Hypomelanoses in children

Abstract

Hypomelanosis of the skin is a frequently encountered problem in childhood, being totally innocent or representing the first sign of a multisystem disorder. Medical history, clinical examination, Wood’s light investigation, histological analysis of the skin and a multidisciplinary consultation can contribute to a correct and early diagnosis of the different types of hypopigmentations. In the present paper, we present a systematic clinical approach to the differential diagnosis of those skin disorders.

Nevus depigmentosus: review of a mark of distinction

“…Both nevus depigmentosus and hypomelanosis of Ito were described coexisting in a manner representative of allelic twin spotting . Some believe that a linear or whorled pattern is a systematized form of ND, but this presentation is best viewed as hypomelanosis of Ito (HOI) . Spontaneous resolution is quite rare…”

“…Hypomelanosis of Ito (HOI), also known as incontinentia pigmenti achromians, is a neurocutaneous disorder that is usually evident at birth with bilateral, irregularly shaped hypopigmented patches often seen on the trunk and extremities . Hypopigmented patches can be whorled or streaked along the lines of Blaschko . Wood's lamp enhances HOI patches.…”

Management strategies for mycosis fungoides in India

“…[19] Hypopigmented MF which needs to be differentiated from vitiligo can be treated on similar lines of management with remission that lead to delayed diagnosis since both respond excellently to topical steroids and phototherapy. [20] A single patch/plaque, although rare, can be subjected to radiotherapy with expected complete response of up to 100%. [21]…”

Pityriasis Lichenoides et Varioliformis Acuta: Remission with Hypopigmentation

“…In a series of 124 children with PL, 91% showed postinflammatory pigmentary changes 3 ; 54% of patients with PLEVA and 56% of children with PLC had hypopigmentation, whereas 33% with PLEVA and 21% with PLC had hyperpigmentation. 4 Hypopigmented macules may even be the presenting sign of PL if patients are examined in an advanced state of the disease. As our case demonstrates, PL should be strongly considered if disseminated inflammatory papules regress with hypopigmented macules.…”

“…Other inflammatory and infectious conditions of childhood often healing with hypopigmentation include atopic dermatitis, pityriasis alba, lichen striatus, morphea, insect bites, lymphomatoid papulosis, mycosis fungoides, chickenpox, herpes zoster, impetigo, and pityriasis versicolor. 4 Hypopigmentation also may result from burns, scalding, and other injuries, topical or intralesional treatment with corticosteroids, and invasive procedures (cryotherapy, dermabrasion, laser treatment). In a series of 124 children with PL, 91% showed postinflammatory pigmentary changes 3 ; 54% of patients with PLEVA and 56% of children with PLC had hypopigmentation, whereas 33% with PLEVA and 21% with PLC had hyperpigmentation.…”