Upper Gastrointestinal (GI) pseudomelanosis is an uncommon entity characterized by endoscopic visualization of speckled dark mucosal pigmentation.
Histochemical analysis revealed the pigment of pseudomelanosis to be mainly iron sulfide, exhibiting unpredictable staining patterns, hypothesized to be secondary to varying sulfur content and iron oxidation.
KEYWORDS: Duodenum, Melanosis, Pseudomelanosis, Stomach.
1 It should be noted that while 'melanosis' has been described previously in the gastrointestinal tract in colon and rectum, duodenal pseudomelanosis is rare with gastric pseudomelanosis being exceedingly rare with only few reported cases.
Because melanosis coli is not due to melanin pigmentation, the names pseudomelanosis
coli or lipofuscinosis coli have been suggested.
La coloracion negra del esofago puede deberse a melanoma maligno, pseudomelanosis
, acantosis nigricans, efecto adverso de medicamentos (quinidina y tetraciclina), ingestion de causticos, infeccion o exposicion a polvo de carbon; sin embargo, el termino <<esofago negro>> tiende a reservarse para denominar la necrosis esofagica aguda.
3,4) Differential diagnosis includes other causes of black colored esophagus with melanosis, pseudomelanosis
, malignant melanoma and acanthosis nigricans.
However, ease of access to laxatives renders them liable to abuse, and chronic administration can lead to complications like dehydration, hypokalaemia and pseudomelanosis coli (Capasso and Gaginella, 1997; Xing and Soffer, 2001).
The results of a recent prospective clinical study in 1095 patients undergoing coloscopic control are based on the coincidence of Pseudomelanosis coli (PMC; a brown/black pigmentation of the colonic mucosa) as a reliable marker of chronic anthranoid laxatives abuse and pathological diagnoses.
2) Altenburger et al (1) mentioned the detailed differential diagnoses of black esophagus, including melanosis, pseudomelanosis
, coal dust deposition, corrosive ingestion, and acanthosis nigricans.
4,6,8) It can be distinguished from melanosis and pseudomelanosis
using melanin and iron stains, if suspected.