Dowling-Degos disease in a 23-year-old Jordanian male: a case report.

Abstract

Background: Dowling-Degos disease is a rare genodermatosis disorder that presents as an autosomal dominant trait during late childhood or in adolescence and is also known as reticulate pigmented anomaly of flexures, Dowling-Degos-Kitamura, or dark dot disease. Dowling-Degos disease is characterized by acquired reticular hyperpigmentation, and manifests as a clustered or reticulated pattern mainly at flexural sites, especially in the folds of the skin with comedone-like follicular papules and pitted perioral scars. It appears in both genders but is more likely in females.

Case presentation: A 23-year-old Jordanian male presented with progressive hyperpigmented macules and papules on his forehead, initially managed with Triderma cream without improvement. Histopathological examination via punch biopsies revealed features consistent with Dowling-Degos disease, excluding malignancy. Treatment was transitioned to sunblock, depigmenting agents (Isis Unit One 4 White), and moisturizers, resulting in significant fading of lesions after 8 months. Genetic counseling was provided owing to the hereditary nature of Dowling-Degos disease, and long-term management strategies were emphasized.

Conclusion: Dowling-Degos disease is a rare genodermatosis that can cause significant psychological distress and a decline in quality of life. Despite challenging treatment, a multidisciplinary approach is essential for improving patient outcomes and managing the elevated risk of skin cancers.