hypopigmentation

{{short description|Area of skin becoming lighter than the baseline skin color}}

{{Infobox medical condition (new)

| name = Hypopigmentation

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| image = Vitiligo03.jpg

| caption = Hypopigmentation in vitiligo

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Hypopigmentation is characterized specifically as an area of skin becoming lighter than the baseline skin color, but not completely devoid of pigment. This is not to be confused with depigmentation, which is characterized as the absence of all pigment. It is caused by melanocyte or melanin depletion, or a decrease in the amino acid tyrosine, which is used by melanocytes to make melanin.{{Cite book |title=Biochemistry |last=Ferrier |first=Denise R. |isbn=978-1-4963-4449-6 |edition= Seventh |location=Philadelphia |oclc=956263971|year=2017 }} Some common genetic causes include mutations in the tyrosinase gene or OCA2 gene.{{Cite book|title=Harrison's Principles of Internal Medicine|last1=Bolognia|first1=Jean|last2=Braverman|first2=Irwin|publisher=McGraw-Hill|year=2014|location=New York, NY|chapter=Skin Manifestations of Internal Disease}}{{Cite book|chapter-url=http://accessmedicine.mhmedical.com.eres.library.manoa.hawaii.edu/content.aspx?bookid=2355§ionid=185845621.|title=The Big Picture: Medical Biochemistry Eds|last=Cross|first=Harold|publisher=McGraw-Hill|location=New York, NY|chapter=Biochemical Basis of Diseases}} As melanin pigments tend to be in the skin, eye, and hair, these are the commonly affected areas in those with hypopigmentation.

Hypopigmentation is common and approximately one in twenty have at least one hypopigmented macule. Hypopigmentation can be upsetting to some, especially those with darker skin whose hypopigmentation marks are seen more visibly. Most causes of hypopigmentation are not serious and can be easily treated.{{Cite journal|last1=Hill|first1=Jeremy P.|last2=Batchelor|first2=Jonathan M.|date=2017-01-12|title=An approach to hypopigmentation|url=https://www.bmj.com/content/356/bmj.i6534|journal=BMJ|language=en|volume=356|pages=i6534|doi=10.1136/bmj.i6534|issn=0959-8138|pmid=28082370|s2cid=26827617}}

Presentation

=Associated conditions=

It is seen in:

Albinism
Idiopathic guttate hypomelanosis
Leprosy
Leucism
Phenylketonuria
Pityriasis alba
Vitiligo
Angelman syndrome
Tinea versicolor
Yaws
An uncommon adverse effect of imatinib therapy
Injections of high concentrations of corticosteroids (transient){{Cite book|chapter-url=http://accessmedicine.mhmedical.com.eres.library.manoa.hawaii.edu/content.aspx?bookid=2449§ionid=194431938.|title=Current Medical Diagnosis & Treatment|last1=Shinkai|first1=Kanade|last2=Fox|first2=Lindy|publisher=McGraw-Hill|year=2018|location=New York, NY|publication-date=2018|chapter=Dermatological Disorders}}

Diagnosis

Areas of lighter pigmentation can be indications of hypopigmentation. Biopsies and genetic information are also used to diagnose.

Treatments

Often, hypopigmentation can be brought on by laser treatments; however, the hypopigmentation can be treated with other lasers or light sources.{{cite journal |last1=Reszko |first1=Anetta |last2=Sukal |first2=Sean A. |last3=Geronemus |first3=Roy G. |title=Reversal of Laser-Induced Hypopigmentation with a Narrow-Band UV-B Light Source in a Patient with Skin Type VI |journal=Dermatologic Surgery |date=14 July 2008 |volume=34 |issue=10 |pages=1423–1426 |doi=10.1097/00042728-200810000-00021|pmid=18637814 }} Micropigmentation can also be used to obtain a more normal appearance of the hypopigmentated skin.{{cite book | last=Haney | first=Beth | title=Aesthetic Procedures: Nurse Practitioner's Guide to Cosmetic Dermatology | chapter=Permanent and Semi-permanent Micro-Pigment Treatments | publisher=Springer International Publishing | publication-place=Cham | date=September 21, 2019 | isbn=978-3-030-19947-0 | doi=10.1007/978-3-030-19948-7_7 | pages=59–66| s2cid=203829421 }}

Treatment for hypopigmentation depends on the initial cause of the discoloration.{{medical citation needed|date=July 2023}}

class="wikitable"

|+Treatments for Hypopigmentation{{Cite book|title=Harrison's Principles of Internal Medicine.|date=2012|publisher=McGraw-Hill|others=Longo, Dan L. (Dan Louis), 1949-, Fauci, Anthony S., 1940-, Kasper, Dennis L., Hauser, Stephen L., Jameson, J. Larry., Loscalzo, Joseph.|isbn=9780071748902|edition= 18th|location=New York|oclc=747712285}}

|Initial Cause of Discoloration

|Treatment

Idiopathic guttate hypomelanosis

|No treatment

Postinflammatory hypopigmentation

|Treat the underlying inflammatory disease to restore pigmentation

Pityriasis versicolor

|A topical ointment, such as selenium sulfide 2.5% or imidazoles.

Can also use oral medications, such as oral imidazoles or triazoles.

Vitiligo

|Topical steroids, including calcineurin inhibitors.

Patients can also have transplants if they are stable or a depigmentation with topical MBEH if the patient has widespread discoloration.