Idiopathic Guttate Hypomelanosis Clinical Presentation

  • Author: Stephen W White, MD; Chief Editor: William D James, MD   more...
 
Updated: Aug 29, 2011
 

History

Typically, idiopathic guttate hypomelanosis develops first on the legs of fair-skinned women in early adult life. Later, it may spread to other sun-exposed areas, such as the arms and the upper part of the back. The face is inexplicably not involved early in idiopathic guttate hypomelanosis. A familial tendency to develop idiopathic guttate hypomelanosis has been noted.[5]

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Physical

Idiopathic guttate hypomelanosis consists of discrete, angular or circular macules that are 1-3 mm in diameter. However, lesions may measure up to 10 mm in diameter. These lighter-than-normal skin macules are off white, hypopigmented, or achromic. They are often noted first on the anterior aspects of the legs. Later, they appear on the forearms. The distribution seems to be photo related, except for the face, which is affected later than the limbs.

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Causes

The exact cause of idiopathic guttate hypomelanosis is not agreed upon; however, it is hypothesized that ultraviolet light plays an important role.[6]

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Contributor Information and Disclosures
Author

Stephen W White, MD  Clinical Assistant Professor, Department of Dermatology, George Washington University Hospital; Chief, Sub-section of Dermatology, Suburban Hospital

Stephen W White, MD is a member of the following medical societies: American Academy of Dermatology, International Society of Dermatology, Society for Investigative Dermatology, and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Christopher R Gorman, MD  Bethesda Dermatology, Private Practice; Assistant Clinical Professor, George Washington University School of Medicine and Health Sciences; Staff Dermatologist, National Naval Medical Center

Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Specialty Editor Board

Daniel Mark Siegel, MD, MS  Director, Procedural Dermatology Fellowship Program, Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American College of Physician Executives, American Society for Dermatologic Surgery, American Society for MOHS Surgery, and International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Ploysangam T, Dee-Ananlap S, Suvanprakorn P. Treatment of idiopathic guttate hypomelanosis with liquid nitrogen: light and electron microscopic studies. J Am Acad Dermatol. Oct 1990;23(4 Pt 1):681-4. [Medline].

  2. Ortonne JP, Perrot H. Idiopathic guttate hypomelanosis. Ultrastructural study. Arch Dermatol. Jun 1980;116(6):664-8. [Medline].

  3. Wallace ML, Grichnik JM, Prieto VG, Shea CR. Numbers and differentiation status of melanocytes in idiopathic guttate hypomelanosis. J Cutan Pathol. Aug 1998;25(7):375-9. [Medline].

  4. Arrunategui A, Trujillo RA, Marulanda MP, et al. HLA-DQ3 is associated with idiopathic guttate hypomelanosis, whereas HLA-DR8 is not, in a group of renal transplant patients. Int J Dermatol. Nov 2002;41(11):744-7. [Medline].

  5. Falabella R, Escobar C, Giraldo N, et al. On the pathogenesis of idiopathic guttate hypomelanosis. J Am Acad Dermatol. Jan 1987;16(1 Pt 1):35-44. [Medline].

  6. Kaya TI, Yazici AC, Tursen U, Ikizoglu G. Idiopathic guttate hypomelanosis: idiopathic or ultraviolet induced?. Photodermatol Photoimmunol Photomed. Oct 2005;21(5):270-1. [Medline].

  7. Asawanonda P, Sutthipong T, Prejawai N. Pimecrolimus for idiopathic guttate hypomelanosis. J Drugs Dermatol. Mar 2010;9(3):238-9. [Medline].

  8. Pagnoni A, Kligman AM, Sadiq I, Stoudemayer T. Hypopigmented macules of photodamaged skin and their treatment with topical tretinoin. Acta Derm Venereol. Jul 1999;79(4):305-10. [Medline].

  9. Friedland R, David M, Feinmesser M, Fenig-Nakar S, Hodak E. Idiopathic guttate hypomelanosis-like lesions in patients with mycosis fungoides: a new adverse effect of phototherapy. J Eur Acad Dermatol Venereol. Feb 17 2010;[Medline].

 
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