Hypopigmentation of the Extremities
Helen Mashek, MD;
Robert Kalb, MD
State University of New York at Buffalo
Arch Dermatol. 1998;134:743-748.
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REPORT OF A CASE
A 65-year-old black woman presented for evaluation of diffuse hypopigmentation of her extremities. The hypopigmentation had been present for approximately 1 year and was asymptomatic. The patient's medical history was significant for sarcoidosis. Physical examination revealed numerous guttate hypopigmented macules of the extremities (Figure 1 and Figure 2). The histopathologic features of a biopsy specimen from a hypopigmented macule are shown in Figure 3 and Figure 4.
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Figure 1.
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Figure 2.
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Figure 3.
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Figure 4.
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What is your diagnosis?
DIAGNOSIS: Sarcoidosis.
Hypopigmentation, which is a rare manifestation of sarcoidosis, was initially described by Maycock et al1 in 1963. Hypopigmented lesions may be the presenting sign of sarcoidosis.2-3 Clinically, the hypopigmented lesions may appear as macules, papules, or nodules. Skin biopsy findings can confirm a suspected diagnosis of sarcoidosis by demonstrating classic noncaseating dermal granulomas. In the previously reported cases, granulomas were rarely seen . . . [Full Text of this Article]
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