Section : Conference Notes

Differential diagnosis of hypomelanoses in children

Differential diagnosis of hypomelanoses in children (N. Van Geel (Ghent, Belgium))

Use a stepwise approach

step 1 history

  • congenital or acquired
  • stable or progressive
  • other medical problems
  • family history

step 2 clinical examination

  • localisation (Woods light important especially in the localized form)
  • number of lesions
  • pattern (linear blaschkoid, segmental)
  • hypomelanosis or amelanosis
  • other problems (neurological,  eyes)

step 3: Apply information of flowchart (differential diagnosis)

  • if diffuse: presence or absence of ocular involvmenet
  1. ocular involvement: albinos group, also Griscelli syndrome, Chediak-Higashi syndrome
  2. no ocular involvement: think of Metabolic causes: Menkies syndrome, phenylcetonuria
  • if localized
  1. depigmentation: waardenburg, piedbaldism
  2. hypopigmentation: tuberous scleroris, nevus depigmentosus, Pigmentation of inflammatory (PIH) or infectious origin, Pigmentary mosaicism (Hypomelanosis of Ito) lichen striatus
  3. no pigment disorder: nevus anemicus
Sclérose Tubéreuse de Bourneville: aspect en feuille de sorbier
Ash-leaf macule in Tuberous Sclerosis

Source of Information: Sy 17. Pigmentation Disorders: From Vitiligo to Hyyperpigmentation. 2011 (10) – 20th Annual Congress of the EADV (European Academy of Dermatology and Venerology) – Lisbon (Lisboa), Portugal