9th July 2023

Other Pigmented Lesions

Vitiligo

Vitiligo is an acquired depigmentation disorder due to epidermal melanocyte loss. Lack of melanin production presents as well-defined depigmented macules or patches, often in a symmetrical pattern and can be localised or progressive. Whilst it can occur on any site, acral, periorificial and genital areas are typically affected. Risk factors include auto-immune disorders, family history, cutaneous trauma, and age <30 years. It is often a clinical diagnosis. Treatments include topical and systemic immunosuppression, phototherapy, or a combination to stimulate re-pigmentation.

Melasma

Melasma is an acquired disorder of facial hyperpigmentation resulting from the overproduction of melanin from melanocytes. It often presents as bilateral and irregular hyperpigmented macules or patches, typically affecting women aged 20-40 years with Fitzpatrick skin type III-IV. Causes include family history, UV exposure and hormones (such as pregnancy, oestrogen/progesterone use in the form of contraceptives and hormone replacement therapies). Sun protection is important, and whilst several topical treatments are available, resolution is often slow, and recurrence is high.