What is the differential diagnosis (Ddx) for hypopigmentation?

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Last updated: May 22, 2025View editorial policy

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Differential Diagnosis for Hypopigmentation

Single Most Likely Diagnosis

  • Vitiligo: An autoimmune condition that destroys melanocytes, leading to well-defined patches of hypopigmentation, often on the face, hands, and wrists. It is a common cause of hypopigmentation and can be associated with other autoimmune diseases.

Other Likely Diagnoses

  • Pityriasis alba: A mild, inflammatory skin condition characterized by small, round patches of hypopigmentation, often on the face, particularly in children. It is associated with atopic dermatitis.
  • Post-inflammatory hypopigmentation: Hypopigmentation that occurs after an inflammatory skin condition, such as eczema, psoriasis, or dermatitis, due to damage to the melanocytes.
  • Tinea versicolor: A fungal infection caused by Malassezia yeast, leading to patches of hypopigmentation or hyperpigmentation on the skin, particularly on the chest and back.

Do Not Miss Diagnoses

  • Tuberous sclerosis: A genetic disorder that can cause hypopigmented macules (ash leaf spots), which are often one of the earliest signs of the condition. Missing this diagnosis could lead to delayed diagnosis of a potentially serious condition.
  • Neurofibromatosis type 1: A genetic disorder that can cause café-au-lait spots, which may appear as hypopigmented patches in some cases. Early diagnosis is crucial for managing associated complications.

Rare Diagnoses

  • Waardenburg syndrome: A rare genetic disorder characterized by congenital deafness, minor defects in the structures arising from the neural crest, and pigmentation abnormalities, including hypopigmentation.
  • Chédiak-Higashi syndrome: A rare genetic disorder that affects the immune system and is characterized by oculocutaneous albinism, which can manifest as hypopigmentation.
  • Griscelli syndrome: A rare genetic disorder that affects melanosome transport and can cause hypopigmentation, often associated with immunodeficiency and other systemic complications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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