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A well-defined, hypopigmented, irregularly shaped, confluent macules forming a patch that is usually found on the trunk; It presents at birth or early in childhood and persists in to adulthood remaining unchanged; Stroking, rubbing, or warming induces erythema of the adjacent normal skin Idiopathic guttate hypomelanosis is a common but underreported condition in elderly patients that usually presents with small, discrete, asymptomatic, hypopigmented macules. 1,2 The skin surrounding the lesions may be normal or mildly erythrocyanotic. Some people with hypopigmentation are at a higher risk for skin cancer. Differential diagnosis. The differential diagnosis is challenging as TFI resemble many other dermatologic conditions. 1 Frequency of the condition is much lower in … Nevus depigmentosus. The hypopigmented macules progress to full depigmentation. ... hypopigmented macules in this 6-year-old child with pityriasis alba. In these cases, the skin is more vulnerable to damage from ultraviolet rays. Erythema, scale, and papules within these macules and patches are variable. It is necessary to perform a clinical differential diagnosis of hypopigmented lesions, including vitiligo, idiopathic guttate hypomelanosis, tinea versicolor, and postinflammatory hypopigmentation. When faced with a patient with hypopigmented macules, the differential diagnosis should include tinea versicolor, pityriasis alba, vitiligo, tuberculoid leprosy, and idiopathic guttate hypomelanosis. Obsessive compulsive disorder (OCD) – The obsessive thoughts and repetitive actions seen in OCD can appear The macules are well circumscribed and each has a central raised lesion. Case presentation A 7-year-old girl presents with a small number of hypopigmented macules on her back that have been present for about three months (Figure 1). This is a broad category of differential diagnoses with variable symptomatology depending on the specific diagnosis. Pigmentation of the skin normally varies according to racial origin (see Fitzpatrick phototypes) and the amount of sun exposure.Pigmentation disorders are often more troublesome in skin of colour.. For example, macules can be moles (which are hyperpigmented, or darker, relative to the skin) or vitiligo lesions (which are hypopigmented or depigmented, or lighter, relative to the skin). The frequency of IGH increases with age. Lesions of pityriasis alba are usually bilateral and located on the face, arms, and neck. Quadrichrome vitiligo features a fourth, dark-brown pigment, which surrounds hair follicles. Introduction. Differential diagnosis Conditions to include in the differential diagnosis include the following. Pigmenting pityriasis alba. BS consists of asymptomatic, small, irregular, hypopigmented macules characterized by a normal histological appearance, which are usually found in individuals aged 20-40 and more frequently in women than men. Hypochromic naevus (naevus depigmentosus). Hypopigmented MF presents with hypopigmented macules and patches. DISCUSSION. The differential diagnosis of pityriasis alba includes the following: Postinflammatory pigment alteration. Lesions often occur on the head, neck, upper extremities, trunk, and buttocks. This is especially true of albinism. The pigment cells or melanocytes are located at the base of the epidermis and produce the protein melanin.Melanin is carried by keratinocytes to the skin surface. a. , discrete, asymptomatic, hypopigmented macules conditions to include in the differential of. Include the following surrounding the lesions may be normal or mildly erythrocyanotic alba! On the head, neck, upper extremities, trunk, and neck macules well... 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