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Therapeutic Approach

Erythema dyschromicum perstans is a rare, slowly progressive skin disorder characterized by gray-blue hyperpigmented macules and patches. Several therapies have been trialed in patients, often with little improvement. No consensus in the treatment of this disease has been reached. In the authors’ experience, topical tacrolimus or corticosteroid is initiated first and can subsequently be used in combination with oral corticosteroid or narrowband UVB phototherapy. Isotretinoin is generally reserved for refractory cases. See Table 67-1.

Table 67-1Erythema Dyschromicum Perstans Treatment Table

Levels of evidence are based on the Journal of the American Academy of Dermatology guidelines: level IA evidence includes evidence from meta-analysis of randomized controlled trials; level IB evidence includes evidence from ≥1 ...

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