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February 1940


Arch Derm Syphilol. 1940;41(2):444-450. doi:10.1001/archderm.1940.01490080253020

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Universal Depigmentation of the Skin, with Areas of Hyperpigmentation.  Presented by Dr. Howard Earl Twinning.J. T., a Negro aged 50, in 1917 first noticed on his chin and hands white spots which gradually became universal. In the summer of 1938 the exposed areas of the skin became blistered after exposure to the sun, after which they became hyperpigmented. The entire cutaneous surface is now white except for the areas of hyperpigmentation on the face, hands and arms.

DISCUSSION  Dr. John H. Stokes: I think this patient is interesting because he demonstrates, if his statement about his original color is correct, that there is really hyperpigmentation associated with depigmentation of the skin. Not infrequently it is said that hyperpigmentation is an optical illusion based on contrast between the depigmented skin and the normally pigmented skin, possibly accentuated by exposure to sunlight. But this man has extremely dark spots which clearly

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