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Correspondence |

Sock-Line Hyperpigmentation: Case Series and Literature Review

David R. Berk, MD; Beatriz Tapia, MD; Anne Lind, MD; Susan J. Bayliss, MD
Arch Dermatol. 2007;143(3):423-431. doi:10.1001/archderm.143.3.428.
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Causes of linear or curvilinear hyperpigmentation in childhood include linear and whorled hypomelanosis, epidermal nevus, postinflammatory hyperpigmentation, and incontinentia pigmenti. Zhu et al1 described 2 infants with palpable, bilateral, curvilinear hyperpigmentation of the calves that did not follow Blaschko lines, appeared shortly after birth, and histologically demonstrated lentiginous melanocytic hyperplasia and basal layer hyperpigmentation. They called this disorder congenital curvilinear palpable hyperpigmentation. We report 5 similar cases and expand the spectrum of findings. We suggest that this hyperpigmentation results from postinflammatory changes from elastic bands of socks rather than a congenital disorder.

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Figure 1.

Case 1 demonstrates linear, circumferential, nonpalpable hyperpigmentation at the right ankle.

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Figure 2.

Case 2 demonstrates linear, circumferential, nonpalpable hyperpigmentation with notching at the right ankle. A, Clinical view. B, Biopsy specimen shows minimal lentiginous melanocytic hyperplasia and basal layer hyperpigmentation; melanophages and free melanin granules are present in the papillary and superficial reticular dermis (hematoxylin-eosin, original magnification ×40).

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Figure 3.

Case 3 demonstrates linear, circumferential, palpable hyperpigmentation at the right ankle.

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Figure 4.

Case 4 demonstrates linear, palpable hyperpigmentation on the posterior surface of the left calf.

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Figure 5.

Case 5 demonstrates linear, nonpalpable hyperpigmentation on the posterior surface of the left leg.

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