Extensive Macular Pigmentation on the Face
A 52-year-old white man with nonitchy, tan "freckling" on his face. The freckles have been present for years. He finds them embarrassing, and would like them to be less noticeable.
The patient started losing skin pigment at age 8, and by age 30 he was almost entirely without pigment, except for his face. The rest of the patient's medical history was negative, except for a keratoacanthoma removed from the dorsum of his left hand about 10 years ago. He tries to avoid recreational exposure to the sun, and does not work outdoors. His brother has a similar loss of pigment.
The most striking cutaneous finding was extensive macular pigmentation of the face (Figure 1), which was actually small areas of remaining pigment, the residua of nearly generalized pigment loss. His hair, which was black, is turning gray with age. The sun-exposed surfaces, including the face and hands, do not show substantial actinic damage. The rest of the physical exam was negative.
(Enlarge Image)
Extensive macular pigmentation of the face.
None were obtained.
What is your diagnosis?
View the correct answer.
<p>Vitiligo</p>
A 52-year-old white man with nonitchy, tan "freckling" on his face. The freckles have been present for years. He finds them embarrassing, and would like them to be less noticeable.
The patient started losing skin pigment at age 8, and by age 30 he was almost entirely without pigment, except for his face. The rest of the patient's medical history was negative, except for a keratoacanthoma removed from the dorsum of his left hand about 10 years ago. He tries to avoid recreational exposure to the sun, and does not work outdoors. His brother has a similar loss of pigment.
The most striking cutaneous finding was extensive macular pigmentation of the face (Figure 1), which was actually small areas of remaining pigment, the residua of nearly generalized pigment loss. His hair, which was black, is turning gray with age. The sun-exposed surfaces, including the face and hands, do not show substantial actinic damage. The rest of the physical exam was negative.
(Enlarge Image)
Extensive macular pigmentation of the face.
None were obtained.
What is your diagnosis?
Albinism
Vitiligo
View the correct answer.
<p>Vitiligo</p>