Decreased skin pigmentation

Overview
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
In alphabetical order.


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

History and Symptoms

 * 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

 * perform eye exam to aid in diagnosis of albinism

Other

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

Laboratory Findings

 * Labs include:
 * CBC (in suspected vitiligo patients)
 * Thyroid function tests

Other Diagnostic Studies

 * Skin biopsy for vitiligo

Acute Pharmacotherapies
Vitiligo
 * Topical steroids

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

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

Primary Prevention

 * Sunscreen can protect from further skin issues