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Hypopigmentation is characterized specifically as an area of skin becoming lighter than the baseline skin color, but not completely devoid of pigment. This is not to be confused with depigmentation, which is characterized as the absence of all pigment.[1] which is caused by melanocyte or melanin depletion, or a decrease in the amino acid tyrosine, which is used by melanocytes to make melanin.[2] Some common genetic causes include mutations in the tyrosinase gene or OCA2 gene.[3][4] As melanin pigments tend to be in the skin, eye, and hair, these are the commonly affected areas in those with hypopigmentation.[2]
Hypopigmentation | |
---|---|
Other names | Tinea Versicolour |
Hypopigmentation in vitiligo. | |
Specialty | Dermatology |
Causes | Fungal Infection, Laser Resurfacing, Tyrosine deficiency, |
Hypopigmentation is common and approximately one in twenty have at least one hypopigmented macule. Hypopigmentation can be upsetting to some, especially those with darker skin whose hypopigmentation marks are seen more visibly. Most causes of hypopigmentation are not serious and can be easily treated by antifungal over the counter medication (see Tinea Versicolor & Malassezia).[5]
Presentation
Associated conditions
It is seen in:
- Tinea versicolor
- Injections of high concentrations of corticosteroids (transient)[1]
- Albinism [2]
- Idiopathic guttate hypomelanosis
- Leprosy
- Leucism
- Phenylketonuria [2]
- Pityriasis alba
- Vitiligo
- Angelman syndrome
- An uncommon adverse effect of imatinib therapy
Diagnosis
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Treatments
Often, hypopigmentation can be brought on by Laser resurfacing treatments; however, the hypopigmentation can be treated with other lasers or light sources.[6]
Treatment for hypopigmentation depends on the initial cause of the discoloration.
Initial Cause of Discoloration | Treatment |
Idiopathic guttate hypomelanosis | No treatment |
Postinflammatory hypopigmentation | Treat the underlying inflammatory disease to restore pigmentation |
Pityriasis versicolor | A topical ointment, such as Selenium sulfide 2.5% or Imidazoles.
Can also use oral medications, such as oral Imidazoles or Triazoles. |
Vitiligo | Topical steroids, including Calcineurin inhibitors.
Patients can also have transplants if they're stable or a depigmentation with topical MBEH if the patient has widespread discoloration. |
Chemical or drug induced leukoderma | Avoidance of causative agent with subsequent treatment similar to vitiligo. |
Piebaldism | None; occasionally transplants. |
See also
References
- ^ a b Shinkai, Kanade; Fox, Lindy (2018). "Dermatological Disorders". Current Medical Diagnosis & Treatment. New York, NY: McGraw-Hill.
- ^ a b c d Ferrier, Denise R. (2017). Biochemistry (Seventh ed.). Philadelphia. ISBN 978-1-4963-4449-6. OCLC 956263971.
{{cite book}}
: CS1 maint: location missing publisher (link) - ^ Bolognia, Jean; Braverman, Irwin (2014). "Skin Manifestations of Internal Disease". Harrison's Principles of Internal Medicine. New York, NY: McGraw-Hill.
- ^ Cross, Harold. "Biochemical Basis of Diseases". The Big Picture: Medical Biochemistry Eds. New York, NY: McGraw-Hill.
- ^ Hill, Jeremy P.; Batchelor, Jonathan M. (2017-01-12). "An approach to hypopigmentation". BMJ. 356: i6534. doi:10.1136/bmj.i6534. ISSN 0959-8138. PMID 28082370.
- ^ Reszko, Anetta; Sukal, Sean A.; Geronemus, Roy G. (14 July 2008). "Reversal of Laser-Induced Hypopigmentation with a Narrow-Band UV-B Light Source in a Patient with Skin Type VI". Dermatologic Surgery. 34 (10): 1423–1426. doi:10.1097/00042728-200810000-00021.
- ^ Harrison's principles of internal medicine. Longo, Dan L. (Dan Louis), 1949-, Fauci, Anthony S., 1940-, Kasper, Dennis L., Hauser, Stephen L., Jameson, J. Larry., Loscalzo, Joseph. (18th ed.). New York: McGraw-Hill. 2012. ISBN 9780071748902. OCLC 747712285.
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: CS1 maint: others (link)
External links