Depigmentation L81.8

Depigmentation is a pathological, clinical symptom caused by a congenital or acquired, solitary or multiple, localized or disseminated, in rare cases also generalized or universal color loss of the skin, caused by a melanin deficiency(hypomelanosis) or by a complete melanin loss(amelanosis) of the skin due to loss or dysfunction of melanocytes. If depigmentation or hypopigmentation occurs temporarily as a result of skin diseases (intra- and/or perilesional), they are called leukoderms, s.a. pseudoleukoderm.

Depigmentation is the opposite pathological finding of hyperpigmentation.

In the following, clinical pictures are listed which are characterized by the clinical symptom "depigmentation".

• Congenital depigmentation:
  • Incontinentia pigmenti achromians = Ito-Syndrome (depigmentation in striped arrangement = Blaschko line pattern)
  • Naevus depigmentosus (mostly localized depigmentation)
  • Albinism (mostly generalized or universal depigmentation)
  • Albinoidism, oculocutaneous (minus variant of albinism)
  • Piebaldism (partial albinism, white forelock)
  • Pringle-Bourneville phacomatosis (ash leaves - depigmentation)
  • Phenylketonuria (diffuse hypopigmentation)
  • Poliosis (white forelock)
  • Waardenburg Syndrome
  • Tietz Syndrome
  • Hermansky-Pudlak syndrome
  • Chédiak-Higashi syndrome (minus variant of oculocutaneous albinoidism)
  • Griscelli syndrome (diffuse hypopigmentation)
  • Elejalde syndrome (partial albinism).
• Acquired depigmentation:
  • Vitiligo
  • Depigmented pseudo scars
  • Scars
  • hypomelanosis guttata idiopathica
  • Progessive macular hypomelanosis (caused by P. acnes)
  • Print depigmentation (contact surfaces in the solarium)
  • Koala Bear Syndrome (Chronic Fatigue Syndrome)
  • Halo-Naevus
  • Postinflammatory depigmentations
  • By the action of chemical noxae (monobenzylether, hydroquinone, benzoyl peroxide, paraternary butylphenol -4-TBP; other phenol derivatives)
  • Drug-induced: phenol derivatives (in bleaching creams), benzoyl peroxide, azelaic acid, retinoids, parenteral glucocorticoids; topical imiquimod, diphencylcopropenone, interferon-alpha, interleukin-2, chloroquine, hydroxychloroquine)
  • Leucoderms:
    • leukoderma psoriaticum
    • leucoderma syphiliticum
    • leucoderma leprosum
    • Onchocerca dermatitis (shinbones)
    • Pityriasis versicolor alba
    • Pityriasis alba.

• Change in melanocyte count
• inadequate melanin synthesis
• defects in the maturation, transport or transfer of melanosomes

The opposite finding, the pathological compression of the melanin of the skin or mucous membrane, is called hyperpigmentation.

1. Giehl K et al (2010) Genetically caused pigmentation disorders. Dermatologist 61: 567-577