STUDY - Technical - New Dacian's Medicine
Hypopigmentation
(Classical / Allopathic Medicine)
Hypopigmentation
(hypomelanosis) is a decrease in normal skin, hair, mucous
membrane, or nail color resulting from deficiency, absence, or
abnormal degradation of the pigment melanin. This sign may be
congenital or acquired, asymptomatic, or associated with other
findings. Its causes include genetic disorders, nutritional
deficiency, exposure to chemicals or drugs, inflammation,
infection, and physical trauma. Typically chronic,
hypopigmentation can be difficult to identify if the patient
is light-skinned or has only slightly decreased coloring.
HISTORY:
Ask the patient if the hypopigmentation was present from birth or developed after skin lesions or a rash. Have other family members experienced hypopigmentation?
Ask the patient if the lesions are painful.
Ask the patient if he has medical problems or a history of burns, physical injury, or physical contact with chemicals.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Find out if the patient has noticed other skin changes, such as erythema, scaling, ulceration, or hyperpigmentation or if sun exposure causes unusually severe burning.
Ask the patient if the hypopigmentation was present from birth or developed after skin lesions or a rash. Have other family members experienced hypopigmentation?
Ask the patient if the lesions are painful.
Ask the patient if he has medical problems or a history of burns, physical injury, or physical contact with chemicals.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Find out if the patient has noticed other skin changes, such as erythema, scaling, ulceration, or hyperpigmentation or if sun exposure causes unusually severe burning.
PHYSICAL
ASSESSMENT:
Examine the patient's skin, noting erythema, scaling, ulceration, areas of hyperpigmentation, and other findings.
Examine the patient's skin, noting erythema, scaling, ulceration, areas of hyperpigmentation, and other findings.
SPECIAL
CONSIDERATIONS:
In fair-skinned patients, a Wood's lamp, which is a special ultraviolet (UV) light, can help differentiate hypopigmented lesions, which appear pale, from depigmented lesions, which appear white.
In fair-skinned patients, a Wood's lamp, which is a special ultraviolet (UV) light, can help differentiate hypopigmented lesions, which appear pale, from depigmented lesions, which appear white.
PEDIATRIC
POINTERS:
In children, hypopigmentation results from genetic or acquired disorders, including albinism, phenylketonuria, and tuberous sclerosis.
In neonates, hypopigmentation may indicate a metabolic or nervous system disorder.
In children, hypopigmentation results from genetic or acquired disorders, including albinism, phenylketonuria, and tuberous sclerosis.
In neonates, hypopigmentation may indicate a metabolic or nervous system disorder.
AGING ISSUES:
In elderly people, hypopigmentation is usually the result of cumulative exposure to UV light.
In elderly people, hypopigmentation is usually the result of cumulative exposure to UV light.
PATIENT
COUNSELING:
Advise patients to use corrective cosmetics to help hide skin lesions and to use sunblock when outdoors because hypopigmented areas may sunburn easily. Advise patients with associated eye problems, such as albinism, to avoid the midday sun and to wear sunglasses.
Encourage regular examinations for early detection and treatment of lesions that may become premalignant or malignant. Refer patients for counseling if lesions cause stress.
Advise patients to use corrective cosmetics to help hide skin lesions and to use sunblock when outdoors because hypopigmented areas may sunburn easily. Advise patients with associated eye problems, such as albinism, to avoid the midday sun and to wear sunglasses.
Encourage regular examinations for early detection and treatment of lesions that may become premalignant or malignant. Refer patients for counseling if lesions cause stress.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)