[Progressive macular confluent hypomelanosis in mixed ethnic melanodermic subjects: an epidemiologic study of 511...

The pathogenesis of the recently described (1985) entity macular confluent progressive hypomelanosis in black subjects of mixed ethnic origin, also called creole dyschromia is unknown. Patients are generally black adults of mixed ethnic origin and present with hypopigmented maculae located asymmetrically in unexposed areas. The mechanism appears to be a phenotypic modification of produced melanosomes. The cases published to date do not provide clear epidemiological data.

We took histories and examined 511 patients in the French West Indies (Martinique) during systematic screening for leprosy. Observations included presence or absence of creole dyschromia, the intensity of the depigmentation. History reports included chronology of the lesions and factors affecting disease course.

One-hundred twenty-one cases of dyschromia were identified, often with few clinical signs. Creole dyschromia was found in one-third of the examined subjects between the age of 17 and 48 years and appeared to be more exception outside this age range. More men than women were found to have the disease and the duration of the clinical course was about 25 years. Clearer skin appeared to be more sensitive and only responded to intermittent exposure to sun.

Due to the fact that the examination was mandatory, it was possible to identify a large number of cases unknown to dermatologists and sometimes to the subject himself. The clinical description corresponded to those given in the literature, but the higher frequency in males, the duration of the clinical course and the sensitivity of clearer skin appear to have been unreported to date.