Editing Hypopigmentation

{{short description|Area of skin becoming lighter than the baseline skin color}}
{{More citations needed|auto=yes|date=December 2009}}
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| name            = Hypopigmentation
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| image           = Vitiligo03.jpg
| caption         = Hypopigmentation in vitiligo
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'''Hypopigmentation''' is characterized specifically as an area of [[Human skin|skin]] becoming lighter than the baseline skin color, but not completely devoid of [[skin pigment|pigment]]. This is not to be confused with [[depigmentation]], which is characterized as the absence of all pigment.<ref name=":1" />  It is caused by [[melanocyte]] or [[melanin]] depletion, or a decrease in the [[amino acid]] [[tyrosine]], which is used by melanocytes to make melanin.<ref name=":0">{{Cite book |title=Biochemistry |last=Ferrier |first=Denise R. |isbn=978-1-4963-4449-6 |edition= Seventh |location=Philadelphia |oclc=956263971|year=2017 }}</ref> Some common genetic causes include mutations in the [[tyrosinase]] gene or [[OCA2]] gene.<ref>{{Cite book|title=Harrison's Principles of Internal Medicine|last1=Bolognia|first1=Jean|last2=Braverman|first2=Irwin|publisher=McGraw-Hill|year=2014|location=New York, NY|chapter=Skin Manifestations of Internal Disease}}</ref><ref>{{Cite book|chapter-url=http://accessmedicine.mhmedical.com.eres.library.manoa.hawaii.edu/content.aspx?bookid=2355&sectionid=185845621.|title=The Big Picture: Medical Biochemistry Eds|last=Cross|first=Harold|publisher=McGraw-Hill|location=New York, NY|chapter=Biochemical Basis of Diseases}}</ref>  As melanin pigments tend to be in the skin, eye, and hair, these are the commonly affected areas in those with hypopigmentation.<ref name=":0" />

Hypopigmentation is common and approximately one in twenty have at least one hypopigmented macule. Hypopigmentation can be upsetting to some, especially those with darker skin whose hypopigmentation marks are seen more visibly. Most causes of hypopigmentation are not serious and can be easily treated.<ref>{{Cite journal|last1=Hill|first1=Jeremy P.|last2=Batchelor|first2=Jonathan M.|date=2017-01-12|title=An approach to hypopigmentation|url=https://www.bmj.com/content/356/bmj.i6534|journal=BMJ|language=en|volume=356|pages=i6534|doi=10.1136/bmj.i6534|issn=0959-8138|pmid=28082370|s2cid=26827617|url-access=subscription}}</ref>

==Presentation==
===Associated conditions===
It is seen in:
* [[Albinism]]<ref name=":0" />
* [[Idiopathic guttate hypomelanosis]]
* [[Leprosy]]
* [[Leucism]]
* [[Phenylketonuria]]<ref name=":0" />
* [[Pityriasis alba]]
* [[Vitiligo]]
* [[Angelman syndrome]]
* [[Tinea versicolor]]
* [[Yaws]]
* An uncommon adverse effect of [[imatinib]] therapy
* Injections of high concentrations of [[corticosteroid]]s (transient)<ref name=":1">{{Cite book|chapter-url=http://accessmedicine.mhmedical.com.eres.library.manoa.hawaii.edu/content.aspx?bookid=2449&sectionid=194431938.|title=Current Medical Diagnosis & Treatment|last1=Shinkai|first1=Kanade|last2=Fox|first2=Lindy|publisher=McGraw-Hill|year=2018|location=New York, NY|publication-date=2018|chapter=Dermatological Disorders}}</ref>

==Diagnosis==
Areas of lighter pigmentation can be indications of hypopigmentation. Biopsies and genetic information are also used to diagnose.

==Treatments==
Often, hypopigmentation can be brought on by laser treatments; however, the hypopigmentation can be treated with other lasers or light sources.<ref>{{cite journal |last1=Reszko |first1=Anetta |last2=Sukal |first2=Sean A. |last3=Geronemus |first3=Roy G. |title=Reversal of Laser-Induced Hypopigmentation with a Narrow-Band UV-B Light Source in a Patient with Skin Type VI |journal=Dermatologic Surgery |date=14 July 2008 |volume=34 |issue=10 |pages=1423–1426 |doi=10.1097/00042728-200810000-00021|pmid=18637814 }}</ref> [[Micropigmentation]] can also be used to obtain a more normal appearance of the hypopigmentated skin.<ref name="Haney pp. 59–66">{{cite book | last=Haney | first=Beth | title=Aesthetic Procedures: Nurse Practitioner's Guide to Cosmetic Dermatology | chapter=Permanent and Semi-permanent Micro-Pigment Treatments | publisher=Springer International Publishing | publication-place=Cham | date=September 21, 2019 | isbn=978-3-030-19947-0 | doi=10.1007/978-3-030-19948-7_7 | pages=59–66| s2cid=203829421 }}</ref>

Treatment for hypopigmentation depends on the initial cause of the discoloration.{{medical citation needed|date=July 2023}}
{| class="wikitable"
|+Treatments for Hypopigmentation<ref>{{Cite book|title=Harrison's Principles of Internal Medicine.|date=2012|publisher=McGraw-Hill|others=Longo, Dan L. (Dan Louis), 1949-, Fauci, Anthony S., 1940-, Kasper, Dennis L., Hauser, Stephen L., Jameson, J. Larry., Loscalzo, Joseph.|isbn=9780071748902|edition= 18th|location=New York|oclc=747712285}}</ref>
|'''Initial Cause of Discoloration'''
|'''Treatment'''
|-
|[[Idiopathic guttate hypomelanosis]]
|No treatment
|-
|[[Postinflammatory hypopigmentation]]
|Treat the underlying inflammatory disease to restore pigmentation
|-
|[[Tinea versicolor|Pityriasis versicolor]]
|A topical ointment, such as selenium sulfide 2.5% or imidazoles.
Can also use oral medications, such as oral imidazoles or triazoles.
|-
|[[Vitiligo]]
|Topical immunosuppressants, including calcineurin inhibitors.
Patients can also have transplants if they are stable or a depigmentation with topical MBEH if the patient has widespread discoloration.
|-
|[[Leukoderma|Chemical or drug induced leukoderma]]
|Avoidance of causative agent with subsequent treatment similar to vitiligo.
|-
|[[Piebaldism]]
|None; occasionally transplants.
|}

==See also==
* [[Hyperpigmentation]]

==References==
{{Reflist}}

== External links ==
{{Medical resources
|  DiseasesDB      = 21207 
|  ICD10           = L80, L81.5-L81.6 
|  ICD9            = {{ICD9|709.0}} 
|  ICDO            = 
|  OMIM            = 
|  MedlinePlus     = 
|  eMedicineSubj   = 
|  eMedicineTopic  = 
|  MeshID          = D017496
}}
{{Pigmentation disorders}}

[[Category:Dermatologic terminology]]
[[Category:Disturbances of human pigmentation]]