Track: Case Reports

Topic: Other

Abstract:

Generalised hyperpigmentation in a child may be attributed to a wide range of disorders. Acquired universal melanosis (AUM), also known as Carbon baby syndrome, is a rare condition characterised by progressive hyperpigmentation of skin since infancy. A 3-month-old male, born to non- consanguineous parents with fair complexion, presenting with diffuse darkening of skin since 2 months presented to the Dermatology OPD. It was insidious in onset, first noticed with involvement of lips, gradually progressed to involve feet, dorsum of hands, trunk and face. Mother's prenatal, natal and postnatal period was uneventful. No history of drug intake, urine discolouration or photosensitivity. No family history of hyperpigmentation of skin. Examination showed generalised, diffuse hyperpigmentation with patchy areas of normally pigmented skin and sparing of palms, soles and mucosa. Hair was normally pigmented with straight terminal hairs and no colour or shaft abnormalities. Growth parameters and milestones were within normal limits. Ophthalmological and other systemic examination revealed normal findings. Investigations revealed Urine for amino acids, Liver and renal function tests, Thyroid profile, USG abdomen to be normal. Serum ACTH was 7.9 microgram/dl (normal). Dermoscopy showed accentuated pseudo-reticular network with occasional brown dots. Histopathology showed Basal and suprabasal layers of epidermis, up till stratum corneum with excessive melanin pigmentation and dermal melanophages. Based on the clinico-histopathological correlation and exclusion of other plausible causes of diffuse hyperpigmentation in an infant, diagnosis of carbon baby syndrome was made. Only a few cases of AUM are described in literature. With its aetiology being unknown, it stays a diagnosis of exclusion.

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NEHA AKHOON, MD dermatology