Case Details

Clinical - Observe the clinical image of a 40-year old Indian lady who developed gradually progressive asymptomatic dark brown to greyish-blue pigmentation with ill-de ned margins involving her forehead, lateral aspect of cheeks, preauricular region extending down till middle neck over the past 3 years. [Fig. 1A]. As a home maker, her sun-exposure was minimal and she denied being very fond of or frequent user of cosmetics and fragrances. She gave history of having used Indian gooseberry (amla) oil over her scalp for many years; and had started using an ammonia-free propriety hair color around 4-5 years back. Being unmarried, she did not use vermillion powder in the scalp parting line. There were no other lesions elsewhere, and examination of mucosae, scalp and hair, and nails was unremarkable. No treatment had been sought or taken till now. A patch and photopatch test with the Indian Standard series and cosmetic series revealed 2+ and 3+ positive allergic reactions to paraphenylenediamine (PPD) and fragrance mix respectively.

Dermoscopy – Dermoscopic image taken from the pre-auricular area (marked with white solid arrow in Fig. 1A] using E-scope