Ashy Dermatosis: Histologic Findings and Potential Associations

In a 1981 study of nine patients with ashy dermatosis, researchers observed consistent histologic findings such as basal cell vacuolation, Civatte bodies, pigmentary incontinence, and a mild perivascular lymphohistiocytic infiltrate. Direct immunofluorescence microscopy showed IgM cytoid bodies in four cases, supporting the hypothesis that postinflammatory hyperpigmentation in ashy dermatosis may be due to basal cell apoptosis. The study also found a notable incidence of atopy (in five patients) and thyroid disease (in three patients), suggesting a potential association with these conditions. The authors argue that ashy dermatosis is a lichenoid reaction and may be related to other dermatoses through the process of apoptosis, and they recommend the use of topical steroids for treatment due to the condition's mildly inflammatory nature.