Introduction: Ashy Dermatosis is an inflammatory skin disorder characterised by progressive macules of ashy-grey hyperpigmentation. Its exact aetiology is unknown and there is no consistently effective treatment. Three cases of Ashy Dermatosis treated with narrowband UVB phototherapy are presented.
Case 1: Fifty-two year old woman with a 12 month history of diffuse slate grey pigmentation localised to her facial and neck region. Biopsy showed dermal melanophages and a patchy lymphocytic infiltrate in keeping with Ashy Dermatosis. A course of narrowband UVB phototherapy was commenced with promising results.
Case 2: Forty-six year old man with 6 months duration of progressive dark bluish discolouration involving his face and neck, anterior chest and forearms. Biopsy results were in keeping with Ashy Dermatosis and he received a trial of narrowband UVB phototherapy.
Case 3: Thirty-four year old man with a 2 year history of hyperpigmented skin involving his facial area, upper limbs and lower back. Ashy Dermatosis was confirmed on biopsy. He has continued with narrowband UVB phototherapy and topical 0.03% tacrolimus therapy.
Discussion: The cases presented showed partial fading of ashy-grey pigmentation and cessation of disease progression with variable courses of narrow band UVB phototherapy. It is believed that narrowband UVB phototherapy reduces lymphocyte proliferation and simulates pigment production. There is limited literature to confirm the efficacy of narrowband UVB phototherapy in the treatment Ashy Dermatosis. Isolated case reports have shown good results, however larger scale randomised trials are warranted to better assess the effectiveness and safety of this treatment.
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