A 9-year-old girl presented with multiple, asymptomatic pigmented skin eruptions over
the trunk and face which had been present for3 months. There was no prior history
of skin lesions or relevant drug intake Cutaneous examination revealed multiple discrete,
dark brown, round-to-oval macules, patches (0.5 to 2 cm in diameter) and flat-topped
velvety plaques over the trunk, back, face and extremities sparing the palms and soles
(Figure). Lesional Darier sign was negative. The remainder of the mucocutaneous sites
and systemic examination was negative. Routine laboratory investigation was normal.
Histopathological findings of irregular acanthosis, slight papillomatosis, basal layer
hyperpigmentation and few melanophages in the papillary dermis reaffirmed the clinical
impression of idiopathic eruptive macular pigmentation (IEMP). She was advised to
apply emollients and she and her parents were counselled, emphasizing the benign,
self-resolving nature of the condition.
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