What are microscopy findings in Riehl melanosis (pigmented contact dermatitis)?

Updated: May 27, 2021
  • Author: Elizabeth K Satter, MD, MPH; Chief Editor: William D James, MD  more...
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Answer

The most distinctive feature on reflectance confocal microscopy is the presence of pigment incontinence consisting of melanophages primarily concentrated in the superficial dermal papilla, associated with a few scattered round-to-polygonal, mildly refractive cells. [45] Additional features include total or partial obliteration of the ringlike structures around the dermal papillae, consistent with the presence of liquefaction of the basal cells, a variable degree of dilated infundibulum, and hyperkeratotic adnexal infundibula. [45]


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