Hypomelanosis guttata idiopathica

Abstract

A 37-year-old white female with dark complexion presented with progressive hypopigmented macules on the face and upper trunk. She was in good health and her family history was unremarkable. Histologic examination of the hypopigmented patches revealed reduced melanin within the basal layers of the epidermis. Using immunohistochemical and ultrastructural studies, the number of melanocytes appeared normal but signs of degeneration were evident and dendrites were shortened. The diagnosis of idiopathic guttate hypomelanosis was established. The clinical picture, etiology and treatment of this relatively common but often unrecognized skin disease is discussed.

Idiopathic guttate hypomelanosis: an electron microscopy study

“…All the components of the basal membrane complex were normal. Schiller, Metze and Böhm, found that melanocytes in IGH had fewer or no dendrites . Τhe number of the melanocytes was normal but they showed degenerative changes, i.e.…”

“…Schiller, Metze and B€ ohm, found that melanocytes in IGH had fewer or no dendrites. 5 Τhe number of the melanocytes was normal but they showed degenerative changes, i.e. the cytoplasm was swollen and the endoplasmic reticulum was hyperplastic.…”

“…Type I and II melanosomes predominated. A significant reduction of mature melanosomes in neighbouring keratinocytes was noted . Ortonne et al .…”

“…the anterior aspect of the shins in females and the upper extremities in males . The lesions do not show any infiltration, scarring, desquamation, or atrophy, but a loss of pigmentation of variable degree is present . The size of the lesions varies between 0.2 and 2 cm.…”

Treatment of idiopathic guttate hypomelanosis with fractional carbon dioxide lasers

“…Genetic factors may also play a role in this condition. 15,16 Medical therapy for idiopathic guttate hypomelanosis includes corticosteroids, either topical or intralesional, and retinoids, typically topical tretinoin. One report describes successful treatment with pimecrolimus 1% ; however, caution is warranted because the author has anecdotal experience possibly suggesting that topical calcineurin inhibitors may be linked to the development of idiopathic guttate hypomelanosis in immunosuppressed patients.…”