Which clinical history findings are characteristic of erythema dyschromicum perstans (EDP)?

Updated: Apr 19, 2019
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Erythema dyschromicum perstans has a slow onset and is unlikely to resolve spontaneously. [15] The clinical course of childhood (prepubertal) may differ from that of adults; erythema dyschromicum perstans may be more likely to resolve within 2-3 years. A proposed clinical classification has been devised, dividing ashy dermatoses from erythema dyschromicum perstans with the former lacking erythematous borders, and having a third category for simulators such as lichen planus variants, and medication-induced melanodermas. [19]

Erythema dyschromicum perstans is an asymptomatic eruption of oval, polycyclic, or irregularly shaped, gray-blue hyperpigmented macules on the trunk, the arms, the face, and the neck. It begins as ash-colored macules, sometimes with an erythematous or elevated border (see the image below). No systemic symptoms or associations exist.

Erythema dyschromicum perstans may resolve in 2-3 years in prepubertal children, but it is more likely to persist in adults. [20]

Ash-colored, partially confluent, macular lesions Ash-colored, partially confluent, macular lesions over the patient's back. Reprint with permission from Cutis 1986; 37: 42-44.

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