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Dermatology (Expert Forum)
2nd Opinion regarding hypopigmentation 2ndary to dermatitis?
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
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2nd Opinion regarding hypopigmentation 2ndary to dermatitis?
by SSY, May 03, 2003 12:00AM
I am writing for a 2nd opinion for hypopigmentation.
I am a 27 yo Asian male with no past medical history, only meds I'm on for several months are Triaz facial wash, clindamycin wipes, and benzamycin for moderate acne which is now cleared. I had been on a 3 month course of minocycline but that is now stopped.
A couple years ago a previous doctor dx'd me with confluent reticulated papillomatosis for multiple hypopigment macules on my chest, back, and shoulders which looked a lot like tinea versicolor but (-) KOH stain, and put me on minocycline and I was treated successfully.
For 2.5 weeks now I've had a 2x3 cm hypopigmented round macule with irregular borders on my forehead. My skin is normally tan and this is subtly lighter (not white) but definitely noticeable, and the skin itself seems smoother than the surrounding normal skin. I also have a 4x4 mm spot on my temple near the hairline (no hair changes) similarly hypopigmented.
My dermatlogist said it was likely from dermatitis although I can't recall any previous rashes or irritations. I haven't had much acne on my forehead either. She did not use a Wood's lamp or biopsy but seemed fairly confident in saying it was essentially *post-inflammatory hypopigmentation*.
I was started on 2.5% cortisone creme twice/day for 7 days just finished. I don't see improvements, and if anything I feel like the area is a little more noticeable now (rest of face seems more tan).
My concerns are:
1) Is there any chance this is "early" vitiligo? (I ask because my father has small patches vitiligo on elbows). Does this sound like post-inflamm hypopigmentation although no clear preceding hx of dermatitis or a variant of the papilomatosis I was dx'd with before?
2) Minocycline helped me the last time I had hypopigmentations although this is a little different; would it hurt to go back on it?
3) Now that I've finished topical steroids how long do I have to wait for color to return, and does it return in most instances?
4) Should I be concerned with all the topical agents I'm on for acne are causing this or making it worse? I heard benzoyl peroxide is a bleaching agent.
Thanks for reading through this; I look forward to your answers.
I know clinically it is not a major medical problem but its cosmetic appearance does concern me somewhat.
I am a 27 yo Asian male with no past medical history, only meds I'm on for several months are Triaz facial wash, clindamycin wipes, and benzamycin for moderate acne which is now cleared. I had been on a 3 month course of minocycline but that is now stopped.
A couple years ago a previous doctor dx'd me with confluent reticulated papillomatosis for multiple hypopigment macules on my chest, back, and shoulders which looked a lot like tinea versicolor but (-) KOH stain, and put me on minocycline and I was treated successfully.
For 2.5 weeks now I've had a 2x3 cm hypopigmented round macule with irregular borders on my forehead. My skin is normally tan and this is subtly lighter (not white) but definitely noticeable, and the skin itself seems smoother than the surrounding normal skin. I also have a 4x4 mm spot on my temple near the hairline (no hair changes) similarly hypopigmented.
My dermatlogist said it was likely from dermatitis although I can't recall any previous rashes or irritations. I haven't had much acne on my forehead either. She did not use a Wood's lamp or biopsy but seemed fairly confident in saying it was essentially *post-inflammatory hypopigmentation*.
I was started on 2.5% cortisone creme twice/day for 7 days just finished. I don't see improvements, and if anything I feel like the area is a little more noticeable now (rest of face seems more tan).
My concerns are:
1) Is there any chance this is "early" vitiligo? (I ask because my father has small patches vitiligo on elbows). Does this sound like post-inflamm hypopigmentation although no clear preceding hx of dermatitis or a variant of the papilomatosis I was dx'd with before?
2) Minocycline helped me the last time I had hypopigmentations although this is a little different; would it hurt to go back on it?
3) Now that I've finished topical steroids how long do I have to wait for color to return, and does it return in most instances?
4) Should I be concerned with all the topical agents I'm on for acne are causing this or making it worse? I heard benzoyl peroxide is a bleaching agent.
Thanks for reading through this; I look forward to your answers.
I know clinically it is not a major medical problem but its cosmetic appearance does concern me somewhat.
Doctor's Answer
by Alan Rockoff, MD, May 04, 2003 12:00AM
, May 04, 2003 12:00AM
Vitiligo doesn't come on as rapidly as the spot you describe. I'm inclined to agree with your dermatologist. We often blam inflammation as the cause for discoloration, even though there was no irritation evident. I don't see any role for minocycline, nor do I think that benzoyl peroxide would bleach your skin.
I advise you to wait 4 weeks and if the spot is still visible, show your doctor and perhaps she'll do a Wood's light examination, just to be sure.
In general, though, the faster things come on, the more likely they are to go away.
Take care.
Dr. Rockoff
I advise you to wait 4 weeks and if the spot is still visible, show your doctor and perhaps she'll do a Wood's light examination, just to be sure.
In general, though, the faster things come on, the more likely they are to go away.
Take care.
Dr. Rockoff
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