Clinical and histopathological study of postinflammatory hypopigmented macular skin lesions

Abstract

INTRODUCTIONThe color of normal skin comes from a mixture of pigments, of which the predominant is melanin. Pigmentation of the skin predominantly depends on the amount and type of melanin. The degree of skin vascularity, presence of carotene, and thickness of the stratum corneum are other factors that play a role.¹ A blemishless skin is the desire of all human beings. Psychological impact ofpigmentary imperfection provides the impetus for an understanding of pathology of post inflammatory hypopigmented disorders. They are the commonest presentations in patients attending Dermatology OPD. Hence there is a need to study various clinical presentations & histopathology of such lesions. ABSTRACT Background:The objective of the study was to study the various etiologies and ascertain different clinicalpresentations of post-inflammatory hypopigmented lesions. Age and sex distribution, socio economic status, seasonal incidence, most common to rare variants amongst all conditions and to correlate them histopathologically. Methods: 100 patients presenting with Post-inflammatory hypopigmented lesions were selected and detailed history and examination was done. Lab investigations and histopathology was done in those cases. Results: Among the various causes of post-inflammatory hypopigmentation, commonly observed conditions were Pityriasis versicolor, mechanical injuries, Pityriasis alba, burns, leprosy, allergic contact dermatitis, morphoea, discoid lupus erythematosus, psoriasis and Steven's Johnson syndrome. Most common age group affected was in 21-30 years of age. Males (60%) were more than females (40%). People of lower socioeconomic status (55%) presented with post-inflammatory hypo pigmented lesions commonly. History of hypopigmentation ranged from 0-6 months in majority of cases. Upper limbs, trunk and face and neck regions were the most common sites involved. Commonest etiology amongst all cases was pityriasisversicolor, followed by mechanical injuries, PityriasisAlba and burns. Clinical diagnosis correlated with histopathology in these cases. Conclusions:The study concluded that post-inflammatory hypopigmented lesions presented with various manifestations, more common in young, male adults, common in people of lower socioeconomic group. Upper limbs, trunk and face and neck are the common sites involved and histopathology correlated with clinical diagnosis in many cases.

Prevalence of Hypopigmentary Disorders in Primary School Children in Zagazig City, Sharkia Governorate, Egypt

“…PIH may occur secondary to abrasions/mechanical trauma or burn, commonly seen on upper limbs, face, and neck region. 24 In the present study, hypopigmented nevus was reported in 9.5% of students, they are mostly unnoticeable due to the fact that they are asymptomatic and may occur over cosmetically unimportant sites which prompts patients to ignore it and not seek treatment.…”

“…23 Pityriasis alba is predominantly seen in children aged 3-16 over face and neck; the sexes are equally susceptible. 24 It was the most common type of hypopigmented diseases in children in the present study representing 58.3%, duration of lesions varied from 1 to 48 month, and face was the most common site of lesion (100%).…”

“…On the other hand, Krishnan and Thapa 36 revealed that (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) years being the most common age group suggesting that the peak of infection with PVC coincides with the sebum production and hormonal influence. Kambil 37 reported that chest wall was the most common site (29.94%), followed by abdomen (24.59%), and then the neck (19.78%) as the distribution of lesions depends on the abundance of sebaceous glands in that particular region.…”

“…The lesions were commonly seen in face, hand, and other parts of the body (33.3%) and duration of lesions varied from 12 to 72 months. PIH may occur secondary to abrasions/mechanical trauma or burn, commonly seen on upper limbs, face, and neck region 24 …”