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Brown and Black Scaly Patches on the Lower Leg—Diagnosis
Arch Dermatol. 2007;143(11):1441-1446.
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Diagnosis: Black stasis dermatitis as a cutaneous marker of hemochromatosis
MICROSCOPIC AND LABORATORY FINDINGS AND CLINICAL COURSE
The histopathologic specimen demonstrated neovascularization with prominent small blood vessels in the papillary dermis and dermal fibrosis, consistent with a diagnosis of stasis dermatitis. Hemosiderin, demonstrated by Perls stain, was conspicuously present throughout the dermis, while increased melanin deposition in the basal layer was demonstrated by Fontana-Masson silver stain. As clinically suspected, hemosiderin deposition was considerably increased in tissue from the patient's left leg compared with the right.
His serum ferritin level was 448.1 ng/mL (reference range, 25-285 ng/mL) (to convert to picomoles per liter, multiply by 2.247); iron saturation, 59.8% (reference range, 20%-50%); and hemoglobin level, 14.9 g/dL (reference range, 14-18 g/dL) (to convert to grams per liter, multiply by 10). Testing for the HFE gene revealed a heterozygous Cys282Tyr mutation. Clinical and microscopic findings were consistent with a diagnosis of stasis dermatitis with black pigmentation in a patient with hemochromatosis. Therapeutic phlebotomies resulted in a rapid decrease of . . . [Full Text of this Article] DISCUSSION
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Arch Dermatol. 2007;143(11):1441-1446.
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