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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Confetti-like Sparing</title>
<author><name sortKey="Wu, Douglas C" sort="Wu, Douglas C" uniqKey="Wu D" first="Douglas C." last="Wu">Douglas C. Wu</name>
<affiliation><nlm:aff id="A1">Goldman, Butterwick, Groff, Fabi and Wu Cosmetic Laser Dermatology, San Diego, California;</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fitzpatrick, Richard E" sort="Fitzpatrick, Richard E" uniqKey="Fitzpatrick R" first="Richard E." last="Fitzpatrick">Richard E. Fitzpatrick</name>
<affiliation><nlm:aff id="A2">Goldman, Butterwick, Fitzpatrick, Groff and Fabi: Cosmetic Laser Dermatology, San Diego, California</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Goldman, Mitchel P" sort="Goldman, Mitchel P" uniqKey="Goldman M" first="Mitchel P." last="Goldman">Mitchel P. Goldman</name>
<affiliation><nlm:aff id="A2">Goldman, Butterwick, Fitzpatrick, Groff and Fabi: Cosmetic Laser Dermatology, San Diego, California</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">27047632</idno>
<idno type="pmc">4771390</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771390</idno>
<idno type="RBID">PMC:4771390</idno>
<date when="2016">2016</date>
<idno type="wicri:Area/Pmc/Corpus">000060</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000060</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Confetti-like Sparing</title>
<author><name sortKey="Wu, Douglas C" sort="Wu, Douglas C" uniqKey="Wu D" first="Douglas C." last="Wu">Douglas C. Wu</name>
<affiliation><nlm:aff id="A1">Goldman, Butterwick, Groff, Fabi and Wu Cosmetic Laser Dermatology, San Diego, California;</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fitzpatrick, Richard E" sort="Fitzpatrick, Richard E" uniqKey="Fitzpatrick R" first="Richard E." last="Fitzpatrick">Richard E. Fitzpatrick</name>
<affiliation><nlm:aff id="A2">Goldman, Butterwick, Fitzpatrick, Groff and Fabi: Cosmetic Laser Dermatology, San Diego, California</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Goldman, Mitchel P" sort="Goldman, Mitchel P" uniqKey="Goldman M" first="Mitchel P." last="Goldman">Mitchel P. Goldman</name>
<affiliation><nlm:aff id="A2">Goldman, Butterwick, Fitzpatrick, Groff and Fabi: Cosmetic Laser Dermatology, San Diego, California</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of Clinical and Aesthetic Dermatology</title>
<idno type="ISSN">1941-2789</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Diagnostic uncertainty when a patient presents with melasma-like Undings can lead to suboptimal treatment and inaccurate prognostic expectations. In this study, the authors present a unique clinical feature of melasma that they term the “Fitzpatrick macule” and test its Utility in establishing diagnostic certainty. The “Fitzpatrick macule” is a confetti-like macule of regularly pigmented skin located within a larger patch of melasma hyperpigmentation. To test its diagnostic Utility, the authors compared clinical photography of known cases of melasma with common mimickers, such as poikiloderma of Civatte and solar lentiginosis, and determined the positivity rate of the Fitzpatrick macule in each scenario. Their results show that 89.1 percent of clinical photographs of melasma were positive for the presence of Fitzpatrick macules compared to 1.1 percent that were negative. In contrast, 37.5 and 56.3 percent of clinical photographs of poikiloderma of Civatte were positive and negative for Fitzpatrick macules, respectively. Solar lentiginosis showed a 5.6 percent positivity and a 77.8 percent negativity for Fitzpatrick macules. The sensitivity and specificity of Fitzpatrick macules for melasma was 99 and 83 percent, respectively. In summary, the authors report a highly sensitive and specific clinical feature of melasma. In cases of diagnostic uncertainty, the presence of Fitzpatrick macules may aid in establishing a diagnosis of melasma.</p>
</div>
</front>
</TEI>
<pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Aesthet Dermatol</journal-id>
<journal-id journal-id-type="iso-abbrev">J Clin Aesthet Dermatol</journal-id>
<journal-id journal-id-type="publisher-id">JCAD</journal-id>
<journal-title-group><journal-title>The Journal of Clinical and Aesthetic Dermatology</journal-title>
</journal-title-group>
<issn pub-type="ppub">1941-2789</issn>
<publisher><publisher-name>Matrix Medical Communications</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27047632</article-id>
<article-id pub-id-type="pmc">4771390</article-id>
<article-id pub-id-type="other">jcad_9_2_48</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>Confetti-like Sparing</article-title>
<subtitle>A Diagnostic Clinical Feature of Melasma</subtitle>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Wu</surname>
<given-names>Douglas C.</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fitzpatrick</surname>
<given-names>Richard E.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Goldman</surname>
<given-names>Mitchel P.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<aff id="A1"><label>a</label>
Goldman, Butterwick, Groff, Fabi and Wu Cosmetic Laser Dermatology, San Diego, California;</aff>
<aff id="A2"><label>b</label>
Goldman, Butterwick, Fitzpatrick, Groff and Fabi: Cosmetic Laser Dermatology, San Diego, California</aff>
</contrib-group>
<author-notes><corresp><bold>ADDRESS CORRESPONDENCE TO:</bold>
Douglas C. Wu, MD, PhD; E-mail: <email xlink:type="simple">dwu@clderm.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>2</month>
<year>2016</year>
</pub-date>
<volume>9</volume>
<issue>2</issue>
<fpage>48</fpage>
<lpage>57</lpage>
<abstract><p>Diagnostic uncertainty when a patient presents with melasma-like Undings can lead to suboptimal treatment and inaccurate prognostic expectations. In this study, the authors present a unique clinical feature of melasma that they term the “Fitzpatrick macule” and test its Utility in establishing diagnostic certainty. The “Fitzpatrick macule” is a confetti-like macule of regularly pigmented skin located within a larger patch of melasma hyperpigmentation. To test its diagnostic Utility, the authors compared clinical photography of known cases of melasma with common mimickers, such as poikiloderma of Civatte and solar lentiginosis, and determined the positivity rate of the Fitzpatrick macule in each scenario. Their results show that 89.1 percent of clinical photographs of melasma were positive for the presence of Fitzpatrick macules compared to 1.1 percent that were negative. In contrast, 37.5 and 56.3 percent of clinical photographs of poikiloderma of Civatte were positive and negative for Fitzpatrick macules, respectively. Solar lentiginosis showed a 5.6 percent positivity and a 77.8 percent negativity for Fitzpatrick macules. The sensitivity and specificity of Fitzpatrick macules for melasma was 99 and 83 percent, respectively. In summary, the authors report a highly sensitive and specific clinical feature of melasma. In cases of diagnostic uncertainty, the presence of Fitzpatrick macules may aid in establishing a diagnosis of melasma.</p>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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