Generic selectors
Exact matches only
Search in title
Search in content
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter To Editor
2005:71:4;292-293
doi: 10.4103/0378-6323.16630
PMID: 16394447

Pigmentary demarcation lines in pregnancy

Lalit Kumar Gupta, CM Kuldeep, Asit Mittal, Vijay Paliwal, Himanshu Singhal, Kalpana Agarwal, Jaya Tantia
 Department of Dermatology, Venereology and Leprology, RNT Medical College, Udaipur (Rajasthan), India

Correspondence Address:
Lalit Kumar Gupta
24-C, Madhuvan, Opp. GPO, Udaipur-313 001 (Raj.)
India
How to cite this article:
Gupta LK, Kuldeep C M, Mittal A, Paliwal V, Singhal H, Agarwal K, Tantia J. Pigmentary demarcation lines in pregnancy. Indian J Dermatol Venereol Leprol 2005;71:292-293
Copyright: (C)2005 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Pigmentary demarcation lines (PDL), also known as Futcher′s lines or Voigt′s lines, are physiological abrupt transition lines from areas of deeper pigmentation to the area with less pigmentation. These have most often been described in the skin of Africans and Japanese.[1] Five types (A-E) have been described. Malakar and Dhar (2000) were the first to report pigmentary demarcation lines over face in Indian population and labeled them as type F PDL.[2] Subsequently, a few more patterns of pigmentary demarcation lines on the face, types F, G and H have also been described in Indian subjects.[3] We report a pregnant woman, who presented with type B pigmentary demarcation lines and generalized cutaneous hyperemia.

A 30-year-old second gravida who was 8 month spregnant presented at the skin outpatient department with asymptomatic, broad, band-like pigmentation over the posterior aspect of both legs and thighs [Figure - 1], extending from the heel to the gluteal crease, that was present since 4 months. The medial borders of the pigmented areas were sharply demarcated while the lateral borders merged imperceptibly into the normal skin. She also had generalized cutaneous hyperemia that blanched completely on diascopy. She did not report similar pigmentation or hyperemia in her previous pregnancy. The patient underwent tightening of the os uteri during the first trimester for a patulous os and had a threatened abortion. She had also received progesterone injections for 3 months. These lines disappeared completely one month after parturition.

PDL are abrupt transition lines from areas of deeper pigmentation to areas with less pigmentation. They are rare examples of streaks of melanocytes, otherwise inapparent. They neither correspond to the lines of Blaschko that mark the distribution of linear nevoid conditions, nor to the dermatomal lines. These are most often observed in darker races and are considered to be normal variants of pigmentation.[4]

Five naturally occurring PDLs, labeled A-E, have been described:[1],[4], [5]

1. Type A (Futcher′s / Voigt′s lines), the most common lines, seen over the dorso-ventral aspect of the arms.

2. Type B, which appear during pregnancy on the lower limbs and regress after delivery.

3. Type C, which are mid sternal, extending from the clavicle to the inferior border of the sternum.

4. Type D, rare, postero-median lines along the spine.

5. Type E, periareolar hypopigmented macules.

In a recent Indian study, three distinct patterns of pigmentary demarcation lines have been described on the face and have been designated as F, G and H types of PDL.[3] The PDL were seen with a much higher frequency in women (9%) than in men (0.75%). Hormonal influence was suggested as a possible explanation for the higher occurrence in females. Type B pigmentary demarcation lines have been reported over the legs during pregnancy, and regress after delivery.[4] PDL seen in our patient typically correspond to type B lines.

The exact cause of pigmentary demarcation lines is still an enigma. They have been considered as an atavistic remnant, where the dorsal skin is pigmented more than the ventral, providing better protection from the sun.[5] Genetic and hormonal influences have also been suggested.[5] The PDL and generalized cutaneous hyperemia in our patient could possibly be due to the progesterone therapy received during early pregnancy. We could not come across a description of type B pigmentary demarcation line in the Indian literature.

References
1.
Selmanowitz VJ, Krivo JM. Pigmentary demarcation lines. Comparision of Negroes with Japanese. Br J Dermatol 1975;93:371-7.
[Google Scholar]
2.
Malakar S, Dhar S. Pigmentary demarcation lines over face. Dermatology 2000;200:85-6.
[Google Scholar]
3.
Somani VK, Razvi F, Sita VN. Pigmentary demarcation lines over the face. Indian J Dermatol Venereol Leprol 2004;70:336-41.
[Google Scholar]
4.
James WD, Meltza MS, Giml MA, Berger TG, Rodman OG. Pigmentary demarcation lines associated with pregnancy. J Am Acad Dermatol 1984;11:438-40.
[Google Scholar]
5.
James WD, Caster JM, Rodman OG. Pigmentary demarcation lines: a population study. J Am Acad Dermatol 1987;16:584-90.
[Google Scholar]

Fulltext Views
880

PDF downloads
112
Show Sections