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  Vol. 142 No. 2, February 2006 TABLE OF CONTENTS
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Diffuse Hypopigmented Macules—Diagnosis

Arch Dermatol. 2006;142:235-240.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Guttate leukoderma in Darier disease.

MICROSCOPIC FINDINGS

Examination of the MART-1–stained skin biopsy specimen from the hypopigmented macule revealed a decreased density of melanocytes in the basal layer of the epidermis. A dermal infiltrate of lymphocytes and melanophages was observed. Notably, there was no evidence of acantholysis within the epidermis. Examination of the skin biopsy specimen from the hyperkeratotic papule showed focal suprabasilar acantholysis and areas of dyskeratotic cells (corps ronds and corps grains).

DISCUSSION

Guttate leukoderma is an unusual feature of Darier disease. Since its first description by Goodall and Richmond1 in 1965, fewer than 20 cases have been reported.2 The lesions of guttate leukoderma have been observed only in dark-skinned individuals of African or Japanese descent.2-5 All of the previously described patients had widespread hypopigmented macules that were distributed in a perifollicular pattern on the trunk and extremities.

The lesions are not preceded by, and do not evolve into, keratotic papules. Histologically, they most commonly demonstrate . . . [Full Text of this Article]


RELATED ARTICLE

Diffuse Hypopigmented Macules—Quiz Case
William L. Fangman, M. Angelica Selim, and John C. Murray
Arch Dermatol. 2006;142(2):235-240.
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