Decreased skin pigmentation

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Contents

* 1 Overview
* 2 Differential Diagnosis
* 3 Diagnosis
* 4 History and Symptoms
* 4.1 Eyes
* 4.2 Other
* 5 Laboratory Findings
* 5.1 Other Diagnostic Studies
* 6 Treatment
* 6.1 Acute Pharmacotherapies
* 6.2 Chronic Pharmacotherapies
* 6.3 Indications for Surgery
* 7 Primary Prevention
* 8 References

## Overview

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Knowing the difference between hypopigmentation and depigmentation is essential to determining the differential diagnosis.

Depigmentation is the complete loss of pigment. Hypopigmentation is a decrease in pigment. They can both indicate the diagnosis whether local or general.

## Differential Diagnosis

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In alphabetical order. [1] [2]

* Albinism
* Chemical leukoderma
* Congenital birthmarks
* Piebaldism
* Pityriasis alba
* Tuberous sclerosis that can result in hypopigmentation
* Vitiligo

## Diagnosis

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## History and Symptoms

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* Determine degree of hypopigmentation and depigmentation
* Family history of thyroid disease, diabetes and endocrine problems
* Obtain personal history, include:

* allergies
* hay fever
* asthma

* these may help determine the diagnosis of atopic dermatitis

### Eyes

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* perform eye exam to aid in diagnosis of albinism

### Other

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* Wood's lamp exam can be used to emphasize Hypo- and depigmented areas

## Laboratory Findings

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* Labs include:

* CBC (in suspected vitiligo patients)
* Thyroid function tests

### Other Diagnostic Studies

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* Skin biopsy for vitiligo

## Treatment

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### Acute Pharmacotherapies

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Vitiligo

* Topical steroids

### Chronic Pharmacotherapies

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Vitiligo

* Oral beta-carotene for patients with chronic vitiligo and albanism

### Indications for Surgery

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Punch minigrafting from normal skin donors to vitiligo patients can aid in the repopulation of melanocytes

## Primary Prevention

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* Sunscreen can protect from further skin issues

## References

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1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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