History
Patients with hypomelanosis of Ito usually seek care from a dermatologist, pediatrician, or neurologist by the time they are aged 2 years.
The hypopigmentation is not preceded by vesicular or verrucous lesions that are usually seen in incontinentia pigmenti.
A family history of hypomelanosis of Ito is rare.
The patient or parents should be asked about the following:
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Seizures
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Mental retardation
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Developmental delay
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Deafness
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Visual problems
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Headache
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Tooth or mouth problems
The most common reported associations are congenital abnormalities, mental retardation, and seizures. [9] Cerebral malformations may occur, and visual impairment may be cortical in nature. [10, 11] Glomerulocystic kidney disease has also been reported. [12]
Physical Examination
Small 0.5- to 1-cm hypopigmented macules coalesce to form reticulated patches along the lines of Blaschko, usually stopping at the midline. They are most often seen on the trunk and limbs. The macules/patches cover more than two dermatomes and are often on both sides of the body. A Wood lamp enhances the pattern, especially in white patients. [8] See the images below.
Careful full body examination is needed to detect dysmorphism, including the following:
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Cleft palate
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Hemihypertrophy
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Limb, hand, and/or foot abnormalities
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Nail abnormalities
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Hypotonia
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Teeth abnormalities
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Hair anomalies
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Face and/or skull anomalies
Neurologic examination is essential to evaluate neural tumors, seizures, and psychomotor delay.
Complications
Complications may occur as a result of associated abnormalities.
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Hypomelanosis of Ito on the arm.
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Hypomelanosis of Ito highlighted with a Wood lamp.
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Hypomelanosis of Ito on the torso.
