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Year : 1990  |  Volume : 56  |  Issue : 6  |  Page : 456-457

Idiopathic guttate hypomelanosis

Correspondence Address:
Lalit Mohan

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A 6-year-old girl had gradully progressive, ennumerable hypopigmented lesions of variable size present on covered as well as on sun exposed parts of the body for the last 3 years. The histopathological findings were compatible with idiopathic guttate hypomelanosis.

Keywords: Idiopathic guttate hypomelanosis

How to cite this article:
Mohan L, Mukhija R D, Bhatia P S, Mishra S D, Mishra R. Idiopathic guttate hypomelanosis. Indian J Dermatol Venereol Leprol 1990;56:456-7

How to cite this URL:
Mohan L, Mukhija R D, Bhatia P S, Mishra S D, Mishra R. Idiopathic guttate hypomelanosis. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2020 May 29];56:456-7. Available from: http://www.ijdvl.com/text.asp?1990/56/6/456/3603

Idiopathic guttate hypomelanosis (IGH) presents mostly in lightly pigmented people as small, hypopigmented spots that appear chiefly on the sun-exposed areas of the extremities in individuals beyond age 30[1], Lesions tend to increase in number with age. In one series of 452 patients, it was seen in only 20% of patients between ages of 20 and 30 but in 80% of patients over the age of 70[2]. Non-actinic lesions on the covered areas are known to occur in Negroids.[2] The lesions rarely become numerous a dozen or two at most.[3] It has been suggested that the disorder results from an age related somatic mutation of melanocytes.[4] We are reporting a case of IGH with unusual findings.

  Case Report Top

A 6 year old girl presented with innumerable (more than 600), well defined, hypopigmented, porcelain - white macules, measuring 1-5 mm in size, in the neck, chest, abdomen [Figure - 1], back, buttocks, upper and lower extremities for past 3 years. Lesions started on the abdomen and gradually in the span of 3 years involved almost whole of the body except of the face. There was no itching or burning even on exposure to sunlight. Histopathology showed reduced number of melanocytes and melanosomes. Fontana­ Masson stain showed melanocytes and melanosomes with black melanin granules. Ratio of melanocytes to keratinocytes in the basal layer was 1 : 20 in vertical section and melanosomes were sparse.

There was no history of preceding inflammation. The lesions did not show fine scales of pityriasis versicolor and KOH examination was negative. The present case had absence of hyperpigmented border seen in vitiligo. The congenital hypopigmented 1-3 cm macules with leaf shaped and confetti-like lesions of tuberous sclerosis were absent.

PUVA therapy on covered lesions and sun screens on sun-exposed lesions were attempted without success. Intra-lesional triamcinolone was not tried because of presence of innumerable lesions.

  Comments Top

In our case the age of onset was 3 years with involvement of covered and sun-exposed areas with innumerable lesions. No case of IGH with these unusual findings have been reported earlier.

  References Top

1.Sober AJ and Fitzpatrick TB: Disturbances of pigmentation, in: Dermatology, Seconded, Editors, Moschella SL and Hurley HJ: WB Saunders, Philadelphia, 1987; p 1299.  Back to cited text no. 1    
2.Cummings KI and Cottel W: Idiopathic guttate hypomelanosis, Arch Dermatol, 1966; 93: 184-186.  Back to cited text no. 2    
3.Domonkos AN, Arnold HL and Odom RB: Andrew's disease of the skin, 7th ed, WB Saunders Company, London, 1982; p 1061.  Back to cited text no. 3    
4.Bleehem SS and Ebling FJG: Disorders of Skin colour, in: Textbook of Dermatology, Fourth ed, Editors, Rook A, Wilkinson DS, Ebling FJG et al: Blackwell Scientific Publications, Oxford, 1988; p 1598.  Back to cited text no. 4    


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