A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Does melanophages contribute to pigmentation of skin? According to Ackerman, the amount of epidermal melanin is the one that decides hyperpigmentation of skin in a person and not the dermal melanophages.. Since dermal melanophages can be seen in vitiligo lesions too.
Yes, normal skin pigmentation is due to amount of melanin in the basal keratinocytes of the epidermis. But melanophages in dermis is a pathological state; when the epidermis is damaged some pigment falls into the dermis and is taken up by macrophages (melanophages). This often corresponds with pigment CHANGES that can be seen clinically, often hyperpigmentation but sometimes hypopigmentation instead. We often call this “post inflammatory hyperpigmentation” or PIH when speaking about it but on my reports I usually say “post inflammatory pigmentary alteration” to encompass both hyper or hypo pigmentation clinically. or I just say “pigment incontinence”. So the melanophages contribute to altered skin pigmentation in abnormal skin but not to the level of skin pigmentation in normal skin.
@@JMGardnerMD thank you for the reply, interesting notice! I was kind of used to thinking that pigmentary incontinence invariably results in clinical hypopigmentation, but this explains some of the tricky cases I've had that looked like VKH in histo, but were hyperpigmented rather than hypo- that one would expect. Gave me food for thought now! :)
Ashy dermatosis (erythema dyschromicum perstans) is basically a type of post inflammatory pigmentation alteration (PIPA) due to interface dermatitis. So identifying vacuolar change and apoptotic keratinocytes (combined with correct Clinical appearance) helps make diagnosis of ashy dermatosis vs other forms of PIPA.
Dr Gardner, im making a presentation about key figures in dermatopathology history and im considering adding you to the list! Thank you for your great contribution to the world.
Hai sir, I do have pIH ,but it's not a common type ,it was very severe that I got black spots all over my body starting from my stomach and they got spreaded all over my body expect face ,and my body colour also turned very dark , i met many skin specialists but no one helped me ,so i started treating my self by using tca , it was not doing great but it did somewhat cleared my spots ,can you suggest me any way so that I can get rid of them if possible ,my age is 25 .
Does exactly the same thing happen to the epidermis when you tan in the sun? The tan goes away after two weeks, so does that mean the melanin production gets back to normal after two weeks?
How would you tell this from dermal melanocytosis and blue naevus please?. I have a biopsy that has many groups of dermal melanophages in papillary dermis with ocadsio al dendritic like melanocytes (pending Red Sox 10)- which if positive - could I call that a blue naevus? Thank you so much
Yes, the difference is that PIH is all melanophages whereas blue nevus or dermal melanocytosis has melanophages plus a variable number of pigmented dendritic melanocytes (SOX-10 or MART-1 or HMB-45 positive).
Hi I had an allergic reaction to hair removing cream and after I washed it off , it was still sitting on my skin days later as my skin had sunken in and darkened , i. Now have pitted skin with post inflammatory hyperpigmentation since 2011 , was using a lightning cream until I stopped and all the PIH came up through , I believe it didn’t fade all these years as their is atrophy and I didn’t scab in those areas as the hair removing cream had absorbed into the skin . I don’t know what to do it had ruined my skin ,
@@JMGardnerMD thank you for reply yes my dermatologist told me that its post inflammatory hyperpigmentation....and told me to apply cream and lotion.... But in Google it says symptoms may include PIH ...that's why I was scared...anyways thanks for your reply god bless you
![Noob To Max With DRAGON REWORK In Blox Fruits [FULL MOVIE]](http://i.ytimg.com/vi/LnBMOinoOvA/mqdefault.jpg)
A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Does melanophages contribute to pigmentation of skin? According to Ackerman, the amount of epidermal melanin is the one that decides hyperpigmentation of skin in a person and not the dermal melanophages.. Since dermal melanophages can be seen in vitiligo lesions too.
Yes, normal skin pigmentation is due to amount of melanin in the basal keratinocytes of the epidermis. But melanophages in dermis is a pathological state; when the epidermis is damaged some pigment falls into the dermis and is taken up by macrophages (melanophages). This often corresponds with pigment CHANGES that can be seen clinically, often hyperpigmentation but sometimes hypopigmentation instead. We often call this “post inflammatory hyperpigmentation” or PIH when speaking about it but on my reports I usually say “post inflammatory pigmentary alteration” to encompass both hyper or hypo pigmentation clinically. or I just say “pigment incontinence”. So the melanophages contribute to altered skin pigmentation in abnormal skin but not to the level of skin pigmentation in normal skin.
@@JMGardnerMD thank you for the reply, interesting notice! I was kind of used to thinking that pigmentary incontinence invariably results in clinical hypopigmentation, but this explains some of the tricky cases I've had that looked like VKH in histo, but were hyperpigmented rather than hypo- that one would expect. Gave me food for thought now! :)
So how do you differentiate this from Ashy Dermatoses?
Ashy dermatosis (erythema dyschromicum perstans) is basically a type of post inflammatory pigmentation alteration (PIPA) due to interface dermatitis. So identifying vacuolar change and apoptotic keratinocytes (combined with correct Clinical appearance) helps make diagnosis of ashy dermatosis vs other forms of PIPA.
Can this lesion have an increase in melanocytes?... Thank you, greetings
Usually there is no increase in melanocytes.
Dr Gardner, im making a presentation about key figures in dermatopathology history and im considering adding you to the list!
Thank you for your great contribution to the world.
You are too kind. I am honored.
Is there treatment for this ?
Does Melanin inhibitors such as hydroquinone or arbutin work to remove these pigments from the dermis?
Yes
Wonderful videos about common findings that we realize now thank to you
Hai sir, I do have pIH ,but it's not a common type ,it was very severe that I got black spots all over my body starting from my stomach and they got spreaded all over my body expect face ,and my body colour also turned very dark , i met many skin specialists but no one helped me ,so i started treating my self by using tca , it was not doing great but it did somewhat cleared my spots ,can you suggest me any way so that I can get rid of them if possible ,my age is 25 .
Omg I’m dealing with the same thing
Does exactly the same thing happen to the epidermis when you tan in the sun? The tan goes away after two weeks, so does that mean the melanin production gets back to normal after two weeks?
Any cure for this Doc?
How would you tell this from dermal melanocytosis and blue naevus please?. I have a biopsy that has many groups of dermal melanophages in papillary dermis with ocadsio al dendritic like melanocytes (pending Red Sox 10)- which if positive - could I call that a blue naevus? Thank you so much
The case in reference is an 86year old with 4mm pigmented macule on the back… thank you 🙏
Yes, the difference is that PIH is all melanophages whereas blue nevus or dermal melanocytosis has melanophages plus a variable number of pigmented dendritic melanocytes (SOX-10 or MART-1 or HMB-45 positive).
@@JMGardnerMD thank you 🙏!
Thanks
Hi I had an allergic reaction to hair removing cream and after I washed it off , it was still sitting on my skin days later as my skin had sunken in and darkened , i. Now have pitted skin with post inflammatory hyperpigmentation since 2011 , was using a lightning cream until I stopped and all the PIH came up through , I believe it didn’t fade all these years as their is atrophy and I didn’t scab in those areas as the hair removing cream had absorbed into the skin . I don’t know what to do it had ruined my skin ,
Dear sir I hav PIH problem...am applying elidel so when will I see the results......so PIH can turnout to be vitiligo am scared
PIH and vitiligo are different. See your dermatologist for more help and information that is right for you.
@@JMGardnerMD thank you for reply yes my dermatologist told me that its post inflammatory hyperpigmentation....and told me to apply cream and lotion....
But in Google it says symptoms may include PIH ...that's why I was scared...anyways thanks for your reply god bless you