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Leukoderma punctata.

R Falabella1, C E Escobar, E Carrascal

  • 1Department of Internal Medicine, Hospital Universitario del Valle, Cali, Columbia, South America.

Journal of the American Academy of Dermatology
|March 1, 1988
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Summary
This summary is machine-generated.

PUVASOL therapy can cause punctate leukoderma, a vitiligo-like condition, in children and young adults. This phototoxic effect leads to hypopigmented spots, with some patients showing potential for recovery.

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Area of Science:

  • Dermatology
  • Photomedicine
  • Pigmentary disorders

Background:

  • Vitiligo is a chronic autoimmune condition causing depigmentation.
  • PUVASOL (psoralen plus ultraviolet A) therapy is used for various skin conditions.
  • Punctate hypopigmentation can occur post-treatment, mimicking vitiligo.

Purpose of the Study:

  • To investigate the development of punctate hypopigmented and achromic spots following PUVASOL therapy.
  • To analyze the clinical and histological features of these lesions.
  • To explore the potential relationship between PUVASOL-induced leukoderma, idiopathic guttate hypomelanosis, and vitiligo.

Main Methods:

  • Clinical observation of 13 patients (aged 7-38) with vitiligo subtypes who developed punctate spots post-PUVASOL.
  • Histopathological examination using Dopa and Fontana stains to assess melanocyte function and melanin.
  • Ultrastructural analysis of keratinocytes and melanocytes.

Main Results:

  • Numerous punctate hypopigmented/achromic spots (0.5-1.5 mm) appeared on sun-exposed extremities post-PUVASOL.
  • Histology revealed decreased but present functional melanocytes and reduced melanin; ultrastructural damage observed.
  • Two patients showed lesion reduction; others remained stable.

Conclusions:

  • PUVASOL therapy can induce a phototoxic reaction resulting in punctate leukoderma, resembling vitiligo.
  • The findings suggest a possible etiologic role of PUVASOL's phototoxic effect.
  • A potential link between idiopathic guttate hypomelanosis, leukoderma punctata, and vitiligo is proposed.