DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages. Dermatosis papulosa nigra describes the presence of multiple, small, 1—5 mm diameter, smooth, firm, black or dark brown papules on face and neck. Dermatosis papulosa nigra is common in people with skin of colour, with Fitzpatrick skin phototype 4, 5 or 6. There is a lower frequency in African Americans with a fairer complexion. Dermatosis papulosa nigra also occurs among dark-skinned Asians and Polynesians, but the exact frequency is unknown.

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Characteristic findings on physical examination Dermatosis papulosa nigra is found in black people. It is assumed that dermatosis papulosa nigra in fact is a variant of seborrheic keratosis in darkly pigmented people. The lesions occur usually as multiple black papules with a diameter of 1 to 5mm. They are preferentially located on the face, neck, upper back and chest.

The lesions resemble tiny pigmented seborrheic keratoses. The clinical appearance is very typical and in most cases the diagnosis can be made without difficulty Figure 1.

Figure 1. Expected results of diagnostic studies Continue Reading. Diagnosis confirmation Differential diagnosis includes other benign skin tumors such as melanocytic nevi, adenoma sebaceum if the lesions are arranged along the nasolabial folds and trichoepitheliomas. In doubtful cases, histopathologic diagnosis will be helpful. Dermatosis papulosa nigra is characterized by acanthosis, moderate papillomatosis and hyperkeratosis.

The histologic picture is identical with acanthotic seborrheic keratosis, with the exception that horn pseudocysts are less common in dermatosis papulosa nigra.

Who is at Risk for Developing this Disease? Dermatosis papulosa nigra is commonly found in black people. Occurrence in Asians and Mexicans has been reported as well. This study found also a preponderance of females with a male:female ratio of Dermatosis papulosa nigra is absent in childhood, but usually develops earlier in life than seborrheic keratoses.

The number of lesions increases with age. What is the Cause of the Disease? Etiology Pathophysiology The etiology of dermatosis papulosa nigra remains elusive. A genetic predisposition may play a role because many patients report a positive family history. Recently, FGFR3 mutations have been identified in dermatosis papulosa nigra. These mutations have been previously reported in seborrheic keratoses. The detection of FGFR3 mutations in dermatosis papulosa nigra further supports the concept that this lesion is indeed merely a variant of acanthotic seborrheic keratosis in darkly pigmented people.

Systemic Implications and Complications Analogous to seborrheic keratosis, dermatosis papulosa nigra is a benign skin tumor without malignant potential. Because of the occasionally high number of lesions and the localization in visible areas, dermatosis papulosa nigra may be cosmetically disturbing and the patients will therefore wish to remove the multiple lesions.

Treatment Options Destructive Modalities cryosurgery electrodessication lasers Surgical Excision Optimal Therapeutic Approach for this Disease It has to be considered that treatment is not necessary due to the benign character of dermatosis papulosa nigra and will only be for cosmetic reasons. Various methods can be used for removal such as shave excision, curettage, cryotherapy, electrodesiccation or ablative lasers.

Pulsed dye laser did not show a better result than curettage or electrodesiccation. Precaution is recommended for all therapies because of a relevant risk of postinflammatory hypo- or hyperpigmentation in darkly pigmented individuals.

Patient Management Patient reassurance that these lesions are benign and are of no significance other than cosmetic appearance is essential.

Treatment is only necessary should the patient desire it or, on the rare occasion, when lesions become irritated. What is the Evidence? Lasers Med Sci. This study has analyzed the prevalence of dermatosis papulosa nigra among darkly pigmented people. Br J Dermatol. This study identified FGFR3 mutations in dermatosis papulosa nigra, supporting a relationship with seborrheic keratosis.

Dermatol Surg. This study compared pulsed dye laser with electrodesiccation and curettage for removal of dermatosis papulosa nigra but found no advantage for the laser treatment. Christian Hafner. The chapter was revised for this program by Dr. Michael Gober. All rights reserved. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC.

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Dermatosis Papulosa Nigra

Dermatosis papulosa nigra, also known as DPN, are small, soft brown papules that may occur on the face and neck of patients of African, Latin, Indian, or Asian descent. While they may not reach the size of their histologically similar seborrheic keratosis counterparts, the lesions do represent a sign of aging in darker skinned patients. However, the lesions can be safely, easily, and effectively removed. Electrodesiccation with a hyfrecator or destruction with the KTP nm laser are my favorite methods for DPN removal.


Dermatosis Papulosa Nigra (DPN)

Dermatosis papulosa nigra DPN is a harmless skin condition that tends to affect people with darker skin. It consists of small, dark bumps that usually appear on your face and neck. While some people only develop a few bumps, others have many. The small black or dark brown bumps caused by DPN are usually smooth, round, and flat. They range in size from 1 to 5 millimeters. Over time, the bumps can become rougher looking.

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