Riehl Melanosis Workup

Author: Helena A Longin, MD; Chief Editor: William D James, MD more...

Updated: Aug 5, 2011

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Laboratory Studies
Procedures
Histologic Findings
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References

Laboratory Studies

Patch test: Perform closed patch testing with the standard series, cosmetic series, fragrance series, and patient's personal products.
Photo-patch test
Provocative use test or repeated open application test (ROAT): Perform this testing when closed patch testing results are equivocal or negative. The concentration of the allergen (eg, preservatives, fragrances) may be too low in the cosmetic series to produce a positive reaction on the back.^[4]

Skin biopsy

Histologic Findings

Most biopsy results have shown interface dermatitis with vacuolar basal layer degeneration. The superficial dermis often contains a mild-to-moderate lymphohistiocytic infiltrate admixed with melanophages. Findings suggestive of spongiosis are lacking. Some biopsy specimens have shown mild atrophy of the dermis, but this is an inconsistent finding. Negative direct immunofluorescence study results help eliminate hyperpigmented lupus erythematosus from the differential diagnosis.

Proceed to Treatment & Management

Contributor Information and Disclosures

Author

Helena A Longin, MD Resident Physician, Department of Dermatology, Naval Medical Center San Diego

Helena A Longin, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Elizabeth Kline Satter, MD, MPH Chairman, Department of Dermatology, Naval Medical Center San Diego

Elizabeth Kline Satter, MD, MPH is a member of the following medical societies: Alpha Omega Alpha and American Medical Women's Association

Disclosure: Nothing to disclose.

Specialty Editor Board

John D Wilkinson, MD, MBBS, MRCS, FRCP Chairman, Clinical Director, Department of Dermatology, Amersham Hospital and High Wycombe Hospital, UK

John D Wilkinson, MD, MBBS, MRCS, FRCP is a member of the following medical societies: American Academy of Dermatology and Royal College of Physicians

Disclosure: Nothing to disclose.

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

Acknowledgments

The authors and editors of eMedicine acknowledge the contributions of previous author, Mohsin Ali, MBBS, FRCP, MRCP, to the development and writing of this article.

References

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Rorsman H. Riehl's melanosis. Int J Dermatol. Mar 1982;21(2):75-8. [Medline].
Nakayama H. Pigmented Contact Dermatitis and Chemical Depigmentation. In: Rycroft R, Menne T, Frosch P, Lepoittevin J, eds. Textbook of Contact Dermatitis. 3^rd ed. New York, NY: Springer; 2001:319-333.
Shenoi SD, Rao R. Pigmented contact dermatitis. Indian J Dermatol Venereol Leprol. Sep-Oct 2007;73(5):285-7. [Medline].
Findlay GH. Some observations on the melanosis of Riehl. S Afr Med J. May 3 1952;26(18):373-5. [Medline].
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Naganuma M, Hirose S, Nakayama Y, Nakajima K, Someya T. A study of the phototoxicity of lemon oil. Arch Dermatol Res. 1985;278(1):31-6. [Medline].
Serrano G, Pujol C, Cuadra J, Gallo S, Aliaga A. Riehl's melanosis: pigmented contact dermatitis caused by fragrances. J Am Acad Dermatol. Nov 1989;21(5 Pt 2):1057-60. [Medline].
Ozkaya-Bayazit E, Buyukbabani N. Non-eczematous pigmented interface dermatitis from para-tertiary-butylphenol-formaldehyde resin in a watchstrap adhesive. Contact Dermatitis. Jan 2001;44(1):45-6. [Medline].
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