Erythema, scale, and papules within these macules and patches are variable. Lesions of pityriasis alba are usually bilateral and located on the face, arms, and neck. 1 Frequency of the condition is much lower in … The hypopigmented macules progress to full depigmentation. 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. When faced with a patient with hypopigmented macules, the differential diagnosis should include tinea versicolor, pityriasis alba, vitiligo, tuberculoid leprosy, and idiopathic guttate hypomelanosis. This is a broad category of differential diagnoses with variable symptomatology depending on the specific diagnosis. a. Quadrichrome vitiligo features a fourth, dark-brown pigment, which surrounds hair follicles. 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. Obsessive compulsive disorder (OCD) – The obsessive thoughts and repetitive actions seen in OCD can appear 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 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.. It is necessary to perform a clinical differential diagnosis of hypopigmented lesions, including vitiligo, idiopathic guttate hypomelanosis, tinea versicolor, and postinflammatory hypopigmentation. Differential diagnosis. 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. Hypopigmented MF presents with hypopigmented macules and patches. Some people with hypopigmentation are at a higher risk for skin cancer. The frequency of IGH increases with age. 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). ... hypopigmented macules in this 6-year-old child with pityriasis alba. Introduction. DISCUSSION. Hypochromic naevus (naevus depigmentosus). Lesions often occur on the head, neck, upper extremities, trunk, and buttocks. 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