Vitiligo is a common pigmentary depigmentation disorder. The pigment cells or melanocytes are located at the base of the epidermis and produce the protein melanin. The most commonly prescribed treatment for tinea versicoloris to just apply an antifungal lotion or wash to the affected area. What caused this hyperpigmented reticulated rash on this. Hypopigmented patches in infant with a history of seizures. Causes of hypopigmented patches of skin and itchy rash. Whilst hypopigmentation simply means a lack of pigment in the skin, there can be a number of different causes. Excimer lasers are the same type used in lasik eye surgery. On examination, faint hypopigmented macules and patches with areas of fine scale are noted. Adolescent female presents with discoloration on her back. These include granulomatous, pustular, purpuric, hyperkeratotic and verrucous. A welldefined, hypopigmented, irregularly shaped, confluent macules forming a patch that is usually found on the trunk. Common pigmentation disorders american family physician. It presents at birth or early in childhood and persists in to adulthood remaining unchanged.
Hydroquinone is actually a skin whitening agent, but it has been used to help blend hypopigmented areas in to the skins natural surrounding color. Hypopigmented patches of skin and skin symptoms symptom. Case presentation a 7yearold girl presents with a small number of hypopigmented macules on her back that have been present for about three months figure 1. The following causes of hypopigmented patches of skin appear in the population at a rate of less than 200,000 people per year in the usa. For people with darker skin, hypopigmentation may also result in stigma.
Nov 26, 2019 a macule is a flat, distinct, discolored area of skin less than 1 centimeter cm wide. Lichen sclerosis et atrophicus a chronic skin disease characterized by shiny, white atrophic skin patches which tend to occur on the neck, genital areas, around the anus, under the breasts and in body foldsread more. Sep 09, 2012 a 55yearold ghanaian woman presented with a 1year history of worsening hyperpigmentation of the skin on the arms, chest, face and buttocks. Here are the causes of white spots on skin, splotches, bumps, dots and light patches as well as treatments to. Hypopigmented macules in pityriasis lichenoides chronica hypopigmented macules in postinflammatory hypopigmentation macule patch cyst nodule papule plaque crust scale bullae pustule vesicle erythema erythroderma telangiectasia ecchymosis petechiae palpable purpura atrophy erosion ulcer eschar gangrene. An important consideration in the differential diagnosis of ppd is mycosis fungoides mf. Melasma an example of hyperpigmentation is melasma. The topic hypopigmented patches on the skin you are seeking is a synonym, or alternative name, or is closely related to the medical condition vitiligo. This is usually several centimetres in diameter, with an irregular but welldefined border. Hypopigmented macules and patches clinical advisor. He complains that the patch feels dry and that he has lost.
These lesions are most commonly located on the back. The patch had been stable in shape, distribution, texture, and relative size since then. On physical examination, he has hypopigmented round patches with fine cigarettepaper scaling centrally located on his proximal arms, hips, thighs, lateral chest wall, and flanks. Disorders of hypopigmentation may also pose diagnostic challenges. Hypopigmentation is the absence of normal amounts of melanin the chemical that gives skin its color caused by disease, injury, burns or other trauma to the skin. White patches developed on spots where corticosteroid was applied. In the right conditions, such as warm, oily, and moist skin, the yeast malassezia can overgrow and cause a rash consisting of tan, pink, brown, or. As most malassezia species are lipiddependent, pytiriasis versicolor is commonly seen in adolescence, associated with a high sebaceous activity in the. Some of the lesions coalesce to form irregularly shaped patches. Hypopigmented patches of skin and itchy rash symptom. Patches also called large macules may have nonpalpable fine scale. Hypopigmentation white or lighter areas of skin colour.
A 55yearold ghanaian woman presented with a 1year history of worsening hyperpigmentation of the skin on the arms, chest, face and buttocks. White macular lesions on a girls back medicine today. It doesnt involve any change in the thickness or texture of the skin. When the cause of the post postinflammatory hypopigmentation is removed, most people get spontaneous improvement within a period of weeks or months. This will typically take a month to a year 2, but can extend into years. There are topical medications that sometimes help, and lightbased procedures like ipl, excimer lasers, and the fraxel restore laser can also. In localized hypopigmentation, there may be multiple patches or areas on the skin that appear. A 35yearold refugee from bhutan, a country in south asia, presents complaining of a hypopigmented skin patch on his right arm. Most causes of hypopigmentation are not serious and can be easily treated. Although a topup treatment was then needed every 1 to 4 months to maintain. Jan 22, 2016 hypopigmented patches on the back of neck. Hypopigmentation developed around the scar in the form of a halo about 2 weeks after the last injection and a linear hypopigmented streak progressed proximally over the forearm. Daniel jun yi wong, medical student, university of melbourne, australia, 20. Hypopigmentation refers to patches of skin that are lighter than your overall skin.
Tinea versicolor pityriasis versicolor dermatology advisor. But they have also been used very effectively for years now in treating hypopigmented scars and stretch marks. If the lesions are hypopigmented, the name pityriasis versicolor alba has been used. Author and disclosure information the location of the pruritic area on this patients back and the darkened patch that followed helped us to identify the cause of her chronic discomfort.
Nevus depigmentosus nevus achromicus is an uncommon birthmark occurring in 0. 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. A 36yearold woman with continuous pain in the sacral region developed erythema ab igne over a 2month period. A 1550nm fraxel laser was used to treat all 7 patients. The patient stated he has had severe back pain associated with the schwannoma and has been using a heating pad for relief every. Some of the lesions coalesce to form irregularly shaped. Dec 04, 2017 hypopigmentation is the loss of skin pigment or color. A woman with an itchy hyperpigmentation on her back. Welldemarcated finely scaling patches, hyper or hypopigmentations are found on clinical examination. Hypopigmented and scaly lesions on a boys cheek medicine today. Pityriasis alba is a common skin condition limited to children and adolescents.
Fourmonthold hispanic boy brought for evaluation because of hypopigmented patches on his skin and a history of seizures. Adolescent female presents with discoloration on her back and. However, examination with a woods light, a skin biopsy, and additional laboratory tests may be required if the clinical diagnosis is uncertain. Dec 07, 2017 hypopigmentation refers to patches of skin that are lighter than your overall skin tone. Hypopigmentation can be upsetting to some, especially those with darker skin whose hypopigmentation marks are seen more visibly. Wellcircumscribed hypopigmented patch on the cheek that was present at birth. The melanocytes of darkskinned people produce more melanin than those of people with light skin.
Hypopigmented patches of skin and vulvar lesion symptom. Tinea versicolor, also known as pityriasis versicolor, is a common noncancerous benign skin condition caused by surface superficial infection with a yeast that commonly lives on the skin. The lesion morphology, color hypopigmented or depigmented, distribution, and pattern are important clues to the diagnosis. Causes of hypopigmented patches of skin that are rare the offical us government definition of a rare disease is one that affects 200,000 people or less. In localized hypopigmentation, there may be multiple patches or areas on the skin that appear white. White patches on skin pictures, fungus, treat, get rid of dry. She reported using a hot water bottle for pain relief during this time.
Common causes of hyperpigmentation include postinflammatory hyperpigmentation, melasma, solar lentigines, ephelides freckles, and cafeaulait macules. Linear hypopigmentation after intralesional or intraarticular injection of triamcinolone acetonide has been reported as a very rare adverse effect. Hypopigmentation is common and approximately one in twenty have at least one hypopigmented macule. By joana sequeira, md diogo pereira, md claudia rainho, md. A hypopigmented patch on a 7yearolds back consultant360. Asymptomatic hypopigmented macules and patches mdedge. It can present with irregular hypopigmented patches with variably distinct. My face is looking very uneven after laser treatment. Stroking, rubbing, or warming induces erythema of the adjacent normal skin. Racehypopigmented patches occur in all racial groups but are much more. That is, the repaired skin lacks normal pigment leaving them white.
An infant with hypopigmented macule photo quiz american. Melanin is carried by keratinocytes to the skin surface. Hypopigmented patches on the skin dermatology jama. Infant was the product of an uncomplicated pregnancy. In some people, the white patches start as dry itchy spots on face, back, arms and legs. The patches are oval in shape and have spared other parts of the body. Achromic naevus is an uncommon birthmark naevus characterised by a welldefined pale patch. A 14monthold caucasian male presented with a hypopigmented patch associated with increased perspiration on the right side of his back, flank, and abdomen. How can hypopigmentation be treated in an infant read medical advice by top doctors. The shagreen patch, a fleshy, irregular plaque often found on the lower back, is another characteristic finding in patients with tuberous sclerosis. The defining clinical features of hmf are hypopigmented toachromic lesions, sometimes with a vitiligolike aspect, which are mainly distributed on the trunk and proximal portions of the extremities, especially the buttocks, as well as the pelvic girdle and the lower limbs.
This brings the yeast back under control and the patches typically disappear fairly quickly, sometimes within days although it can take a month or two. Hypopigmented macules, also known as ashleaf spots, can be present at. Jan 01, 20 our patient developed erythema ab igne on his back and flank following nightly use of a heating pad to his back for 1 year to relieve his tumorassociated pain. Numerous round and oval, hypopigmented, slightly scaling patches on the upper back. They are not typically as large as the lesions seen in this patient and the presence of multiple simultaneously hypopigmented lesions would be unusual. At 4 weeks after the last injection, the hypopigmented streak stopped progressing and the lesion on the wrist started to repigment. The face, hands, forearms, chest, back and shins are the most. At birth, he had multiple hypopigmented patches on his face, torso. Nevus depigmentosus is characterized by a congenital, asymptomatic, nonprogressive, hypopigmented macule or patch that is stable in shape. Pathophysiology this organism is part of the normal skin flora, especially in areas of sebaceous prominence, and conditions such a high heat and humidity or other predisposing factors allow.
A macule is a flat, distinct, discolored area of skin less than 1 centimeter cm wide. A 7yearold girl presents with a small number of hypopigmented macules on her back that have been present for about three months figure 1. The macules are well circumscribed and each has a central raised lesion. Hyperpigmented patch on the leg mdedge dermatology. The name of the condition comes from pityriasis meaning flakingscaly skin, and the latin word for white, alba. Leung, md, and benjamin barankin, md a 7yearold boy presented with an asymptomatic light patch on his back that had been first noted in the neonatal period. Closer examination of individual lesions reveals a fine white scale. Mycosis fungoides is a cutaneous tcell lymphoma that clinically presents as a single or multiple hypopigmented or hyperpigmented patches or as erythematous. The patches occur mostly on the chest, back and arms. Hypopigmentation is the loss of skin pigment or color. This is not to be confused with depigmentation, which is characterized as the absence of all pigment.
Another case has been reported 7 a an 11yearold girl had an elevated scar on the back of her wrist, which had. That is, with your eyes closed, you cannot discern a boundary to the lesional area. Hypopigmentation refers to patches of skin that are lighter than your overall skin tone. The idea being to lessen the contrast between the two areas. But if the melanocytes that give skin color are destroyed. Coalescing hypopigmented patches of tinea versicolor. A 30yearold woman with no significant past medical history presented with asymptomatic hypopigmented macules and patches on her back. Your skins pigmentation, or color, is based on the production of a substance called melanin. Apr 01, 2007 the shagreen patch, a fleshy, irregular plaque often found on the lower back, is another characteristic finding in patients with tuberous sclerosis. Hypopigmented patch without sensation clinical advisor.
Hypopigmented patches of skin and skin symptoms and paleness 4 causes hypopigmented patches of skin and skin symptoms and skin color changes 4 causes hypopigmented patches of skin and skin symptoms and skin problems 4 causes hypopigmented patches of skin and skin symptoms and hair loss 3 causes. Conditions to include in the differential diagnosis include the following. It is caused by melanocyte or melanin depletion, or a decrease in the amino acid tyrosine, which is used by melanocytes to. A 32yearold male with a past medical history of recurrent t12l1 leftsided schwannoma presented with a 1year history of a hyperpigmented lesion in the midlower back figures 1 and 2, left to right. If you have post inflammatory hypopigmentation from a skin injury or skin rejuvenation procedure, you may want to wait before seeking treatment. The hypopigmentation is oriented linearly, spreads proximally, and may or may not be associated with skin atrophy. Hyperpigmentation can also be caused by various drugs, including some antibiotics, antiarrhythmics, and antimalarial drugs. Jan 31, 2020 another study published in dermatologic surgery in 2007, was done on hypopigmented scars on the faces of 7 patients. If it is macular, you cannot feel the involved area. See detailed information below for a list of 11 causes of hypopigmented patches of skin, symptom checker, including diseases and drug side effect causes. A hypopigmented patch on a 7yearolds back alexander k. Tinea versicolor is a common superficial fungal infection of the stratum corneum caused by the lipophilic yeast malassezia furfur pityrosporum orbiculare. White patches on skin are caused by vitiligo, skin fungus, loss of pigment, sun exposure or tanning etc.
Jan 15, 2009 common causes of hyperpigmentation include postinflammatory hyperpigmentation, melasma, solar lentigines, ephelides freckles, and cafeaulait macules. The white hypopigmented areas will return to normal by themselves over time. Differential diagnosis conditions to include in the differential diagnosis include the following. Hypopigmented patches on the skin dermatology jama jama.
Hypopigmentation can be upsetting, particularly if visible. Hypopigmented definition of hypopigmented by medical. Pruritic hyperpigmented patch on back mdedge family medicine. Pigmentation disorders are often more troublesome in skin of colour. Hypopigmented patches doctor answers on healthcaremagic. List of 21 causes for hypopigmented patches of skin and vulvar lesion, alternative diagnoses, rare causes, misdiagnoses, patient stories, and much more. Extensive pityriasis alba is believed to be a primary, acquired hypopigmentation observed in females aged 1825 years of mixed ethnic origin. A study was done back in 2004 which showed a 100% correction in skin color after just 9 treatments. Common hypopigmented patches queries answered by top. What caused this hyperpigmented reticulated rash on this man.