Table 1.
Condition | Clinical Characteristics | Dermatoscopy |
---|---|---|
Hypopigmented Disorders | ||
Pityriasis alba [55,56] |
Flat, acquired roundish, asymptomatic hypopigmented macules with a subtle scaling, often located on the facial skin in children and adolescents. | Poorly demarcated hypopigmented areas covered with fine scales (lamellar or branny). |
Vitiligo [51,56] | Flat, acquired and persistent, uni- or bilateral, well-demarcated hypopigmented roundish or linear macules. | Well-demarcated, non-scaly, diffuse white areas, usually accompanied with perifollicular hyperpigmentation and leukotrichia. |
Idiopathic guttate hypomelanosis [51,56] |
Flat, acquired hypo- or depigmented, variably sized roundish or polygonal macules predominantly located on sun-exposed sites and sparing the face. | Numerous well- to poorly defined hypopigmented areas characterised by various shades of white, bordering randomly distributed hyperpigmented reticular lines (cloudy sky-like pattern). |
Leprosy (borderline or borderline tuberculoid) [56,57] |
Distinct, acquired, circular, erythematous plaques with well-defined edges, forming a saucer-like shape, where the margins slope inside. | Orange-yellow or white structureless areas, with reduced number of hair units/follicular and eccrine ostia (white clods and dots, respectively). Orange clods, and vascular polymorphism (lines serpentine, clods, dots) can be present in some cases. |
Progressive macular hypomelanosis [58] |
Flat, acquired, symmetrically distributed, coalescing, non-scaly hypopigmented macules affecting the trunk and back. | Disseminated folliculocentric depigmented areas displaying subtle pigmentation of reticular lines. If present, delicate white scales are mainly restricted to skin creases. |
Ash leaf macules in tuberous sclerosis [56,59] |
Congenital, flat lanceolate depigmented macules present in tuberous sclerosis or isolated. | Poorly demarcated depigmented areas. Subtle background reticular lines are preserved. |
Nevus depigmentosus [51,56] |
Congenital, asymptomatic flat pale macules with fixed shape, typically present at birth. | Poorly defined hypopigmented area with subtle faded physiological reticular lines of background pigmentation and peripheral islands of normal-coloured skin. |
Nevus anemicus [56,60] |
Congenital, segmental flat area of depigmentation. | Poorly defined whitish area surrounded with red peripheral zone that often feature linear serpentine vessels. |
Extragenital lichen sclerosus [51,56] |
Acquired, usually asymptomatic, flat-topped papules or plaques affecting the trunk or/and extremities. | Well-delineated structureless white-yellowish areas. Active lesions feature typical yellowish follicular plugs. Diffuse white scale, polarising-dependent white structures (lines, areas, 4-dotted clods, and rainbow pattern), haemorrhages, dotted, linear serpentine and/or branching vessels can be present. |
Hypopigmented mycosis fungoides [56,61] |
Acquired, patchy hypopigmented areas. | Poorly defined hypopigmented pink-white areas deprived of physiological background pigmentation of lines reticular. |
Hyperpigmented disorders | ||
Confluent and reticulated papillomatosis [56,62] | Acquired, flat, asymptomatic, grey-brown scaly papules coalescing into larger patches arranged in a reticular fashion, commonly affecting the torso. | Subtle/small white scales and brownish clods separated by hypopigmented lines (cobblestone appearance, or gyri and sulci pattern). |
Becker’s nevus [56,63] | Congenital, irregularly shaped hyperpigmented macule often accompanied by hypertrichosis, commonly affecting shoulder girdle or upper chest. | Poorly demarcated brown reticular or structureless areas and increased hair density. |
Idiopathic eruptive macular hyperpigmentation [64,65] | Disseminated, nonconfluent, and asymptomatic pigmented macules affecting the trunk, neck, and proximal extremities, developing in childhood or adolescence without any background of inflammatory lesions or drug trigger. | Pigmented dots and clods distributed over the accentuated lines reticular (physiological pigmentation) with preservation of normally pigmented skin markings and follicular ostia. |