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Acquired hypopigmentation disorders other than vitiligo

Mi Ryung Roh, MD, PhD
Sang Ho Oh, MD, PhD
Section Editor
Hensin Tsao, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc


The color of human skin is mainly determined by the two types of melanin, the black-brown eumelanin and the yellow-red pheomelanin. Other significant contributors include the capillary blood flow, chromophores such as carotene or lycopene, and the collagen content of the dermis. Altered skin pigmentation can result from increased or decreased melanin, abnormal melanin distribution, decreased hemoglobin, or deposition of exogenous substances [1].

While hypopigmentation is a general term that refers to any form of decreased or absent skin pigmentation, hypomelanosis more specifically refers to a reduction of epidermal melanin. Hypopigmentation disorders may be congenital or acquired, diffuse (generalized) or localized, and may occur in isolation or be associated with a wide range of congenital or acquired disorders [2,3].

This topic will review the acquired hypopigmentation disorders other than vitiligo. Vitiligo is discussed separately. Hyperpigmentation disorders are also discussed separately. (See "Vitiligo: Pathogenesis, clinical features, and diagnosis" and "Vitiligo: Management and prognosis" and "Acquired hyperpigmentation disorders".)


The diagnosis of hypopigmentation disorders is in many cases made on clinical grounds, based upon a detailed medical history and physical examination. The lesion morphology, color (hypopigmented or depigmented), distribution, and pattern are important clues to the diagnosis. However, examination with a Wood's light, a skin biopsy, and additional laboratory tests may be required if the clinical diagnosis is uncertain. The differential diagnosis of hypopigmentation disorders is illustrated in the algorithm (algorithm 1).

Patient evaluation — The initial patient evaluation involves a detailed family and personal history and a complete physical examination, which should include a careful search for additional cutaneous and extracutaneous signs and symptoms.

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Literature review current through: Nov 2017. | This topic last updated: Jul 25, 2016.
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