<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1409-0015</journal-id>
<journal-title><![CDATA[Medicina Legal de Costa Rica]]></journal-title>
<abbrev-journal-title><![CDATA[Med. leg. Costa Rica]]></abbrev-journal-title>
<issn>1409-0015</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Medicina Forense]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-00152016000100170</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Dermatosis cenicienta]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Umaña Brenes]]></surname>
<given-names><![CDATA[Alberto Alonso]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Vargas]]></surname>
<given-names><![CDATA[Alexandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Iberoamérica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2016</year>
</pub-date>
<volume>33</volume>
<numero>1</numero>
<fpage>170</fpage>
<lpage>174</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-00152016000100170&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-00152016000100170&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-00152016000100170&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La dermatosis cenicienta es una hipermelanosis idiopática con máculas de color azul grisáceo, que fue descrita inicialmente en El Salvador por Oswaldo Ramírez en 1957. Predomina en la población hispana de piel fototipo IV, siendo más común en adultos entre la segunda y tercera década de la vida. Aunque se desconoce la etiología, se han identificado factores predisponentes como la ingesta de nitrato de amonio, benzodiacepinas, exposición a pesticidas y fungicidas como clorotalonil, entre otros. A nivel histopatológico se visualiza degeneración e hiperpigmentación de la capa basal. Clínicamente, el tórax y las extremidades proximales son las áreas anatómicas comúnmente afectadas en esta enfermedad asintomática y de curso crónico. La historia clínica y el examen físico son la base del diagnóstico, así como una biopsia de piel de los bordes activos para confirmar el mismo. Aunque existen diversas opciones terapéuticas, solamente la clofazimina y la dapsona han mostrado eficacia en el tratamiento de la dermatosis cenicienta. El líquen plano pigmentado y la pigmentación macular eruptiva idiopática son dos de los principales diagnósticos diferenciales que el clínico debe considerar.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Ashy dermatoses is an idiopathic hypermelanosis with blue-gray macules, which was first described by Oswaldo Ramírez in El Salvador in 1957. It predominates in the Hispanic population with skin type IV, being most common in adults between the second and third decade of life. Although the etiology is unknown, predisposing factors have been identified as the intake of ammonium nitrate, benzodiazepines, exposure to pesticides and fungicides such as chlorothalonil, etc. Degeneration and hyperpigmentation of the basal layer is the main histopathologycal characteristics. Clinically, the chest and the proximal extremities are the anatomical areas commonly affected in this asymptomatic disease with chronic course. The clinical history and the physical examination are the basis of diagnosis, the biopsy of the skin active borders confirms it. Although there are several treatment options, only dapsone and clofazimine have shown efficacy in the ashy dermatosis treatment. Lichen planus pigmentosus and idiopathic eruptive macular pigmentation are two of the main differential diagnoses, the clinician should consider.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Dermatosis]]></kwd>
<kwd lng="es"><![CDATA[enfermedades de la piel]]></kwd>
<kwd lng="es"><![CDATA[eritema discrómico perstans]]></kwd>
<kwd lng="es"><![CDATA[pigmentación de la piel]]></kwd>
<kwd lng="es"><![CDATA[hiperpigmentación]]></kwd>
<kwd lng="es"><![CDATA[dermatosis cenicienta]]></kwd>
<kwd lng="es"><![CDATA[clofazimina]]></kwd>
<kwd lng="en"><![CDATA[Dermatoses]]></kwd>
<kwd lng="en"><![CDATA[skin diseases]]></kwd>
<kwd lng="en"><![CDATA[erythema dyshromicum perstans]]></kwd>
<kwd lng="en"><![CDATA[skin pigmentation]]></kwd>
<kwd lng="en"><![CDATA[ashy dermatosis]]></kwd>
<kwd lng="en"><![CDATA[hyperpigmentation]]></kwd>
<kwd lng="en"><![CDATA[Clofazimine]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Contreras]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Carrillo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hojyo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Arenas]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Domínguez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dermatosis cenicienta: Eritema discrómico perstans]]></article-title>
<source><![CDATA[Med Cutan Iber Lat Am]]></source>
<year>2005</year>
<volume>33</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>97-102</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tschen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tschen]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[McGavran]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Erythema Dyschromicum Perstans]]></article-title>
<source><![CDATA[J Am Acad Dermatol]]></source>
<year>1980</year>
<volume>2</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>295-302</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silverberg]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[McKinster]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kwang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<source><![CDATA[Pediatric Skin of Color]]></source>
<year>2015</year>
<page-range>101-3</page-range><publisher-loc><![CDATA[Nueva York, USA ]]></publisher-loc>
<publisher-name><![CDATA[Springer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zaynoun]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rubeiz]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ghani]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ashy dermatoses- a critical review of the literature and a proponed simplified clinical classification]]></article-title>
<source><![CDATA[International Journal of Dermatology]]></source>
<year>2008</year>
<volume>47</volume>
<page-range>542-4</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Numata]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Harada]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Tsuboi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mitsuhashi]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<source><![CDATA[Case Reports in Dermatology]]></source>
<year>2015</year>
<volume>7</volume>
<page-range>146-50</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jackson]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Pandya]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Dermatology Atlas for Skin of Color]]></source>
<year>2014</year>
<page-range>33-7</page-range><publisher-loc><![CDATA[Nueva York, USA ]]></publisher-loc>
<publisher-name><![CDATA[Springer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[DeMay]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Erythema Dyschromicum Perstans]]></article-title>
<source><![CDATA[Journal of the Dermatology Nurses&#8217; Association]]></source>
<year>2011</year>
<volume>3</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>223-4</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vásquez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Isaza]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Orozco]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Restrepo]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Trujillo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tapia]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Immunopathologic study of erythema dyschromicum perstans (ashy dermatosis)]]></article-title>
<source><![CDATA[International Journal of Dermatology]]></source>
<year>2006</year>
<volume>45</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>937-41</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mahajan]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Chauhan]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Mehta]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Lath]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Erythema Dyshcromicus Perstans: Response to Topical Tacrolimus]]></article-title>
<source><![CDATA[Indian J Dermatol]]></source>
<year>2005</year>
<volume>60</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[I ríbar]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Herrero]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Escudero]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Eritema discrómico perstans o dermatitis cenicienta. A propósito de un caso]]></article-title>
<source><![CDATA[Aten Primaria]]></source>
<year>2003</year>
<volume>31</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>129-30</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ono]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Miyachi]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Kabashima]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ashy dermatosis with prior pruritic and scaling skin lesions]]></article-title>
<source><![CDATA[The Journal of Dermatology]]></source>
<year>2012</year>
<volume>39</volume>
<page-range>1-2</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chakrabarti]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Chattopadhyay]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ashy Dermatosis: A Controversial Entity]]></article-title>
<source><![CDATA[Indian J Dermatol]]></source>
<year>2012</year>
<volume>57</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>61-2</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Piquero]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Abrusci]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Briceño]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Gross]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mosca]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical trial with clofazimine for treating erythema dyschromicus perstans. Evaluation of cell- mediated immunity]]></article-title>
<source><![CDATA[Int J Dermatol]]></source>
<year>1989</year>
<volume>28</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>198-200</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jackson]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Nesbitt]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Differential diagnoses for the dermatologist]]></source>
<year>2012</year>
<edition>2</edition>
<publisher-loc><![CDATA[New York, USA ]]></publisher-loc>
<publisher-name><![CDATA[Springer]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
