Ann Dermatol.  2009 Aug;21(3):261-267. 10.5021/ad.2009.21.3.261.

Progressive Macular Hypomelanosis in Korean Patients: A Clinicopathologic Study

• Hwang SW
• Hong SK
• Kim SH
• Park JH
• Seo JK
• Sung HS
• Lee D

• KMID: 2266287
• DOI: http://doi.org/10.5021/ad.2009.21.3.261

Abstract

BACKGROUND: Progressive macular hypomelanosis is characterized by ill-defined, non-scaly, hypopigmented macules primarily on the trunk of the body. Although numerous cases of progressive macular hypomelanosis have been reported, there have been no clinicopathologic studies of progressive macular hypomelanosis in Korean patients.
OBJECTIVE
In this study we examined the clinical characteristics, histologic findings, and treatment methods for progressive macular hypomelanosis in a Korean population.
METHODS
Between 1996 and 2005, 20 patients presented to the Department of Dermatology at Busan Paik Hospital with acquired, non-scaly, confluent, hypopigmented macules on the trunk, and with no history of inflammation or infection. The medical records, clinical photographs, and pathologic findings for each patient were examined.
RESULTS
The patients included 5 men and 15 women. The mean age of onset was 21.05+/-3.47 years. The back was the most common site of involvement. All KOH examinations were negative. A Wood's lamp examination showed hypopigmented lesions compared with the adjacent normal skin. A microscopic examination showed a reduction in the number of melanin granules in the lesions compared with the adjacent normal skin, although S-100 immunohistochemical staining did not reveal significant differences in the number of melanocytes. Among the 20 patients, 7 received topical drug therapy, 6 were treated with narrow-band ultraviolet B phototherapy, 4 received oral minocycline, and 3 did not receive any treatment.
CONCLUSION
Most of the patients with progressive macular hypomelanosis had asymptomatic ill-defined, non- scaly, and symmetric hypopigmented macules, especially on the back and abdomen. Histologically, the number of melanocytes did not differ significantly between the hypopigmented macules and the normal perilesional skin. No effective treatment is known for progressive macular hypomelanosis; however, narrow-band ultraviolet B phototherapy may be a useful treatment modality.

Keyword

Narrowband ultraviolet B phototherapy; Progressive macular hypomelanosis

MeSH Terms

Abdomen
Age of Onset
Dermatology
Female
Humans
Hypopigmentation
Inflammation
Male
Medical Records
Melanins
Melanocytes
Minocycline
Phototherapy
Skin
Melanins
Minocycline

Figure

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  Fig. 1 Case 13. Non-scaly, confluent, hypopigmented macules on the lower back and buttocks.

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  Fig. 2 Case 12. (A) Ill-defined confluent, non-scaly hypopigmented patch with scattered macules are noted on the back. (B) Hypopigmented lesions were successfully treated after nine sessions of narrowband ultraviolet B phototherapy.

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  Fig. 3 Case 17. The biopsy obtained from the hypopigmented lesion (A) shows less melanin granules in the basal layer than normal skin (B) (H&E, ×100).

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  Fig. 4 Case 13. There was no difference in the number of S-100 protein-positive cells between the hypopigmented macule (A) and perilesional normal-appearing skin (B) (S-100 protein, ×400).

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