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Disorders of Hypopigmentation and Depigmentation

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Dermatoanthropology of Ethnic Skin and Hair

Abstract

There are numerous disorders characterized by hypopigmentation and depigmentation which affect individuals of all skin types. Disorders of hypopigmentation typically denote a decrease in melanin production or melanocyte function, while disorders of depigmentation are characterized by a total loss of melanin or melanocytes. Consequently, individuals with these conditions experience lightening of the affected skin or even a total loss of skin color. While, this can be devastating to all that are affected, those of darker skin types are typically at greater risk of feeling the adversity of dyschromia. In this chapter, we discuss various disorders of hypopigmentation and depigmentation, their pathogenesis, and treatment options.

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References

  1. Halder RM, Nandedkar MA, Neal KW. Pigmentary disorders in ethnic skin. Dermatol Clin. 2003;21:617–28.

    Article  PubMed  Google Scholar 

  2. Nazzaro-Porro M, Passi S. Identification of tyrosinase inhibitor in culture of Pityrosporum. J Invest Dermatol. 1978;71:389–402.

    Article  Google Scholar 

  3. Karaoui R, Bou-Resli M, Alzaid NS, Mousa A. Tinea versicolor: ultrastructural studies on hypopigmented and hyperpigmented skin. Dermatologica. 1981;162:69–73.

    Article  CAS  PubMed  Google Scholar 

  4. Odom RB, James WD, Berger TG, editors. Disorders resulting from fungi and yeast. In: Diseases of the Skin, 12th ed. Philadelphia, PA: Elsevier; 2011. p. 285–318.

    Google Scholar 

  5. Charles CR, Sire DJ, Johnson BL, Beidler JG. Hypopigmentation in tinea versicolor: a histochemical and electron microscopic study. Int J Dermatol. 1973;12:48–58.

    Article  CAS  PubMed  Google Scholar 

  6. Galadari I, el Komy M, Mousa A, Hashimoto K, Mehregan AH. Tinea versicolor: histologic and ultrastructural investigation of pigmentary changes. Int J Dermatol. 1992;31(4):253–6.

    Article  CAS  PubMed  Google Scholar 

  7. Falabella R, Escobar C, Giraldo N, Rovetto P, Gil J, Barona MI, Acosta F, Alzate A. On the pathogenesis of idiopathic guttate hypomelanosis. J Am Acad Dermatol. 1987;16(pt 1):35–44.

    Article  CAS  PubMed  Google Scholar 

  8. Cummings KI, Cottel WI. Idiopathic guttate hypomelanosis. Arch Dermatol. 1966;93:184.

    Article  CAS  PubMed  Google Scholar 

  9. Savall R, Ferrandiz C, Ferrer I, Peyri J. Idiopathic guttate hypomelanosis. Br J Dermatol. 1980;103:635.

    Article  CAS  PubMed  Google Scholar 

  10. Ortonne J-P. Idiopathic guttate hypomelanosis: ultrastructural study. Arch Dermatol. 1980;116:664.

    Article  CAS  PubMed  Google Scholar 

  11. Wilson PD, Lavker RM, Kligman AM. On the nature of idiopathic guttate hypomelanosis. Acta Dermatol Venereol. 1982;62:301.

    CAS  Google Scholar 

  12. Wallace ML, Grichnik JM, Prieto VG, et al. Numbers and differentiation status of melanocytes in idiopathic guttate hypomelanosis. J Cutan Pathol. 1998;25:375–9.

    Article  CAS  PubMed  Google Scholar 

  13. Golhar A, Pillar T, Eidelman S, Etzioni A. Vitiligo and idiopathic guttate hypomelanosis. Repigmentation of skin following engraftment onto nude mice. Arch Dermatol. 1989;125(10):1363–6.

    Article  Google Scholar 

  14. Ploysangam T, Dee-Ananlap S, Suvanprakorn P. Treatment of idiopathic guttate hypomelanosis with liquid nitrogen: light and electron microscopic studies. J Am Acad Dermatol. 1990;23(4 Pt 1):681–4.

    Article  CAS  PubMed  Google Scholar 

  15. Hexsel DM. Treatment of idiopathic guttate hypomelanosis by localized superficial dermabrasion. Dermatol Surg. 1999;25(11):917–8.

    Article  CAS  PubMed  Google Scholar 

  16. Halder RM. Pigmentary disorders in pigmented skins. In: Halder RM, editor. Dermatology and dermatological therapy of pigmented skins. Boca Raton, FL: CRC Press; 2005.

    Google Scholar 

  17. Dhar S, Kanwar AJ, Dawn G. Pigmenting pityriasis alba. Pediatr Dermatol. 1995;12:197–8.

    Article  CAS  PubMed  Google Scholar 

  18. Watkins DB. Pityriasis alba: a form of atopic dermatitis. A preliminary report. Arch Dermatol. 1961;83:915–9.

    Article  CAS  PubMed  Google Scholar 

  19. Diepgen TL, Fartasch M, Hornstein OP. Evaluation and relevance of atopic basic and minor features in patients with atopic dermatitis and in the general population. Acta Derm Venereol Suppl (Stockh). 1989;144:50–4.

    CAS  Google Scholar 

  20. Bassaly M, Miale A Jr, Prasad AS. Studies on pityriasis alba: a common facial skin lesion in Egyptian children. Arch Dermstol. 1963;88:272–5.

    Article  CAS  Google Scholar 

  21. Martin RF, Lugo-Somolinos A, Sanchez JL. Clinicopathologic study on pityriasis alba. Bol Asoc Med PR. 1990;82:463–5.

    CAS  Google Scholar 

  22. Zaynoun ST, Aftimos BG, Tenekjian KK, et al. Extensive pityriasis alba: a histological, histochemical and ultrastructural study. Br J Dermatol. 1983;108:83–90.

    Article  CAS  PubMed  Google Scholar 

  23. Wells BT, Whyte HJ, Kierland RR. Pityriasis alba: a ten year survey and review of the literature. Arch Dermatol. 1960;82:183–9.

    Article  CAS  PubMed  Google Scholar 

  24. Galan EB, Janniger CK. Pityriasis alba. Cutis. 1998;61:11–3.

    CAS  PubMed  Google Scholar 

  25. Galadari E, Helmy M, Ahmed M. Trace elements in serum of pityriasis alba patients. Int J Dermatol. 1992;31:525–6.

    Article  CAS  PubMed  Google Scholar 

  26. Lin A. Topical immunotherapy. In: Wolverton SE, editor. Comprehensive dermatological therapy. Philadelphia, PA: Saunders; 2001. p. 617–9.

    Google Scholar 

  27. Morelli JG, Norris DA. Influence of inflammatory mediators and cytokines on human melanocyte function. J Invest Dermatol. 1993;100(2 Suppl):191S–5S.

    Article  CAS  PubMed  Google Scholar 

  28. Ellis DA, Tan AK. How we do it: management of facial hyperpigmentation. J Otolaryngol. 1997;26(4):286–9.

    CAS  PubMed  Google Scholar 

  29. Ortonne JP, Bahadoran P, Fitzpatrick TB, et al. Hypomelanoses and hypermelanoses. In: Freedberg IM, Eisen AZ, Wolff K, et al., editors. Fitzpatrick’s dermatology in general medicine, 6th ed. New York City, NY: McGraw-Hill; 2003. p. 857.

    Google Scholar 

  30. Vachiramon V, Thadanipon K. Postinflammatory hypopigmentation. Clin Exp Dermatol. 2011;36(7):708–14.

    Article  CAS  PubMed  Google Scholar 

  31. Tang M, Tan SH, Lim LC. Leukoderma associated with Sézary syndrome: a rare presentation. J Am Acad Dermatol. 2003;49:S247–9.

    Article  PubMed  Google Scholar 

  32. Whitmore SE, Simmons-O’Brien E, Rotler FS. Hypopigmented mycosis fungoides. Arch Dermatol. 1994;130:476–80.

    Google Scholar 

  33. Whittaker SJ, MacKie RM. Cutaneous lymphomas and lymphocytic infiltrates. In: Burns T, Breathnach S, Cox N, et al., editors. Rook’s textbook of dermatology, vol. 3, 7th ed. Oxford, England: Blackwell; 2004. p. 51–3.

    Google Scholar 

  34. Singh F, Lebwohl MG. Cutaneous T-cell lymphoma treatment using bexarotene and PUVA: a case series. J Am Acad Dermatol. 2004;51:570–3.

    Article  PubMed  Google Scholar 

  35. Knobler E. Current management strategies for cutaneous T-cell lymphoma. Clin Dermatol. 2004;22:197–208.

    Article  PubMed  Google Scholar 

  36. Relyveld GN, Kingswijk MM, Reitsma JB, Menke HE, Bos JD, Westerhof W. Benzoyl peroxide/clindamycin/UVA is more effective than fluticasone/UVA in progressive macular hypomelanosis: a randomized study. J Am Acad Dermatol. 2006;55:836–43.

    Article  PubMed  Google Scholar 

  37. Relyveld GN, Menke HE, Westerhof W. Progressive macular hypomelanosis: an overview. Am J Clin Dermatol. 2007;8(1):13–9.

    Article  PubMed  Google Scholar 

  38. Guillet G, Helenon R, Gauthier Y, et al. Progressive macular hypomelanosis of the trunk: primary acquired hypopigmentation. J Cutan Pathol. 1988;15:286–9.

    Article  CAS  PubMed  Google Scholar 

  39. Guillet G, Helenon R, Guillet MH, et al. Hypomelanose maculeuse confluente et progressive du metis melanoderme. Ann Dermatol Venereol. 1992;119(1):19–24.

    CAS  PubMed  Google Scholar 

  40. Relyveld GN, Kingswijk M, Reitsma JB, et al. Benzoyl peroxide/clindamycin/ultraviolet A is more effective than fluticasone/ultraviolet A in progressive macular hypomelanosis: a randomized study. J Am Acad Dermatol. 2006;55(5):836–43.

    Article  PubMed  Google Scholar 

  41. Menke HE, Ossekoppele R, Dekker SK, et al. Nummulaire en confluerende hypomelanosis van de romp. Ned Tijdsch Dermatol Venereol. 1997;7:117–22.

    Google Scholar 

  42. Ward KA, Moss C, Sanders DS. Human piebaldism: relationship between phenotype and site of kit gene mutation. Br J Dermatol. 1995;132:929–35.

    Article  CAS  PubMed  Google Scholar 

  43. Thomas I, Kihiczac GG, Fox MD, et al. Piebaldism: an update. Int J Dermatol. 2004;43:716–9.

    Article  PubMed  Google Scholar 

  44. Spritz RA. The molecular basis of human piebaldism. Pigment Cell Res. 1992;5:340–3.

    Article  CAS  PubMed  Google Scholar 

  45. Giebel LB, Strunk KM, Holmes SA, Spritz RA. Organization and nucleotide sequence of the human KIT (mast/stem cell growth factor receptor) proto-oncogene. Oncogene. 1992;7:2207–17.

    CAS  PubMed  Google Scholar 

  46. Boissy RE, Nordlund JJ. Molecular basis of congenital hypopigmentary disorders in humans: a review. Pigment Cell Res. 1997;10:2–24.

    Article  Google Scholar 

  47. Syrris P, Heathcote K, Carrozzo R, et al. Human piebaldism: six novel mutations of the proto-oncogene KIT. Hum Mutat. 2002;20:234.

    Article  PubMed  Google Scholar 

  48. Richards KA, Fukai K, Oiso N, et al. A novel KIT mutation results in piebaldism with progressive depigmentation. J Am Acad Dermatol. 2001;44:288–92.

    Article  CAS  PubMed  Google Scholar 

  49. Sanchez-Martin M, Perez-Losada J, Rodriguez-Garcia A, et al. Deletion of the SLUG(SNAI2) gene results in human piebaldism. Am J Med Genet A. 2003;122:125–32.

    Article  Google Scholar 

  50. Mahakrishnan A, Srinivasan MS. Piebaldism with Hirschprung’s disease. Arch Dermatol. 1980;116:1102.

    Article  CAS  PubMed  Google Scholar 

  51. Passeron T, Mantoux F, Ortonne JP. Genetic disorders of pigmentation. Clin Dermatol. 2005;23:56–67.

    Article  PubMed  Google Scholar 

  52. Toyofuku K, Wada I, Spritz RA, Hearing VJ. The molecular basis of oculocutaneous albinism type 1 (OCA1): sorting failure and degradation of mutant tyrosinases results in a lack of pigmentation. Biochem J. 2001;355:259–69.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Brilliant MH. The mouse p (pink-eyed dilution) and human P genes, oculocutaneous albinism type 2 (OCA2), and melanosomal pH. Pigment Cell Res. 2001;14:86–93.

    Article  CAS  PubMed  Google Scholar 

  54. Rosemblat S, Sviderskaya EV, Easty DJ, Wilson A, Kwon BS, Bennett DC, Orlow SJ. Melanosomal defects in melanocytes from mice lacking expression of the pink-eyed dilution gene: correction by culture in the presence of excess tyrosine. Exp Cell Res. 1998;239:344–52.

    Article  CAS  PubMed  Google Scholar 

  55. Puri N, Gardner JM, Brilliant MH. Aberrant pH of melanosomes in pink-eyed dilution (p) mutant melanocytes. J Invest Dermatol. 2000;115:607–13.

    Article  CAS  PubMed  Google Scholar 

  56. Manga P, Orlow SJ. Inverse correlation between pink-eyed dilution protein expression and induction of melanogenesis by bafilomycin A1. Pigment Cell Res. 2001;14:362–7.

    Article  CAS  PubMed  Google Scholar 

  57. Brilliant MH. The mouse p (pink-eyed dilution) and human P genes, oculocutaneous albinism type 2 (OCA2), and melanosomal pH. Pigment Cell Res. 2001;14:86–93.

    Article  CAS  PubMed  Google Scholar 

  58. Spritz RA. The molecular basis of human piebaldism. Pigment Cell Res. 1992;5:340–3.

    Article  CAS  PubMed  Google Scholar 

  59. Sarangarajan R, Boissy RE. Tyrp1 and oculocutaneous albinism type 3. Pigment Cell Res. 2001;14:437–44.

    Article  CAS  PubMed  Google Scholar 

  60. Newton JM, Cohen-Barak O, Hagiwara N, et al. Mutations in the human orthologue of the mouse underwhite gene (uw) underlie a new form of oculocutaneous albinism, OCA4. Am J Hum Genet. 2001;69:981–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Bothwell JE. Pigmented skin lesions in tyrosinase-positive oculocutaneous albinos: a study in black South Africans. Int J Dermatol. 1997;36(11):831–6.

    Article  CAS  PubMed  Google Scholar 

  62. Witkop CJ Jr, Hill CW, Desnick S, Theis JK, Thorn HL, Jenkins M. Ophthalmologic, biochemical, platelet and ultrastructural defects in the various types of oculocutaneous albinism. J Invest Dermatol. 1973;60:443–56.

    Article  CAS  PubMed  Google Scholar 

  63. Ortonne JP. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, Jorizzo JL, Rapini RP, editors. Dermatology. 2nd ed. Spain: Mosby Elsevier; 2003. p. 913–38.

    Google Scholar 

  64. Kromberg JGR, Castle D, Zwane EM, Jenkins T. Albinism and skin cancer in Southern Africa. Clin Genet. 1989;36:43–52.

    Article  CAS  PubMed  Google Scholar 

  65. Perry PK, Silverberg NB. Cutaneous malignancy in albinism. Cutis. 2001;67(5):427–30.

    CAS  PubMed  Google Scholar 

  66. Kovac S. Vitiligo. J Am Acad Dermatol. 1998;38:647–66.

    Article  Google Scholar 

  67. Alikhan A, Felsten LM, Daly M, et al. Vitiligo: a comprehensive overview Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up. J Am Acad Dernatol. 2011;65(3):473–91.

    Google Scholar 

  68. Halder RM, Chappell JL. Vitiligo update. Semin Cutan Med Surg. 2009;28(2):86–92.

    Article  CAS  PubMed  Google Scholar 

  69. Westerhof W, Nieuweboer-Krobotova L. Treatment of vitiligo with UVB radiation vs topical psoralen plus UVA. Arch Dermatol. 1997;133(12):1525–8.

    Article  CAS  PubMed  Google Scholar 

  70. Scherschun L, Kim JJ, Lim HW. Narrow-band ultraviolet B is a useful and well-tolerated treatment for vitiligo. J Am Acad Dermatol. 2001;44:999–1003.

    Article  CAS  PubMed  Google Scholar 

  71. Passeron T, Ortonne JP. Use of the 308-nm excimer laser for psoriasis and vitiligo. Clin Dermatol. 2006;24:33–42.

    Article  PubMed  Google Scholar 

  72. Ortonne JP, Passeron T. Melanin pigmentary disorders: treatment update. Dermatol Clin. 2005;23:209–26.

    Article  PubMed  Google Scholar 

  73. Bose SK. Modified Thiersch grafting in stable vitiligo. J Dermatol. 1996;23(5):362–4.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Rebat M. Halder .

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Patel, T.J., Rodney, I.J., Halder, R.M. (2017). Disorders of Hypopigmentation and Depigmentation. In: Vashi, N., Maibach, H. (eds) Dermatoanthropology of Ethnic Skin and Hair. Springer, Cham. https://doi.org/10.1007/978-3-319-53961-4_14

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