Guttate Hypopigmentation

Guttate Hypopigmentation

Electra Nicolaidou

Andreas Katsambas


Idiopathic guttate hypomelanosis (IGH) is a common acquired skin disorder, characterized by the presence of well-defined, round to oval, porcelain white macules a few millimeters in diameter. The lesions are usually noticed on the extensor surface of the upper and lower extremities, and their prevalence increases with age. The pathogenesis of the disorder is not clear, although chronic sun exposure seems a strong contributing factor.

IGH is very common with a reported prevalence of 87% in patients older than 40 years. The prevalence is higher with advancing age and similar among males and females.1 Lesions may appear quite early in life, even before the age of 20 years.2 IGH is described in all races and skin types.

The lesions of IGH are asymptomatic, but many affected patients seek medical care to confirm the benign nature of the disorder and to discuss the aesthetic improvement of the lesions. Many dermatologists choose to reassure the patients and offer no treatment. Recent studies have, however, used several treatment modalities with good results.


Idiopathic guttate hypomelanosis presents with well-demarcated, round to oval porcelain white macules with a diameter of 0.5 to 6 mm predominantly distributed on the extensor surfaces of the upper and lower extremities (Figure 2.2.1). Larger lesions have also been described.

Lesions have a predilection for sun-exposed areas of arms and shins, but they can also occur on sun-protected sites. Involvement of the face has been described in 6% of patients.1 The number and size of the lesions increase with increasing age (Figure 2.2.2), and more than 100 lesions have been described in older individuals.


The exact pathogenesis of IGH remains obscure. As it mainly occurs on sun-exposed areas, chronic ultraviolet (UV) exposure seems to play a pivotal role in the development of the lesions. However, IGH lesions are also found on nonexposed sites, suggesting that senile degeneration of the skin may also contribute to the pathogenesis of the disorder.5

Jun 29, 2020 | Posted by in Dermatology | Comments Off on Guttate Hypopigmentation
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