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Indian Pediatr 2011;48: 967-968

Carbon Baby Syndrome (Universal Acquired Melanosis)


Piyush Kumar, Kalyan Ghosh and *Arunasis Maiti

Department of Dermatology, Medical College and Hospital; and *Department of Dermatology,
Midnapore Medical College and Hospital,Paschim Midnapore,
88, College street, Kolkata 700 073, West Bengal, India.
Email: [email protected]
 
 


A 5-years-old girl born to non-consanguineous parents presented with progressive generalized hyperpigmentation since 3 months of age. The darkening of skin was first noticed over the feet and face at the age of 3 months and gradually progressed to involve the entire body. There was no history of prior drug intake or other skin lesions, no history of discoloration of urine or photosensitivity. On examination, baby had generalized dark-black hyper-pigmentation, oral mucosa was involved; genitalia were spared. Face showed patchy areas of normal skin. [Fig.1] The skin texture and sweat secretion were normal. Systemic and ophthalmological examination was normal. Her weight was 15 kg and blood pressure was 104/70 mm Hg. Liver function tests, electrolytes, thyroid profile, serum cortisol, and ferritin were within normal limits. Skin biopsy revealed excessive melanin pigmentation of the epidermis with few melanophages in the dermis. A diagnosis of universal acquired melanosis (carbon baby syndrome) was made.

Fig. 1 Generalized dark-black hyperpigmentation, mimi-cking negroid skin color. Note palm involvement.

Addison disease (low blood pressure, hyponatremia, hyperkalemia, low serum cortisol level), Cushing disease (obese patient, cushingoid habitus, hyperglycemia, hypokalemia, elevated serum cortisol level), hemochromatosis (high transferrin saturation and ferritin level, genetic tests for the C282Y and H63D), and lichen planus pigmentosus (usually macular lesions, rarely diffuse hyperpigmentation, characteristic histopathology findings- lichenoid infiltration, basal vacuolar change and prominent melanin incontinence; usually mild as compared to classical lichen planus) were excluded based on their distinguishing features. Universal acquired melanosis is a diagnosis of exclusion. It is a progressive condition; long term prognosis and treatment is not established.
 

 

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