Erythema dischromicum perstans in a 15-year-old patient

Persistent pigmented erythema, also known as ashy dermatosis, is an acquired chronic
hyperpigmentation disorder first described in 1957 by Oswaldo Ramírez. In Guatemala,
the literature remains limited, making case documentation valuable for understanding its
prevalence, distribution, and clinical behavior. It is characterized by asymptomatic bluish-
gray macules located on the face, neck, and extremities, with histologic findings of dermal
melanophages and keratinocyte vacuolization. We present the case of a 15-year-old
female with progressive hyperpigmented lesions on the face and neck, without relevant
medical history or exposure to medications or chemicals. The diagnosis was confirmed
by skin biopsy. Treatment with dapsone 100 mg daily resulted in marked clinical improvement and significant reduction of the lesions after one month, demonstrating a
favorable therapeutic response.