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Progressive macular hypomelanosis: an epidemiological study and therapeutic response to phototherapy.

Duarte I1, Nina BI, Gordiano MC, Buense R, Lazzarini R.

Author information

Abstract

BACKGROUND:

Progressive macular hypomelanosis is a common dermatosis in various continents. Its cause is unknown and proposed treatments 

have had little effect.

OBJECTIVES:

To determine epidemiological aspects of progressive macular hypomelanosis in patients referred to a phototherapy clinic 

between 1997 and 2008 and to evaluate therapeutic response to PUVA (psoralen + UVA) photochemotherapy or narrowband UVB 

phototherapy.

METHODS:

Eighty-four patients with progressive macular hypomelanosis were evaluated. After 16 phototherapy sessions, therapeutic 

response was classified as: unchanged, slightly improved (<50% of repigmentation), moderately improved (50-79% of 

repigmentation), much improved (80-99%) or cured (100%). After a minimum of three months, patients whose response was 

classified as cured or much improved were contacted by telephone to evaluate the persistence of the therapeutic response.

RESULTS:

Most of the patients were women (79%) and white (85%). Age at onset of progressive macular hypomelanosis ranged from 13 to 36 

years. PUVA was prescribed for 27 patients and narrowband UVB phototherapy for 57. No significant difference was found 

between the outcomes obtained with PUVA and those obtained with narrowband UVB phototherapy (Fisher's exact test; p<0.05). 

The majority of patients (81%) had 50% or more repigmentation, with 65% being classified as cured or much improved. 

Nevertheless, there was a recurrence of the lesions in 72% of patients.

CONCLUSIONS:

The fact that no patients were over 40 years of age suggests that progressive macular hypomelanosis is a self-limiting 

disease. Both PUVA and narrowband UVB are effective therapeutic options; however, they do not prevent recurrence of the 

disease.

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