Ashy dermatosis-like hyperpigmentation in a patient taking hydroxyurea

Ashy dermatosis is a pigmentary disorder on the spectrum of acquired macular pigmentation of uncertain etiology.1 It is most prevalent in patients from Central and South America and is characterized by widespread blue-gray macules with predilection for the face, neck, trunk, and upper extremities. Dermoscopy may show gray-blue dots corresponding to melanophages in the dermis, and histology demonstrates pigmentary incontinence of the papillary dermis. The etiology of ashy dermatosis is unknown but may involve a CD8+ T-lymphocyte–mediated antigen response at the basement membrane.

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