Dermatol Surg 2017 Apr;43(4):553-557

*Westlake Dermatology, Austin, Texas; †Department of Medicine (Dermatology), Dell Medical School, University of Texas at Austin, Austin, Texas.

Background: Idiopathic guttate hypomelanosis (IGH) is a commonly acquired benign leukoderma characterized by multiple discrete, hypo- or depigmented macules often on extremities that can be aesthetically undesirable for patients. This is the first study using excimer laser for treatment.

Objective: To determine the effectiveness of excimer laser for repigmentation of idiopathic guttate hypomelanosis. Read More

Indian J Dermatol Venereol Leprol 2017 Mar-Apr;83(2):205-211

Department of Dermatology and Venereology, Government Medical College, Thrissur, Kerala, India.

Background: There are few population-based studies on prevalence of cutaneous problems in diabetes mellitus.

Aims: To identify skin problems associated with diabetes mellitus among elderly persons in a village in Kerala.

Methods: In this population-based cross-sectional survey, we compared the prevalence of skin problems among 287 elderly diabetics (aged 65 years or more) with 275 randomly selected elderly persons without diabetes mellitus. Read More

Dermatol Ther (Heidelb) 2016 Dec 9;6(4):471-507. Epub 2016 Sep 9.

Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.

Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. Read More

J Dermatolog Treat 2017 May 23;28(3):271-275. Epub 2016 Aug 23.

a Division of Dermatology, Chulabhorn International College of Medicine , Thammasat University , Pathum Thani , Thailand.

Background: Idiopathic guttate hypomelanosis (IGH) is a common hypopigmentation affecting a large amount of older population. However, there is no standard treatment. Cryotherapy has been reported as an alternative therapy for years; nevertheless, there is no randomized controlled study to determine its efficacy. Read More

Am J Clin Dermatol 2016 Aug;17(4):403-11

Department of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Rangsit Campus, Klong Luang, Pathum Thani, 12120, Thailand.

Idiopathic guttate hypomelanosis is a common acquired leukoderma characterized by multiple, discrete round or oval, porcelain-white macules on sun-exposed areas, especially on the extensor surface of forearms and pretibial areas. It usually affects individuals aged over 40 years and the likelihood of acquiring it increases with age. The exact pathogenesis remains controversial. Read More

J Dermatolog Treat 2016 Oct 10;27(5):456-60. Epub 2016 Feb 10.

a Division of Dermatology , Department of Medicine, Faculty of Medicine, Chulalongkorn University , Bangkok , Thailand and.

Background: The efficacy of fractional photothermolysis and topical use of calcineurin inhibitors as treatments of idiopathic guttate hypomelanosis (IGH) have been reported. Data on combination treatments are lacking.

Objectives: To evaluate the efficacy and safety of 1550-nm ytterbium/erbium fiber laser combined with 0. Read More

Cutis 2015 Sep;96(3):156,184-5

PO Box 8000, Northern Blvd, Old Westbury, NY 11568, USA.

J Dermatol 2015 Nov 27;42(11):1118-9. Epub 2015 Jul 27.

Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.

Indian Dermatol Online J 2015 May-Jun;6(3):164-7

Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India.

Background: Depigmented skin lesions are of great concern in the society, especially in the Indian subcontinent. These comprise many infective and inflammatory conditions that cause apprehension and anxiety among patients due to the social stigma attached to these conditions. Idiopathic guttate hypomelanosis (IGH) appears similar to many depigmented lesions and differentiation of IGH from these conditions is difficult clinically as well as histopathologically. Read More

Indian J Dermatol 2014 Nov;59(6):571-4

Department of Dermatology, P. D. Hinduja Hospital, Mahim, Mumbai, India.

Biopsy findings in 55 cases of idiopathic guttate hypomelanosis (IGH) are reported. Most cases had a flat epidermis with loss of the rete pattern and a thickened orthokeratotic basket weave stratum corneum. The epidermis had markedly decreased to absent melanin in the basal layer and reduced numbers of melanocytes at the dermoepidermal junction. Read More

J Eur Acad Dermatol Venereol 2015 Nov 10;29(11):2238-42. Epub 2014 Oct 10.

Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Background: Idiopathic guttate hypomelanosis (IGH) is a common pigmentary disorder affecting a large number of individuals. Many patients seek medical attention due to aesthetic concern. However, no standard treatment is available. Read More

J Eur Acad Dermatol Venereol 2015 Jul 4;29(7):1435-8. Epub 2014 Aug 4.

Department of Anatomy, National and Kapodistrian University of Athens Medical School, Athens, Greece.

Background: Few published data, concerning the electron microscopy findings of idiopathic guttate hypomelanosis have been published so far.

Objectives: To reveal the electron microscopic findings of idiopathic guttate hypomelanosis and their aetiopathogenetic associations.

Methods: Punch biopsy specimens from four patients with idiopathic guttate hypomelanosis, after being properly processed, were observed under the electron microscope. Read More

Indian J Dermatol Venereol Leprol 2014 Mar-Apr;80(2):141-4

Delhi Dermpath Laboratory, New Delhi, India.

We present three cases of a rare eruptive variant of tumor of follicular infundibulum. Two patients presented with hypopigmented macules. The clinical differential diagnoses considered in these two cases were vitiligo, lichen sclerosus et atrophicus, and idiopathic guttate hypomelanosis. Read More

Indian Dermatol Online J 2014 Jan;5(1):14-8

Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

Context: Therapeutic wounding includes wounding the skin to induce pigmentation of the depigmented skin patches that was earlier used for repigmenting small patches of stable vitiligo. In this study, we have used the same principle to induce pigmentation in idiopathic guttate hypomelanosis (IGH) by spot peel with 88% phenol.

Aims: To study the efficacy of phenol in causing repigmentation in IGH and its adverse effect profile. Read More

J Cosmet Laser Ther 2013 May 8. Epub 2013 May 8.

Abstract Objective: Idiopathic guttate hypomelanosis (IGH) is an acquired leukoderma found in all races. The treatment of choice is still controversial. This study aimed at evaluating the effect of CO2FL on IGH. Read More

Clin Exp Dermatol 2013 Jul 20;38(5):526-9. Epub 2013 Apr 20.

Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.

We have occasionally seen patients with acquired well-demarcated, scattered hypopigmented papules. In this study, we investigated the clinical and histopathological characteristics of such lesions. Biopsies were taken from the lesional and perilesional normal skin from 10 of 13 patients, which were compared with 10 idiopathic guttate hypomelanosis (IGH) samples. Read More

Saudi J Kidney Dis Transpl 2013 Jan;24(1):36-40

Department of Nephrology, Golestan University of Medical Sciences, Gorgan, Iran.

Mucocutaneous manifestations are common among patients on hemodialysis (HD). This study was undertaken to determine the prevalence of mucocutaneous manifestations in patients with end-stage renal disease (ESRD) who are on HD. In this cross-sectional, descriptive and analytic study conducted in 2009, 100 patients on HD at the Five Azar Hospital in Gorgan city were randomly selected. Read More

J Eur Acad Dermatol Venereol 2013 Feb 31;27(2):e243-6. Epub 2012 May 31.

Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Background: Idiopathic guttate hypomelanosis (IGH) is a commonly acquired leucoderma that is characterized by discrete, round or oval porcelain-white macules ∼2-5 mm in diameter that increases in number with age. A variety of therapies with variable success rates, including cryotherapy, superficial abrasion and topical retinoids are currently being used.

Objectives: The effects of fractional CO(2) laser therapy on IGH were investigated in this pilot study. Read More

J Eur Acad Dermatol Venereol 2013 Apr 10;27(4):460-4. Epub 2012 Feb 10.

Division of Dermatology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

Background: Idiopathic guttate hypomelanosis (IGH) is an idiopathic disorder affecting a large number of people. Effective treatments are not yet available. Objectives To investigate the efficacy of topical 0. Read More

Int J Dermatol 2011 Jul;50(7):798-805

Department of Dermatology, School of Medicine, Kyunghee University, Seoul, South Korea.

Background: The lesions of idiopathic guttate hypomelanosis (IGH) are commonly seen in elderly persons, although this is an often unrecognized skin disease with an obscure etiopathogenesis. The prevalence and clinical features of IGH have not yet been well studied.

Objectives: The purposes of this study were to evaluate the prevalence of IGH in different age groups and to determine the association of IGH with other dermatoses related to photoaging. Read More

Int J Dermatol 2010 Feb;49(2):162-6

Department of Dermatology and Laboratory of Cell Biology, Ajou University School of Medicine, Yeongtong-Gu, Suwon, Korea.

Background: The histological findings associated with idiopathic guttate hypomelanosis (IGH) are hyperkeratosis, an atrophic epidermis, and flattened rete ridges. In addition, a decreased melanin content and reduced numbers of melanocytes are reported features. However, there are few recent studies that have been published on the histopathology of IGH and no comparative studies are available on the skin lesions and perilesional skin of patients with IGH. Read More

J Drugs Dermatol 2010 Mar;9(3):238-9

Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok,Thailand.

Idiopathic guttate hypomelanosis (IGH) is a very common skin disorder, although the precise prevalence of which is unknown. There are no universally safe and efficacious treatments for this condition. The authors report the success of 1% pimecrolimus cream in inducing repigmentation is this hypomelanotic disorder. Read More

J Eur Acad Dermatol Venereol 2010 Sep 17;24(9):1026-30. Epub 2010 Feb 17.

Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petah Tiqwa, Israel.

Background: Idiopathic guttate hypomelanosis (IGH) is a common pigmentary disorder, the aetiology and pathogenesis of which are largely unknown. The appearance of IGH-like lesions during phototherapy has been reported previously in only one patient.

Objective: To describe the clinical and histological features of phototherapy-induced IGH-like lesions, their relation to ultraviolet dosimetry and the course of this eruption in patients with mycosis fungoides (MF). Read More

Int J Dermatol 2009 Oct;48(10):1057-61

Department of Dermatology, School of Medicine, Mustafa Kemal University, Antakya, Hatay, Turkey.

Background: Beta-thalassemia major affects multiple organs and is associated with considerable morbidity and mortality. The goal of this analysis was to document the frequency of skin diseases among patients with beta-thalassemia major.

Methods: A sample of 78 patients with beta-thalassemia major was recruited and interviewed at the thalassemia clinic between April and June 2008. Read More

Photodermatol Photoimmunol Photomed 2005 Oct;21(5):270-1

Department of Dermatology, Faculty of Medicine, Mersin University, Mersin, Turkey.

Idiopathic guttate hypomelanosis (IGH) is a common but often unrecognized skin disease with obscure etiopathogenesis. As the lesions mostly develop on the exposed parts of the extremities, ultraviolet has been hypothesized to induce these lesions. However, previous statistical studies did not confirm any association between ultraviolet and IGH. Read More

Br J Dermatol 2005 Jul;153(1):190-3

Department of Dermatology, University of Münster, Von Esmarch-Str. 58, D-48149 Münster, Germany.

Confetti leucoderma can occur in a variety of unrelated skin disorders and is often a diagnostic challenge. We describe a 33-year-old man with a history of mycosis fungoides and vitiligo. He developed disseminated 1-2-mm round-shaped leucodermic lesions 6 months after psoralen photochemotherapy and 12 months after systemic therapy with interferon. Read More

J Dermatol 2004 May;31(5):437-9

Int J Dermatol 2002 Nov;41(11):744-7

Department of Dermatology, School of Medicine, Universidad del Valle, Cali, Colombia.

Background: The etiology of idiopathic guttate hypomelanosis (IGH) remains uncertain; however, solar exposure and heredity have been proposed as causative factors.

Objective: To explore the genetic predisposition to the development of IGH.

Methods: A comparative case-control study was performed at a dermatology department at a university hospital. Read More

Dermatol Surg 1999 Nov;25(11):917-8

Acta Derm Venereol 1999 Jul;79(4):305-10

S.K.I.N. Incorporated, Conshohocken, PA 19428, USA.

Hypopigmented macules are frequently observed in the photodamaged skin of elderly people. We undertook to study and treat 2 types of hypomelanosis of photoaged skin. These lesions were: 1) idiopathic guttate hypomelanosis; and 2) macular hypomelanosis. Read More

Indian J Dermatol Venereol Leprol 1998 Nov-Dec;64(6):270-2

Department of Dermatology and STD, Command Hospital, (Southern Command) Pune- 40, India.

A total of 320 patients of more than 60 years of age were studied for dermatological changes with aging. The male female ratio of patients was 3:1. Majority of cases (60. Read More

J Cutan Pathol 1998 Aug;25(7):375-9

Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.

The etiology and pathogenesis of idiopathic guttate hypomelanosis (IGH) are largely unknown. To investigate whether the pathologic alteration in IGH involves changes in melanocytic differentiation, cell number, or both, we studied nine lesions of IGH by immunoperoxidase, using monoclonal antibodies against the KIT receptor and a panel of melanocyte differentiation antigens (tyrosinase-related protein-1, tyrosinase, and gp100/pme117). In each case, compared with grossly normal non-lesional skin, IGH lesions showed markedly reduced numbers both of KIT+ cells and of cells expressing melanocyte differentiation antigens (p < 0. Read More

Br J Dermatol 1998 Apr;138(4):678-83

Department of Dermatology, National Cheng-Kung University Hospital, Tainan, Taiwan.

Clear cell papulosis is a new entity first described in 1987. To date, six patients have been reported: all were young Taiwanese children. The disease is characterized clinically by multiple small, whitish maculopapules distributed along the milk line and by the presence of large, benign pagetoid cells in the epidermis resembling the clear cell of the nipple. Read More

Hautarzt 1997 Sep;48(9):662-5

Hautklinik, Westfälischen Wilhelms-Universität Münster.

A 37-year-old white female with dark complexion presented with progressive hypopigmented macules on the face and upper trunk. She was in good health and her family history was unremarkable. Histologic examination of the hypopigmented patches revealed reduced melanin within the basal layers of the epidermis. Read More

Semin Cutan Med Surg 1997 Mar;16(1):30-5

Dermatology and Cutaneous Sciences Division, Faculty of Medicine, University of Alberta, Edmonton, Canada.

The clinical, histopathologic, and electron microscopic features of guttate leukodermas are reviewed, including the hypomelanoses of the skin and hair observed in the tuberous sclerosis complex (TSC). The hypopigmentation seen in patients with TSC is related primarily to a decrease in the function of epidermal and follicular melanocytes; the density of active melanocytes is normal. Poorly developed dendritic processes are observed frequently as are melanosomes that are smaller in size and less melanized than those in melanocytes of uninvolved skin and hair. Read More

Postgrad Med 1996 Jun;99(6):177-86

Division of dermatology and cutaneous surgery, University of Florida College of Medicine, Gainesville, USA.

The many types of pigmentation disorders may present in diverse forms and distributions and have various causes. They can be inherited (eg, vitiligo, familial periorbital hyperpigmentation), acquired (eg, postinflammatory pityriasis alba, idiopathic guttate hypomelanosis, Becker's nevus, melasma), infectious (eg, tinea versicolor), benign and self-limiting (eg, isolated café au lait spots, photocontact dermatitis), or a sign of more serious underlying disease (eg, multiple café au lait spots, malignant acanthosis nigricans). Primary care physicians see many patients with skin complaints and can often accomplish the early recognition and appropriate treatment that is paramount to cost-effective medicine. Read More

Ann Dermatol Venereol 1994 ;121(1):7-10

Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, France.

Introduction: A congenital guttate hypomelanosis is an unusual feature not yet mentioned in the dermatologic literature.

Case Report: We observed 1982 in a 28 y. female patient numerous guttate lesions, which were flat and pigmented on the light-exposed areas of her limbs, flat or papulokeratotic and depigmented on her trunk. Read More

J Am Acad Dermatol 1990 Oct;23(4 Pt 1):681-4

Lions Suphannahong Dermatology Clinic, Chulalongkorn Hospital, Bangkok, Thailand.

Idiopathic guttate hypomelanosis is a common skin disorder of unknown cause. Our studies have shown that significantly fewer dopa-positive melanocytes are in the white macules of idiopathic guttate hypomelanosis than in normal skin. By electron microscopy we observed that the melanocytes in the lesional skin were round and less dendritic with fewer melanosomes than in normal pigment cells. Read More

Br J Dermatol 1990 Apr;122 Suppl 35:21-8

Dermatology Service, Pasteur Hospital, Nice, France.

In subjects older than 25-30 years the number of enzymatically active melanocytes detectable by the dopa reaction decreases by about 10-20% per decade, with exposed skin having approximately twice as many pigment cells as unexposed skin. Chronic exposure to sunlight may stimulate the epidermal melanocyte system rather than accelerating chronological ageing. The number of melanocytic naevi declines with age. Read More

J Int Med Res 1990 ;18 Suppl 3:8C-17C

Department of Dermatology, Pasteur Hospital, Nice, France.

The main clinical, histological, ultrastructural and biochemical changes to the pigmentary system following photo-exposure are reviewed. Acute exposure to ultraviolet (UV) radiation induces an immediate pigment-darkening reaction, due to photo-oxidation of preformed melanin, followed by delayed tanning, the mechanism of which is unknown. Chronic exposure to UV induces photo-ageing with uneven pigment distribution. Read More

Arch Dermatol 1989 Oct;125(10):1363-6

Skin Research Laboratory, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Several diseases are included in the category of hypomelanosis. Their clinical course as well as the pathogenesis are diverse and in many cases poorly understood. The aim of the present study is to use the nude mice model to determine whether the primary defect in various pigmentary skin disorders is inherent to the tissue itself or is secondary to systemic factors. Read More

Dermatol Clin 1988 Apr;6(2):241-7

Universidad Del Valle, Cali, Colombia.

Idiopathic guttate hypomelanosis is a common and frequently ignored dermatosis. It appears late in life and increases with aging. The studies so far reported do not support the hypothesis of a residual leukoderma following trauma, and the relation of IGH to chronic solar exposure has not yet been documented. Read More

J Am Acad Dermatol 1988 Mar;18(3):485-94

Department of Internal Medicine, Hospital Universitario del Valle, Cali, Columbia, South America.

Thirteen patients with vitiligo (1 segmental, 4 focal, 8 generalized) aged 7 to 38, most of them female children, developed numerous punctate hypopigmented and achromic spots. The spots measured 0.5 to 1. Read More

J Am Podiatr Med Assoc 1987 Jun;77(6):302-3

J Am Acad Dermatol 1987 Jan;16(1 Pt 1):35-44

Idiopathic guttate hypomelanosis is a common leukodermic dermatosis of obscure origin, consisting of small 2- to 5-mm achromic or hypopigmented macules, mainly affecting the exposed upper and lower extremities. In a group of 400 consecutive dermatologic patients, idiopathic guttate hypomelanosis was much more prevalent in women than in men. However, in both sexes this prevalence became more common with advancing age. Read More

J Am Acad Dermatol 1985 Dec;13(6):968-74

Patients with three types of leukoderma--vitiligo, idiopathic guttate hypomelanosis, and postinflammatory leukoderma--had successful repigmentation after transplantation of autologous melanocytes. The procedure was performed easily by producing blisters on normal skin and on depigmented lesions. Blisters were produced by suction or by freezing with liquid nitrogen. Read More

Acta Derm Venereol 1982 ;62(4):301-6

Clinical and morphologic studies were made of 20 cases of guttate hypomelanosis. The sharply demarcated hypopigmented macules were present on both covered and exposed sites, excluding sunlight exposure as a cause. Skin surface replicas and biopsies showed no evidence of post-traumatic or post-inflammatory scarring. Read More

Br J Dermatol 1980 Dec;103(6):635-42

Idiopathic guttate hypomelanosis is usually associated with guttate hyperkeratosis, xerosis, and lentiginosis not related to the patient's age. Histologically, hypopigmented macules show remarkably decreased melanin, decreased DOPA-oxidase activity and a decreased number of melanosomes in the melanocytes with predominance of Stages I and II and small sizes. The epidermis is always atrophic. Read More

Arch Dermatol 1980 Jun;116(6):664-8

Idiopathic guattate hypomelanosis (IGH) has been studied histochemically (split-dopa) and ultrastructurally in three patients. Affected skin was compared to normal surrounding skin. Argentic stains revealed a decrease in the melanin content of affected epidemis and pigment granules were irregularly distributed. Read More

Bull Soc Fr Dermatol Syphiligr 1968 ;75(1):133-6