medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2023-5-10-15medalphabet-3062Research ArticleСтатьиГипомеланоз каплевидный идиопатический: вопросы дифференциального диагноза и терапииIdiopathic guttate hypomelanosis: Issues of differential diagnosis and therapyhttps://orcid.org/0000-0001-7073-9511ЯковлевА. Б.YakovlevA. B.

Яковлев Алексей Борисович - кандидат медицинских наук, врач-дерматовенеролог, доцент кафедры дерматовенерологии и косметологии, доцент ВАК.

Москва

Yakovlev Aleksey B. - PhD Med, dermatovenereologist, associate professor at Dept of Dermatovenereology and Cosmetology, associate professor of the Higher Attestation Commission

Moscow

ale64080530@yandex.ruhttps://orcid.org/0000-0002-4672-697XТамразоваА. В.TamrazovaA. V.

Тамразова Анаит Вардановна - врач-дерматовенеролог, аспирант кафедры дерматовенерологии и косметологии.

Москва

Tamrazova Anahit V., dermatovenereologist, postgraduate student of Dept of Dermatovenereology and Cosmetology.

Moscow

anaittamrazova@gmail.comФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical AcademyRussian Federation20233004202305Дерматология (1)1015Copyright © Яковлев А.Б., Тамразова А.В., 20232023Яковлев А.Б., Тамразова А.В.Yakovlev A.B., Tamrazova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3062

Гипомеланоз идиопатический каплевидный характеризуется появлением небольших стойких гипопигментированных округлых пятен на коже. Несмотря на высокую распространенность заболевания среди населения, данный дерматоз, как правило, остается нераспознанным в течение всей жизни, а также с трудом поддается существующей на данный момент терапии, оставаясь косметическим дефектом на всю жизнь. В данной статье представлена информация об эпидемиологии, патогенезе, клинических проявлениях, дифференциальной диагностике и терапии идиопатического каплевидного гипомеланоза.

Hypomelanosis is an idiopathic guttate process with the appearance of small struts of hypopigmented, rounded patches on the skin. Despite the high caution of diseases among the population, this dermatosis, as a rule, remains unrecognized throughout life, and it is also difficult to consider this moment of therapy, remaining a cosmetic defect throughout life. This article provides information on the epidemiology, pathogenesis, manifestations, differential diagnosis and therapy of idiopathic guttate hypomelanosis.

гипомеланоз идиопатический каплевидныйГИКгипопигментациинарушение пигментацииhypomelanosis idiopathic guttateIGHhypopigmentationpigmentation disordersReferencesBrown F., Crane J. S. Idiopathic Guttate Hypomelanosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 12, 2022.Brown F., Crane J. S. Idiopathic Guttate Hypomelanosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 12, 2022.Катина М. А., Лесничая О. В. Идиопатический каплевидный гипомеланоз: обзор литературы, случай из практики. Дерматовенерология. Косметология. 2021. Т. 7. № 1. С. 76–84. DOI: 10.34883/PI.2021.7.1.016.Katina M. A., Lesnichaya O. V. Idiopathic guttate hypomelanosis: A review of the literature, a case report. Dermatovenereology. Cosmetology. 2021. V. 7. No. 1. P. 76–84. DOI: 10.34883/PI.2021.7.1.016.Costa O. G. Leucopathie symétrique progressive des extrémités [Progressive symmetrical leukopathia of the extremities]. Annales de Dermatologie et de Syphiligraphie (Paris). 1951. Vol. 78. No 4. P. 452–454.Costa O. G. Leucopathie symétrique progressive des extrémités [Progressive symmetrical leukopathia of the extremities]. Annales de Dermatologie et de Syphiligraphie (Paris). 1951. Vol. 78. No 4. P. 452–454.Cummings K. I., Cottel W. I. Idiopathic guttate hypomelanosis. Archives of Dermatology. 1966. Vol. 93. No 2. P. 184–186.Cummings K. I., Cottel W. I. Idiopathic guttate hypomelanosis. Archives of Dermatology. 1966. Vol. 93. No 2. P. 184–186.Juntongjin P., Laosakul K. Idiopathic Guttate Hypomelanosis: A Review of its Etiology, Pathogenesis, Findings, and Treatments. American Journal of Clinical Dermatology. 2016. Vol. 17. No 4. P. 403–411. DOI: 10.1007/s40257–016–0195–3.Juntongjin P., Laosakul K. Idiopathic Guttate Hypomelanosis: A Review of its Etiology, Pathogenesis, Findings, and Treatments. American Journal of Clinical Dermatology. 2016. Vol. 17. No 4. P. 403–411. DOI: 10.1007/s40257–016–0195–3.Shin M. K., Jeong K. H., Oh I. H., Choe B. K., Lee M. H. Clinical features of idiopathic guttate hypomelanosis in 646 subjects and association with other aspects of photoaging. International Journal of Dermatology. 2011. Vol. 50. No 7. P. 798–805. DOI: 10.1111/j.1365–4632.2010.04743.x.Shin M. K., Jeong K. H., Oh I. H., Choe B. K., Lee M. H. Clinical features of idiopathic guttate hypomelanosis in 646 subjects and association with other aspects of photoaging. International Journal of Dermatology. 2011. Vol. 50. No 7. P. 798–805. DOI: 10.1111/j.1365–4632.2010.04743.x.Kim S. K., Kim E. H., Kang H. Y., Lee E. S., Sohn S., Kim Y. C. Comprehensive understanding of idiopathic guttate hypomelanosis: Clinical and histopathological correlation. International Journal of Dermatology. 2010. Vol. 49. No. 2. P. 162–166. DOI: 10.1111/j.1365–4632.2009.04209.x.Kim S. K., Kim E. H., Kang H. Y., Lee E. S., Sohn S., Kim Y. C. Comprehensive understanding of idiopathic guttate hypomelanosis: Clinical and histopathological correlation. International Journal of Dermatology. 2010. Vol. 49. No. 2. P. 162–166. DOI: 10.1111/j.1365–4632.2009.04209.x.Falabella R., Escobar C. E., Giraldo N., Rovetto P., Gil J., Barona M. I., Acosta F., Alzate A. On the pathogenesis of idiopathic guttate hypomelanosis. Journal of the American Academy of Dermatology. 1987 Jan. Vol. 16. No 1. Pt 1. P. 35–44. DOI: 10.1016/s0190–9622(87)70003–6.Falabella R., Escobar C. E., Giraldo N., Rovetto P., Gil J., Barona M. I., Acosta F., Alzate A. On the pathogenesis of idiopathic guttate hypomelanosis. Journal of the American Academy of Dermatology. 1987 Jan. Vol. 16. No 1. Pt 1. P. 35–44. DOI: 10.1016/s0190–9622(87)70003–6.Kaya T. I., Yazici A. C., Tursen U., Ikizoglu G. Idiopathic guttate hypomelanosis: Idiopathic or ultraviolet induced? Photodermatology, Photoimmunology and Photomedicine. 2005. Vol. 21. No 5. P. 270–271. DOI: 10.1111/j.1600–0781.2005.00171.x.Kaya T. I., Yazici A. C., Tursen U., Ikizoglu G. Idiopathic guttate hypomelanosis: Idiopathic or ultraviolet induced? Photodermatology, Photoimmunology and Photomedicine. 2005. Vol. 21. No 5. P. 270–271. DOI: 10.1111/j.1600–0781.2005.00171.x.Mazioti M. Idiopathic guttate hypomelanosis: A mini review. Pigmentary Disorders. 2015. Vol .2. No. 10. P. 212–214.Mazioti M. Idiopathic guttate hypomelanosis: A mini review. Pigmentary Disorders. 2015. Vol .2. No. 10. P. 212–214.Zeeshan M., Sonthalia S., Yadav P., Gupta P., Agrawal M., Bhatia J., Jha A. K., Roy P. K. Do oxidative stress and melanin accumulation contribute to the pathogenesis of idiopathic guttate hypomelanosis: A prospective case-control study. Journal of Cosmetic Dermatology. 2022 Mar. Vol. 21. No. 3. P. 1154–1162. DOI: 10.1111/jocd.14171.Zeeshan M., Sonthalia S., Yadav P., Gupta P., Agrawal M., Bhatia J., Jha A. K., Roy P. K. Do oxidative stress and melanin accumulation contribute to the pathogenesis of idiopathic guttate hypomelanosis: A prospective case-control study. Journal of Cosmetic Dermatology. 2022 Mar. Vol. 21. No. 3. P. 1154–1162. DOI: 10.1111/jocd.14171.Friedland R., David M., Feinmesser M., Fenig-Nakar S., Hodak E. Idiopathic guttate hypomelanosis-like lesions in patients with mycosis fungoides: a new adverse effect of phototherapy. Journal of the European Academy of Dermatology and Venereology. 2010. Vol. 24. No. 9. P. 1026–1030.Friedland R., David M., Feinmesser M., Fenig-Nakar S., Hodak E. Idiopathic guttate hypomelanosis-like lesions in patients with mycosis fungoides: a new adverse effect of phototherapy. Journal of the European Academy of Dermatology and Venereology. 2010. Vol. 24. No. 9. P. 1026–1030.Arbache S., Michalany N. S., de Almeida H. L. Jr, Hirata S. H. Unveiling idiopathic guttate hypomelanosis: Pathology, immunohistochemistry, and ultrastructural study. International Journal of Dermatology. 2022. Vol. 61. No. 8. P. 995–1002. DOI: 10.1111/ijd.16076.Arbache S., Michalany N. S., de Almeida H. L. Jr, Hirata S. H. Unveiling idiopathic guttate hypomelanosis: Pathology, immunohistochemistry, and ultrastructural study. International Journal of Dermatology. 2022. Vol. 61. No. 8. P. 995–1002. DOI: 10.1111/ijd.16076.Arrunategui A., Trujillo R. A., Marulanda M. P. et al. HLA-DQ3 is associated with idiopathic guttate hypomelanosis, whereas HLA-DR 8 is not, in a group of renal transplant patients. International Journal of Dermatology. 2002. Vol. 41. No. 11. P. 744–747. DOI: 10.1046/j.1365–4362.2002.01630.x.Arrunategui A., Trujillo R. A., Marulanda M. P. et al. HLA-DQ3 is associated with idiopathic guttate hypomelanosis, whereas HLA-DR 8 is not, in a group of renal transplant patients. International Journal of Dermatology. 2002. Vol. 41. No. 11. P. 744–747. DOI: 10.1046/j.1365–4362.2002.01630.x.Podder I., Sarkar R. (2018) Idiopathic guttate hypomelanosis – a comprehensive review. Pigment International. Vol. 5. No. 2, P. 83–90. 16. DOI: 10.1111/jdv.18757.Podder I., Sarkar R. (2018) Idiopathic guttate hypomelanosis – a comprehensive review. Pigment International. Vol. 5. No. 2, P. 83–90.Kim T. H., Park H., Baek D. J., Kang H. Y. Melanocytes in idiopathic guttate hypomelanosis disappear and are senescent [published online ahead of print, 2022 Nov 17]. Journal of the European Academy of Dermatology and Venereology. 2022. DOI: 10.1111/jdv.18757.Kim T. H., Park H., Baek D. J., Kang H. Y. Melanocytes in idiopathic guttate hypomelanosis disappear and are senescent [published online ahead of print, 2022 Nov 17]. Journal of the European Academy of Dermatology and Venereology. 2022. DOI: 10.1111/jdv.18757.Kim J. Y., Lee S. H., Ahn Y., Lee E. J., Park M. Y., Hwang S., Almurayshid A., Lim B. J., Oh S. H. Role of senescent fibroblasts in the development of idiopathic guttate hypomelanosis. British Journal of Dermatology. 2020. Vol. 182. No 6. P. 1481–1482. DOI: 10.1111/bjd.18801.Kim J. Y., Lee S. H., Ahn Y., Lee E. J., Park M. Y., Hwang S., Almurayshid A., Lim B. J., Oh S. H. Role of senescent fibroblasts in the development of idiopathic guttate hypomelanosis. British Journal of Dermatology. 2020. Vol. 182. No 6. P. 1481–1482. DOI: 10.1111/bjd.18801.Buch J., Patil A., Kroumpouzos G., Kassir M., Galadari H., Gold M. et al. Idiopathic guttate hypomelanosis: Presentation and Management. Journal of Cosmetic and Laser Therapy. 2021 Vol. 23. No. 1–2. P. 1–8. DOI: 10.1080/14764172.2021.1957116.Buch J., Patil A., Kroumpouzos G., Kassir M., Galadari H., Gold M. et al. Idiopathic guttate hypomelanosis: Presentation and Management. Journal of Cosmetic and Laser Therapy. 2021 Vol. 23. No. 1–2. P. 1–8. DOI: 10.1080/14764172.2021.1957116.Ankad B. S., Beergouder S. L. Dermoscopic evaluation of idiopathic guttate hypomelanosis: A preliminary observation. Indian Dermatology Online Journal. 2015. Vol. 6. No. 3. P. 164–167.Ankad B. S., Beergouder S. L. Dermoscopic evaluation of idiopathic guttate hypomelanosis: A preliminary observation. Indian Dermatology Online Journal. 2015. Vol. 6. No. 3. P. 164–167.Errichetti E., Stinco G. Dermoscopy of idiopathic guttate hypomelanosis. The Journal of Dermatology. 2015 Nov. Vol. 42. No. 11. P. 1118–1119. DOI: 10.1111/1346–8138.13035.Errichetti E., Stinco G. Dermoscopy of idiopathic guttate hypomelanosis. The Journal of Dermatology. 2015 Nov. Vol. 42. No. 11. P. 1118–1119. DOI: 10.1111/1346–8138.13035.Rani S., Kumar R., Kumarasinghe P., Bhardwaj S., Srivastava N., Madaan A., Parsad D. Melanocyte abnormalities and senescence in the pathogenesis of idiopathic guttate hypomelanosis. International Journal of Dermatology. 2018 May. Vol. 57. No. 5. P. 559–565. DOI: 10.1111/ijd.13960.Rani S., Kumar R., Kumarasinghe P., Bhardwaj S., Srivastava N., Madaan A., Parsad D. Melanocyte abnormalities and senescence in the pathogenesis of idiopathic guttate hypomelanosis. International Journal of Dermatology. 2018 May. Vol. 57. No. 5. P. 559–565. DOI: 10.1111/ijd.13960.Joshi R. Skip areas of retained melanin: a clue to the histopathological diagnosis of idiopathic guttate hypomelanosis. Indian Journal of Dermatology. 2014. Vol. 59. No. 6. P. 571–574. DOI: 10.4103/0019–5154.143516.Joshi R. Skip areas of retained melanin: a clue to the histopathological diagnosis of idiopathic guttate hypomelanosis. Indian Journal of Dermatology. 2014. Vol. 59. No. 6. P. 571–574. DOI: 10.4103/0019–5154.143516.Ortonne J. P., Perrot H. Idiopathic guttate hypomelanosis: ultrastructural study. Archives of Dermatology. 1980. Vol. 116. P. 664–668. DOI: 10.1001/archderm.1980.01640300052016.Ortonne J. P., Perrot H. Idiopathic guttate hypomelanosis: ultrastructural study. Archives of Dermatology. 1980. Vol. 116. P. 664–668. DOI: 10.1001/archderm.1980.01640300052016.Kakepis M., Havaki S., Katoulis A., Katsambas A., Stavrianeas N., Troupis T. G. Idiopathic guttate hypomelanosis: an electron microscopy study. Journal of the European Academy of Dermatology and Venereology. 2015 Jul. Vol. 29. No. 7. P. 1435–1438. DOI: 10.1111/jdv.12646.Kakepis M., Havaki S., Katoulis A., Katsambas A., Stavrianeas N., Troupis T. G. Idiopathic guttate hypomelanosis: an electron microscopy study. Journal of the European Academy of Dermatology and Venereology. 2015 Jul. Vol. 29. No. 7. P. 1435–1438. DOI: 10.1111/jdv.12646.Falabella R., Escobar CE, Carrascal E, Arroyave JA. Leukoderma punctata. Journal of the American Academy of Dermatology. 1988 Mar. Vol. 18. No. 3. P. 485–494. DOI: 10.1016/s0190–9622(88)70071–7.Falabella R., Escobar CE, Carrascal E, Arroyave JA. Leukoderma punctata. Journal of the American Academy of Dermatology. 1988 Mar. Vol. 18. No. 3. P. 485–494. DOI: 10.1016/s0190–9622(88)70071–7.Harish M. R., Shashikumar B. M., Magod P. R., Deepadarkshan K. Dermoscopic analysis of idiopathic guttate hypomelanosis: A cross sectional study. Pigment Int. 2021. No. 8. P. 25–29.Harish M. R., Shashikumar B. M., Magod P. R., Deepadarkshan K. Dermoscopic analysis of idiopathic guttate hypomelanosis: A cross sectional study. Pigment Int. 2021. No. 8. P. 25–29.Gilhar A., Pillar T., Eidelman S., Etzioni A. Vitiligo and idiopathic guttate hypomelanosis. Repigmentation of skin following engraftment onto nude mice. Archives of Dermatology. 1989 Oct. Vol. 125. No. 10. P. 1363–1366. DOI: 10.1001/archderm.125.10.1363.Gilhar A., Pillar T., Eidelman S., Etzioni A. Vitiligo and idiopathic guttate hypomelanosis. Repigmentation of skin following engraftment onto nude mice. Archives of Dermatology. 1989 Oct. Vol. 125. No. 10. P. 1363–1366. DOI: 10.1001/archderm.125.10.1363.Mayser P. A., Preuss J. Pityriasis versicolor: Aktuelles zu einer alten Erkrankung [Pityriasis versicolor: New aspects of an old disease]. Hautarzt. 2012. Vol. 63. No. 11. P. 859–867. DOI: 10.1007/s00105–012–2380–5.Mayser P. A., Preuss J. Pityriasis versicolor: Aktuelles zu einer alten Erkrankung [Pityriasis versicolor: New aspects of an old disease]. Hautarzt. 2012. Vol. 63. No. 11. P. 859–867. DOI: 10.1007/s00105–012–2380–5.Mathur M., Acharya P., Karki A., Kc N., Shah J. Dermoscopic pattern of pityriasis versicolor. Clinical, Cosmetic and Investigational Dermatology. 2019. Vol. 12. P. 303–309. DOI: 10.2147/CCID.S 195166.Mathur M., Acharya P., Karki A., Kc N., Shah J. Dermoscopic pattern of pityriasis versicolor. Clinical, Cosmetic and Investigational Dermatology. 2019. Vol. 12. P. 303–309. DOI: 10.2147/CCID.S 195166.Гаджимурадов М. Н., Хачалов Г. Б., Асадулаева З. Г., Ганиев К. Д., Набигулаева З. М., Муслимов М. О. Клиническая классификация ограниченной склеродермии. Клиническая дерматология и венерология. 2013. Т. 11. № 4. С. 80–87.Gadzhimuradov M. N., Khachalov G. B., Asadulaeva Z. G., Ganiev K. D., Nabigulaeva Z. M., Muslimov M. O. Clinical classification of limited scleroderma. Clinical Dermatology and Venereology. 2013. V. 11. No. 4. P. 80–87.Relyveld G. N., Menke H. E., Westerhof W. Progressive macular hypomelanosis: an overview. American Journal of Clinical Dermatology. 2007. Vol. 8. No 1. P. 13–19. DOI: 10.2165/00128071–200708010–00002.Relyveld G. N., Menke H. E., Westerhof W. Progressive macular hypomelanosis: an overview. American Journal of Clinical Dermatology. 2007. Vol. 8. No 1. P. 13–19. DOI: 10.2165/00128071–200708010–00002.Sil A., Khatua P. Eruptive hypomelanosis: an under-recognized viral exanthem [published online ahead of print, 2022 Oct 18]. The Journal of Pediatrics. 2022. S 0022–3476 (22) 00897–6. DOI: 10.1016/j.jpeds.2022.06.040.Sil A., Khatua P. Eruptive hypomelanosis: an under-recognized viral exanthem [published online ahead of print, 2022 Oct 18]. The Journal of Pediatrics. 2022. S 0022–3476 (22) 00897–6. DOI: 10.1016/j.jpeds.2022.06.040.Дорофеева М. Ю., Белоусова Е. Д., Пивоварова А. М. Рекомендации по диагностике и лечению туберозного склероза. Журнал неврологии и психиатрии им. С. С. Корсакова. 2014. Т. 114. № 3. С. 58–74.Dorofeeva M. Yu., Belousova E. D., Pivovarova A. M. Recommendations for the diagnosis and treatment of tuberous sclerosis. Journal of Neurology and Psychiatry n. a. S. S. Korsakov. 2014. V. 114. No. 3. P. 58–74.Asawanonda P., Sutthipong T., Prejawai N. Pimecrolimus for idiopathic guttate hypomelanosis. Journal of Drugs in Dermatology. 2010. Vol. 9. No. 3. P. 238–239.Asawanonda P., Sutthipong T., Prejawai N. Pimecrolimus for idiopathic guttate hypomelanosis. Journal of Drugs in Dermatology. 2010. Vol. 9. No. 3. P. 238–239.Pagnoni A. K., Sadiq I., Stoudemayer T. Hypopigmented maculesof photodamaged skin and their treatment with topical tretinoin. Acta Dermato-Venereologica. 1999. Vol. 79. P. 305–310.Pagnoni A. K., Sadiq I., Stoudemayer T. Hypopigmented maculesof photodamaged skin and their treatment with topical tretinoin. Acta Dermato-Venereologica. 1999. Vol. 79. P. 305–310.Koh W. S., Kim J. E., Ro Y. S., Ko J. Y. Comparative study of ablative fractional photothermolysis versus topical retinoid cream in the treatment of idiopathic guttate hypomelanosis. Journal of Cosmetic and Laser Therapy. 2018. Vol. 20. No. 7–8. P. 405–409. DOI: 10.1080/14764172.2018.1444771.Koh W. S., Kim J. E., Ro Y. S., Ko J. Y. Comparative study of ablative fractional photothermolysis versus topical retinoid cream in the treatment of idiopathic guttate hypomelanosis. Journal of Cosmetic and Laser Therapy. 2018. Vol. 20. No. 7–8. P. 405–409. DOI: 10.1080/14764172.2018.1444771.Vedamurthy M., Vanasekar P., Raghupathy S. Use of 50 % trichloroacetic acid in the treatment of idiopathic guttate hypomelanosis. American Journal of Clinical Dermatology. 2022. Jan. Vol. 86. No. 1. P. e11 – e12. DOI: 10.1016/j.jaad.2020.04.110.Vedamurthy M., Vanasekar P., Raghupathy S. Use of 50 % trichloroacetic acid in the treatment of idiopathic guttate hypomelanosis. American Journal of Clinical Dermatology. 2022. Jan. Vol. 86. No. 1. P. e11 – e12. DOI: 10.1016/j.jaad.2020.04.110.Arbache S., de Mendonça M. T., Arbache S. T., Hirata S. H. Treatment of idiopathic guttate hypomelanosis with a tattoo device versus a handheld needle. JAAD International. 2021. Vol. 6. No. 3. P. 14–16. DOI: 10.1016/j.jdin.2021.01.005.Arbache S., de Mendonça M. T., Arbache S. T., Hirata S. H. Treatment of idiopathic guttate hypomelanosis with a tattoo device versus a handheld needle. JAAD International. 2021. Vol. 6. No. 3. P. 14–16. DOI: 10.1016/j.jdin.2021.01.005.

The authors declare that there are no conflicts of interest present.