A case of non‐rhododendrol whitening cosmetics‐induced leukoderma

Abstract

Among the five kinds of whitening cosmetics that the patient had used, four contained 2L-ascorbic acid-glucoside (AA-2G), which is a stabilized derivative of ascorbic acid, and one contained β-arbutin, which is made from hydroquinone. Both of them are listed as quasi-drugs for the labeling of ingredient names in Japan; they are commonly found in Japan and have been used as safe whitening agents for a long time. It remains unclear whether the AA-2G, β-arbutin, or another ingredient caused the leukoderma in the present case.In the present case, the leukoderma was not significantly improved and new lesions appeared even after discontinuation of the causative agents, as has been reported in some cases of rhododendrol-induced leukoderma. However, the leukoderma was alleviated with the use of topical tacrolimus ointment. The clinical course suggests that an autoimmune response might have been triggered by the long-term use of whitening agents 5 and involved in the pathogenesis of the leukoderma in the present case.We believe the accumulation of data from similar cases in the future is necessary for elucidating the pathological mechanism of whitening agent-induced leukoderma.