A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary systemthe organ system that encloses the body and includes skin, hair, nails, and related muscle and glands. Lesions consist of scaly hyper andor hypopigmented macules that coalesce into patches. Around 1 in 20 people have at least one hypopigmented macule. Jun 06, 2016 hypopigmented, finely scaled macules and patches on the trunk and extremities of darkerskinned individuals have a wide clinical differential diagnosis in a dermatologic encounter. Erythema, scale, and papules within these macules and patches are variable.
Most commonly, this type of rash can be attributed to a benign etiology such as tinea versicolor, idiopathic guttate hypomelanosis, pityriasis alba, and vitiligo. Learn vocabulary, terms, and more with flashcards, games, and other study tools. In the case of hypopigmentation after laser hair removal for example, this will normally repigment by itself. Dec 07, 2017 hypopigmentation refers to patches of skin that are lighter than your overall skin tone. Hyperhidrosis is the most important predisposing factor. Hypopigmented macules secondary to imatinib for the treatment of chronic. Malassezia requires an oily environment for growth. These spots began appearing about 7 months earlier and were asymptomatic. Hypopigmentation can be upsetting to some, especially those with darker skin whose hypopigmentation marks are seen more visibly.
Early ctcl often lacks the histologic criteria necessary for a definitive diagnosis. The idea being to lessen the contrast between the two areas. Cases have been reported in both the first and second decades of life. The patient indicated that she had evacuated new orleans following hurricane katrina by wading through polluted waters for hours before being rescued. Hypopigmented macules are the earliest cutaneous finding in tuberous sclerosis ts. The following causes of hypopigmented patches of skin appear in the population at a rate of substantially less than 200,000 people per year in the usa.
Tinea versicolor tv, or pityriasis versicolor, is a noninflammatory, superficial cutaneous fungal infection caused by malassezia furfur. Macules may be a sign of something serious or mean absolutely nothing at all. The melanocytes of darkskinned people produce more melanin than those of people with light skin. Hypopigmentation is the loss of skin color due to a disease or trauma. Hyperpigmented lesions may have a pink, tan, brown, violaceous, gray or black hue. Hypopigmented definition of hypopigmented by medical dictionary. Amelanotic macules or patches surrounded by normal skin with discrete, usually convex, margins. Causes of hypopigmented patches of skin without any prevalence information. That is, you can sometimes end up with hypopigmented skin following certain laser treatments.
A preterm male infant in the nicu develops a rash with erythematous and hypopigmented macules, patches, and papules of the arms, axillae, neck, upper back, groin, and legs. A diffuse bluish patch that was suspected to be an aberrant mongolian spot surrounded the hypopigmented areas. Four days passed before she had access to a shower, and thats when. A child presented with multiple, asymptomatic, scattered white macules on the lower abdomen and pubic area, which were present at birth and had gradually increased in size and number. It usually presents as patches, plaques, nodules, or tumors although. Hypopigmented macules jama dermatology jama network.
Most causes of hypopigmentation are not serious and can be easily treated. In this article, learn about the different types of. The physical examination revealed numerous hypopigmented macules on her thighs figs 1 and 2. However, they are also common in the general population, which raises the question of when a patient with one or more hypopigmented macules should be evaluated for ts. Some of the lesions coalesce to form irregularly shaped patches.
Dermoscopy of hypopigmented lesions in children full. Note the characteristic, illdefined, hypopigmented macules in this. Your skins pigmentation, or color, is based on the production of a substance called melanin. The major function of this system is as a barrier against the external environment.
Hypopigmented macules, also known as ashleaf spots, can be present at birth and are most common on the trunk and lower extremities. Therapies include sodium stibogluconate, amphotericin b andor paromomycin. There are a whole range of treatment approaches available. Progressive macular hypomelanosis of note, there are subsets of lichen striatus. Hypopigmented macules and patches in infants have a variety of etiologies such as pityriasis alba, nevus depigmentosus, nevus anemicus, ashleaf spot in tuberous sclerosis, and uncommonly, pv. An infant with hypopigmented macule photo quiz american. Nov 12, 2019 in its hyphal form, it produces skin lesions that appear as scaly, round or oval, hypopigmented, hyperpigmented, or pink macules or patches. It presents with perioral hypopigmented macules that converge into irregular patches to spread to the malar region, forehead and scalp. The shagreen patch, a fleshy, irregular plaque often found on the lower back, is another characteristic finding in patients with tuberous sclerosis. It presents as flat, scaly and hypopigmented patches and. Hypopigmentation is common and approximately one in twenty have at least one hypopigmented macule. Nov 26, 2019 macule is just a word that doctors use to describe what they see on the skin. Report of a case a 68yearold black woman complained of an increasing number of white spots on her arms and legs. Mf is an uncommon clinical variant of mf characterized by hypopigmented macules.
Hypopigmented macules, also known as ashleaf spots, can be present at. Aug 01, 2017 pubmed is a searchable database of medical literature and lists journal articles that discuss macules hereditary congenital hypopigmented and hyperpigmented. Well to illdefined hypopigmented macules with smooth. Check the full list of possible causes and conditions now. Malassezia species are commensal flora of the skin and its colonization is established at. Hypopigmentation can be upsetting, particularly if visible. Spontaneous disappearance of hypopigmented macules and patches. Sun exposure may increase the contrast with normal skin, prompting patients. In the case of illness or injury, the persons skin may change color, becoming darker hyperpigmentation or lighter hypopigmentation. Extensive pityriasis alba is believed to be a primary, acquired hypopigmentation observed in females aged 1825 years of mixed ethnic origin. Psep appears as smooth, oval or round hypopigmented macules or patches. Hypo pigmented skin lesions are commonly encountered in daytoday practice, and they pose a diagnostic challenge for the clinician. Pityriasis alba, a relatively common skin disorder in children and young adults, is characterized by the presence of illdefined, scaly, faintly erythematous patches.
A child with multiple hypopigmented macules on the abdomen. Hypopigmented definition of hypopigmented by medical. Its course is indolent for several years and thus source of delayed diagnosis. In its hyphal form, it produces skin lesions that appear as scaly, round or oval, hypopigmented, hyperpigmented, or pink macules or patches. Hypopigmentation white or lighter areas of skin colour. These lesions eventually subside, leaving hypopigmented areas that then slowly return to. Malassezia species are commensal flora of the skin and its colonization is established at birth and increases with age 4. Physical examination revealed multiple, welldemarcated, hypopigmented 1 to 5mm macules on the lower abdomen and pubic area figure, a and b. The pigment cells or melanocytes are located at the base of the epidermis and produce the protein melanin.
Lesions coalesced into patches over the midline back. On examination, faint hypopigmented macules and patches with areas of fine scale are noted. Macules can be seen on any part of the body, but are most frequently found on the chest, back, face, and arms. Figure 2 persistent smooth, hypopigmented patches of pityriasis alba on the face.
Acquired hypopigmentation disorders other than vitiligo uptodate. Hypopigmented, finely scaled macules and patches on the trunk and extremities of darkerskinned individuals have a wide clinical differential diagnosis in a dermatologic encounter. Hypopigmented macules and patches clinical advisor. These include granulomatous, pustular, purpuric, hyperkeratotic and verrucous, bullous, invisible, and. Mycosis fungoides mf, the most common primary cutaneous tcell lymphoma, is a neoplasic disease characterized by classical noninfiltrated lesions patches, plaques, tumors, and erythrodermic stages. As with many things, laser therapy can be both cure and cause.
Macule is just a word that doctors use to describe what they see on the skin. A 52yearold african american woman sought care for a hypopigmented rash that shed had for 7 months. Conditions of the human integumentary system constitute a broad spectrum of diseases, also. Causes of hypopigmented patches of skin that are very rare. Click on the link to view a sample search on this topic. The disease has predilection for darkskinned individuals. Lesions consist of scaly hyper and or hypopigmented macules that coalesce into patches. Management is similar to hmf, and if treated with narrowband uvb phototherapy, it can resolve within two years. Such light patches can occur at birth or in early infancy. Lesions were also present on her upper extremities and. The shagreen patch, a fleshy, irregular plaque often found on the.
Dec 04, 2017 hypopigmentation is the loss of skin color due to a disease or trauma. This area of decreased pigment hypopigmentation is referred to as an ash leaf macule and is seen with the inherited disorder, tuberous sclerosis. Progressive macular hypomelanosis pmh presents as asymptomatic, illdefined hypopigmented macules and patches on the trunk and back. This clinical variant of the classic pityriasis alba cpa is most common among children, and it is characterized by hypopigmented macules and. Parentalguardian consent was obtained for publication of this figure.
Asymptomatic hypopigmented macules and patches mdedge. Pigmentation disorders are often more troublesome in skin of colour. The rash was on her upper thighs and arms in a symmetric distribution. The patches may have slight and subtle surface patches scale.
Apr 01, 2007 an infant with a hypopigmented macule. Hypopigmented mycosis fungoides hmf is an atypical, rare and unique variant of mycosis fungoides characterized by solely hypopigmented patches or in combination with erythematous patches or plaques. People often think that pityriasis alba gets worse in the summer, but it just becomes more obvious as the normal, surrounding skin becomes darker with sun exposure. Disorders of hypopigmentation may also pose diagnostic challenges. It can affect people from birth or develop later in life. Hypopigmented lichen striatus with minimal papules has been termed lichen striatus albus. Pityriasis alba is characterized by oval but poorly demarcated, slightly scaly, hypopigmented macules or patches located on the face typically the cheeks, upper trunk, or extensor surfaces of the arms fig. They are one of the commonest complains in the dermatology clinics and generally share the same patient complaint which is characterized by the presence of hypo or depigmented patches or macules. This area of decreased pigment hypopigmentation is referred to as an ash leaf macule and is seen with the. A 55yearold white man presented with multiple hypopigmented macules, mainly on both forearms and shins, which had been present for several years. Pubmed is a searchable database of medical literature and lists journal articles that discuss macules hereditary congenital hypopigmented and hyperpigmented. The problem is it can take months without additional treatment. This is usually several centimetres in diameter, with an irregular but welldefined border. Occasionally, the condition begins as mildly itchy, pink patches that develop into hypopigmented patches.
Hypopigmented macules, also known as ashleaf spots, can be present at birth and are most common on. An infant with a hypopigmented macule american academy of. Neonate with a hypopigmented rash american academy of. Achromic naevus is an uncommon birthmark characterised by a welldefined pale patch. Hydroquinone is actually a skin whitening agent, but it has been used to help blend hypopigmented areas in to the skins natural surrounding color. The condition is unusual in children but when it occurs the lesions are usually on the face unlike in adults, for whom the lesions are most commonly on the torso. They may be hypopigmented lighter than the surrounding skin, hyperpigmented darker than the surrounding skins, or appear pink or red. A woods light examination highlights the macules and helps to identify them in fairskinned patients. Treatment failure and disease relapse are common and difficult to differentiate from delayed repigmenation. List of 11 disease causes of hypopigmented patches of skin, patient stories, diagnostic guides. For people with darker skin, hypopigmentation may also result in stigma. Melanin is carried by keratinocytes to the skin surface.
Common pigmentation disorders american family physician. If you have a skin lesion or many that is flat and less than 1 cm in size, and want to find out whats. Often, smaller hypopigmented macules arise around the edges, resembling a splash of paint. Oval ash leaf hypopigmented macules are the earliest cutaneous sign of tuberous sclerosis.
The patient recalled that the lesions initially had begun approximately 10 years ago as a few small lighter areas on the extensor aspect of the forearms and shins. Progressive macular hypomelanosis plastic surgery key. Tinea versicolor tv, or pityriasis versicolor, is a noninflammatory, superficial cutaneous fungal infection caused by malassezia furfur, also known as pityrosporum orbiculare or p. Hypopigmentation refers to patches of skin that are lighter than your overall skin tone. In some people, these patches can appear all over the body. Asymptomatic hypopigmented macules on the trunk and limbs of a. Mf is an uncommon clinical variant of mf characterized by hypopigmented macules and papules without atrophy fig.
Lesions often occur on the head, neck, upper extremities, trunk, and buttocks. Spontaneous disappearance of hypopigmented macules and. See detailed information below for a list of 11 causes of hypopigmented patches of skin, symptom checker, including diseases and drug side effect causes. Hypopigmented lesions in a teenaged girl contemporary. Diagnostic checklist, medical tests, doctor questions, and. The rash has a geometric pattern in areas of occlusion ie, under leads and wires and maceration with white exudate in the axillae fig 1.
The distribution is patchy and there are often large numbers of macules that can coalesce and produce larger lesions. Hypopigmented mf presents with hypopigmented macules and patches. White spots on legs causes and fast home remedies skincarederm. A concise approach to childhood hypopigmentation ncbi.