Presenter: Alexandra Grob, DO, Kristi Hawley, DO
Dermatology Program: Oakwood Southshore Medical Center
Program Director: Steven Grekin, DO, FAOCD
Submitted on: June 2, 2014
CHIEF COMPLAINT: multiple asymptomatic “white” patches present since birth
CLINICAL HISTORY: A 14-year-old Caucasian female presented with multiple asymptomatic “white” patches on her forehead, bilateral arms, and legs, present since birth. She states the patches have grown in proportion to her growth, and that “brown spots” gradually began to form within and around these areas. She states her father and paternal grandfather also have similar clinical findings. A review of systems was negative for hearing impairment, ocular abnormalities, or recurrent infections. She denies any previous treatment.
PHYSICAL EXAM:
Physical examination revealed a well-appearing adolescent female with large, symmetric, depigmented patches at the extensor surfaces of her bilateral midlegs, and bilateral mid forearms. Macules of baseline pigment and hyperpigmentation were irregularly scattered within and at the periphery of these patches. A triangular hypopigmented patch at the midfrontal scalp hairline was accompanied by the depigmentation of terminal hairs in this region. She was Fitzpatrick skin type I with homogeneously colored blue eyes.
LABORATORY TESTS:
No laboratory tests were performed.
DERMATOHISTOPATHOLOGY:
No biopsy was performed.
DIFFERENTIAL DIAGNOSIS:
1. Piebaldism
2. Vitiligo
3. Waardenburg Syndrome
4. Albinism
5. Neurofibromatosis I
