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Nevus Depigmentosus. Presented by Monika Berg, MD, and William Tarnowski, MD.
A 22-year-old black woman had two discrete macular areas of hypopigmentation confined to the left side of the neck, upper chest, and back, corresponding to dermatomes C2 through C4 and T4 and T5. Past history reveals no neurologic disease and the family history is noncontributory in regard to a pigmentation or central nervous system abnormality.A regimen of methoxsalen, 40 mg two hours prior to ultraviolet light exposure, was recently prescribed for the patient. She has had four treatments and as yet has shown no response to therapy.
Dr T. B. Fitzpatrick: The differential diagnosis includes the following: nevus depigmentosus, which I think this patient has; tuberous sclerosis, neurofibromatosis, ataxia telangiectasia, and vitiligo, which may all be rarely present in a unilateral dermatome-like distribution. This lesion does not represent "vitiligo," but more correctly a form of leukoderma.An
Hadley TP. NEW ENGLAND DERMATOLOGICAL SOCIETY. Arch Dermatol. 1974;109(6):920-921. doi:10.1001/archderm.1974.01630060084039