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Progressive Macular HypomelanosisL81.6
Synonym(s)
HistoryThis section has been translated automatically.
Guillet et al. 1988
DefinitionThis section has been translated automatically.
Chronic, disseminated, nummular and confluent hypomelanosis of the trunk and, more rarely, of the lower extremities with nummular, non-scaling bright spots, often confluent in the midline of the body. Persons with a darker complexion are more frequently affected.
EtiopathogenesisThis section has been translated automatically.
Propionibacterium acnes (subtype III was proven to be present in 73.9% of patients compared to a healthy control population with 14.2%) seems to play an essential role etiopathogenetically(Petersen RL et al. 2017) by producing a factor X that interferes with melanogenesis and leads to a reduced melanin production with altered melanogenesis (see Pityriasis versicolor).
ManifestationThis section has been translated automatically.
Preferably between the ages of 10 and 50.
LocalizationThis section has been translated automatically.
Preferred on the fuselage
Clinical featuresThis section has been translated automatically.
Disseminated, 2.0-5.0 cm, indistinctly circumscribed (differentiation from vitiligo), non-scaling, white or grayish-white, round, oval or circular patches. No itching. Wood's light can show accentuation of the patches with faint red fluorescence around the macules and more obvious red fluorescence of the follicles (this finding is not always found).
HistologyThis section has been translated automatically.
Decreased pigmentation of the otherwise completely normal epidermis and dermis. Melanocyte number decreased. Ultrastructurally, there is an increased number of immature melanosomes.
Differential diagnosisThis section has been translated automatically.
Pityriasis versicolor alba (native mycological preparation)
Disseminated Lichen sclerosus (histological differentiation possible)
Confetti type of morphea (histological differentiation possible)
Vitiligo (the white spotting of Vitiligo is more prominent and sharply defined)
TherapyThis section has been translated automatically.
UVB irradiations with UVB-narrowband. Alternatively, combination therapy with 5% benzoyl peroxide (+ PUVA).
Note(s)This section has been translated automatically.
LiteratureThis section has been translated automatically.
- Böhm M (2015) Differential diagnosis of hypomelanosis. Dermatologist 66: 945-958
- Fistarol S et al (2010) Pigmentary disorders. JDDG 8: 187-203
- Leonard N et al (2020) Successful treatment of progressive macular hypomelanosis. Dermatol Reports 12: 8509.
- Montero LC et al (2011) Progressive macular hypomelanosis, excellent response with narrow-band ultraviolet B phototherapy. Photodermatol Photoimmunol Photomed 27:162-163.
- Petersen RL et al (2017) Propionibacterium Acnes Phylogenetic Type III is Associated with Progressive Macular Hypomelanosis. Eur J Microbiol Immunol (Bp) 7:37-45.