Pigmentary Demarcation Lines

September 14, 2005
Eric J. Lewis, MD

,
Charles E. Crutchfield III, MD

The sharp transitions in pigmentation on the anterior surface of the arms of this 49-year-old black man were noted as an incidental finding. The arms' lateral aspects were distinctly more deeply pigmented than the medial aspects. In addition, a hyperpigmented band was present over each pectoral area, while a hypopigmented vertical stripe covered the sternum. These symmetric transitions in pigmentation are normal variants found most commonly in blacks and are known as pigmentary demarcation lines.

The sharp transitions in pigmentation on the anterior surface of the arms of this 49-year-old black man were noted as an incidental finding. The arms' lateral aspects were distinctly more deeply pigmented than the medial aspects. In addition, a hyperpigmented band was present over each pectoral area, while a hypopigmented vertical stripe covered the sternum. These symmetric transitions in pigmentation are normal variants found most commonly in blacks and are known as pigmentary demarcation lines.

Drs Eric J. Lewis and Charles E. Crutchfield III of Minneapolis report that there are at least five recognized patterns of pigmentary demarcation lines. They involve the following areas: the anterolateral aspects of the upper arms and across the pectoral region (known as Futcher's, or Voigt's, line)1; the posteromedial portion of the lower limbs; the presternal and parasternal areas overlain with a vertical hypopigmented line; the posteromedial area of spine; and the bilateral aspect of the chest, from the mid-third of the clavicle to the periareolar skin. Approximately three quarters of the black population have at least one pigmentary demarcation line, while perhaps 20% of white persons are so affected. It is more common in black women than in black men.2 Because these lines are normal occurrences and are not harmful, reassurance is the only treatment necessary.

REFERENCES:1. Williams DF, Kaplan DL. Common dermatoses of black skin: a guide to recognition and therapy. Consultant. 1998;38:189-199.
2. James WD, Carter JM, Rodman OG. Pigmentary demarcation lines: a population survey. J Am Acad Dermatol. 1987;16(3 pt 1):584-590.

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