CHEMICAL LEUKODERMA

By Gary M. White, MD

Chemical leukoderma White patches on the left arm only after splashing chemicals there.


Chemical leukoderma is the complete loss of pigment in a localized area after skin contact with any of a variety of chemicals.

Clinical

The changes of chemical leukoderma may be indistinguishable from vitiligo. White, depigmented macules and patches in the areas of contact are seen.

Chemical Leukoderma vs Vitiligo

Sometimes, it is hard to distinguish chemical leukoderma from vitiligo. For example, a young woman uses a new lip gloss and several days later, develops redness and irrition of the lip. 2 weeks later, a depigmented patch develops and persists. Was it chemical leukoderma or koebnerized vitiligo? In these situations, stopping any offending agents and treating as if vitiligo is in order.

Treatment

Cessation of exposure is of course mandatory. The skin may or may not repigment. The standard treatments for vitiligo, e.g. nbUVB may be recommended. The 308-nm excimer laser has been employed with some success.

Additional Pictures

This middle-aged man held the pesticide sprayer in this arm's hand off and on treating his lawn over one year's time. Confetti-like white macules developed on this arm only.

Chemical Leukoderma

Gardening chemicals splashed on the left arm, causing a chemical leukoderma.
Chemical leukoderma

A woman bleached her underwear and developed depigmented patches at sites of contact.
Chemical Leukoderma Chemical Leukoderma

References

Footwear leukoderma. Indian J Dermatol Venereol Leprol 2015;81:1-3

Leukoderma after imiquimod. from BMC Infect Dis. 2014; 14: 329

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