By Gary M. White, MD
Depigmented skin has lost all the pigment. Hypopigmented skin has lost only part of the pigment.
|Nevus Depigmentosus||Depigmented patch. Can be segmental.|
|Ash Leaf Macule||Depigmented patch. Can be segmental. Look for other signs of tuberous sclerosis, (e.g., facial angiofibromas, periungual tumors, Shagreen patch)|
|Segmental Pigmentation Disorder||Lesions are segmental, but not dermatomal and do not follow Blaschko's lines.|
|Hypomelanosis of Ito||Bizarre whorled areas of depigmentation along Blaschko's lines|
|Piebaldism||White forelock and normal pigmented skin in the hypopigmented areas|
|Waardenburg Syndrome||White forelock, normal pigmented skin in the hypopigmented areas, increased interpupillary distance, deafness and heterochromic irides|
|Vitiligo||Chalk white color. Completely depigmented. Commonly segmental, but if classic, will be progressive.|
|Nevus Anemicus||Edge can be changed/blurred/removed by pressure. Is not accentuated with Wood's light.|
Ash Leaf Macule in Tuberous Sclerosis
Segmental Pigmentation Disorder
Hypomelanosis of Ito
A permanent white patch in an area of lichen simplex chronicus (after clearing with topical steroids) and constant scratching.
Progressive Macular Hypomelanosis
Cutaneous T-Cell Lymphoma
Chronic Graft Vs. Host Disease
Malignant Atrophic Papulosis
White Lentiginosis Diffuse, scattered, acquired, lenticular, white macules in darker-skinned females, adult and children.
Idiopathic Guttate Hypomelanosis
Punctate Leukoderma after Q switched laser therapy Ann Dermatol. 2017 Oct; 29(5): 630–632
Early vitiligo: A confetti-like pattern of depigmentation may be a harbinger of rapidly progressing vitiligo [JAAD 2015;73:272-5].
Idiopathic Confetti-like leukoderma [Am J Dermatopathol. 2012 Feb;34(1):117-21].
White Lentiginosis Familial often. Darker skinned patients. Usually women.
Vitiligo associated with Large Congenital Nevi. Depigmented patches may occur within large congenital nevi, adjacent to them, or distal [PD 2016;33;307].
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