Pediatric Hypomelanosis of Ito Treatment & Management

Updated: Aug 04, 2022
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Surgical Care

Approximately 30% of patients with seizures do not respond to anticonvulsant medications. In these patients, conduct an appropriate evaluation to verify if they are good candidates for resective epilepsy surgery or vagal nerve stimulation.

The patient may have large lesions and require a hemispherectomy for the treatment of their refractory epilepsy; however, in other cases, the removal of a more focal lesion may stop the seizures.

Cataracts and retinal detachment may produce loss of vision and can be successfully treated with surgery.

In patients with craniofacial malformation, such as cleft lip and palate, repair is done in the same fashion as in patients without hypomelanosis of Ito.



Consultation with an orthopedic specialist is indicated for patients with skeletal abnormalities.

Suggest consultation with an ophthalmologist for patients with ophthalmologic abnormalities.

Consultation with a nephrologist is recommended for patients with renal abnormalities.

Suggest a consultation with an endocrinologist for patients with associated abnormalities.

Patients with hypomelanosis of Ito who were initially seen by a dermatologist may benefit from a consultation with a neurologist; conversely, patients initially referred to a neurologist may benefit from a consultation with a dermatologist and geneticist. Always offer the patient and parents the option of a consultation with a geneticist.

Refer patients who have seizures that are not completely controlled by anticonvulsant medications to an appropriate tertiary center with a comprehensive epilepsy program for proper evaluation (video-EEG, single-photon emission computed tomography [SPECT] or positron emission tomography [PET], high-resolution MRI).