Home About us Editorial board Ahead of print Current issue Archives Instructions Submit article Search Subscribe Contacts Login
  • Users Online: 430
  • Home
  • Print this page
  • Email this page


 
 Table of Contents  
THE CLINICAL PICTURE
Year : 2014  |  Volume : 1  |  Issue : 1  |  Page : 31

Punctate leukoderma


Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication26-Jun-2014

Correspondence Address:
Muthu Sendhil Kumaran
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2349-5847.135439

Rights and Permissions

How to cite this article:
Uprety S, Vinay K, Kumaran MS. Punctate leukoderma. Pigment Int 2014;1:31

How to cite this URL:
Uprety S, Vinay K, Kumaran MS. Punctate leukoderma. Pigment Int [serial online] 2014 [cited 2019 Oct 15];1:31. Available from: http://www.pigmentinternational.com/text.asp?2014/1/1/31/135439

A 40-year-old male patient with acrofacial vitiligo, presented with multiple punctate, well-defined depigmented macules, over chest, back, and proximal extremities [Figure 1] and [Figure 2]. They appeared 6 months after psoralen plus ultraviolet A (PUVA) sol (psoralen + sunlight) treatment. Based on history and clinical findings a diagnosis of punctate leukoderma was made.
Figure 1: Multiple punctate, well-defined depigmented macules, over back

Click here to view
Figure 2: Close up of multiple punctate, well-defined depigmented macules, over the back

Click here to view


Punctate leukoderma is an adverse effect of PUVA therapy, characterized by multiple discrete, hypopigmented or achromic, round to oval macules distributed over extremities, chest, and back. It is attributed to nuclear damage of both the keratinocytes and melanocytes caused by the formation of psoralen photo adducts. Histopathology demonstrates decrease, but not absence of melanocytes and melanin pigment. Ultrastructural studies have shown cellular damage with vacuolar degeneration of both keratinocytes and melanocytes.

The other clinical mimics of punctate leukoderma include vitiligo itself, tuberous sclerosis, chemical leukoderma, tinea versicolor and idiopathic guttate hypomelanosis. Idiopathic guttate hypomelanosis is a disease of advanced age in the pigmented races. The lesions are small, achromic, angulated macules distributed predominantly over extremities. The ultrastructural changes as seen in PUVA induced punctate leukoderma are not present. Vitiligo histopathologically shows absence of melanocytes and melanin pigment. Absence of fine scales and a negative KOH scraping can exclude the diagnosis of tinea versicolor.


    Figures

  [Figure 1], [Figure 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Article Figures

 Article Access Statistics
    Viewed2797    
    Printed38    
    Emailed0    
    PDF Downloaded194    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]