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A form of progressive mucocutaneous pigmentation caused by singly dispersed melanosomes within keratinocytes.

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Universal Acquired Melanosis; Progressive Black Carbon Hyperpigmentation of Infancy.

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Two case reports. Inheritance pattern is undetermined.

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Diffuse and progressive hyperpigmentation that becomes generalized is present from early infancy on. Facial features include sparse scalp hair with decreased pigmentation, broad cheeks, long and bulbous nose, anomalies of the external female genitalia, and mental retardation. Histologic examination of the skin reveals a so-called “negroid pattern" in the epidermal melanosomes.

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Mental retardation may result in increased anxiety and limited cooperation. Sedative and anxiolytic premedication and the presence of the primary caregiver during induction of anesthesia may be helpful. No other specific anesthetic considerations. Rule out other (more common) diseases that may cause abnormal pigmentation. In the neonate, diffuse discoloration may be caused by adrenal insufficiency and should be excluded prior to surgery or anesthesia. A transient gray-brown color can be seen following phototherapy for hyperbilirubinemia.

Ruiz-Maldonado R, Tamayo L, Fernandez-Diez J: Universal acquired melanosis. The carbon baby. Arch Dermatol 114:775, 1978.  [PubMed: 646402]

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