to Kin Fon Leong M.B.B.S. (UM), MRCPCH (Edinburg) .

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Editors and Affiliations

  1. Department of Dermatology, Mt. Sinai St. Luke’s-Roosevelt Hospital and Beth Israel Medical centers, New York, New York, USA

    Nanette B. Silverberg

  2. Department of Pediatric Dermatology, National Institute of Pediatrics, Mexico City, Mexico

    Carola Durán-McKinster

  3. Department of Dermatology, Changi General Hospital, Singapore, Singapore

    Yong-Kwang Tay

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Leong, K.F. (2015). Pigmentary Development of East Asian Skin. In: Silverberg, N., Durán-McKinster, C., Tay, YK. (eds) Pediatric Skin of Color. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6654-3_3

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