Differential diagnosis of hypomelanoses in children (N. Van Geel (Ghent, Belgium))

Use a stepwise approach:


1. Step 1 History

  • -congenital or acquired
  • -stable or progressive
  • -other medical problems
  • -family history


2. Step 2 Clinical Examination

  • -localisation (Woods light important especially in the localized form)
  • -number of lesions
  • -pattern (linear blaschkoid, segmental)
  • -hypomelanosis or amelanosis
  • -other problems (neurological,  eyes)


3. Step 3: Apply information of flowchart (differential diagnosis)

  • -if diffuse: presence or absence of ocular involvmenet
  1. a. ocular involvement: albinos group, also Griscelli syndrome, Chediak-Higashi syndrome
  2. b. no ocular involvement: think of Metabolic causes: Menkies syndrome, phenylcetonuria


  • if localized
  1. -depigmentation: waardenburg, piedbaldism
  2. -hypopigmentation: tuberous scleroris, nevus depigmentosus, Pigmentation of inflammatory (PIH) or infectious origin, Pigmentary mosaicism (Hypomelanosis of Ito) lichen striatus
  3. -no pigment disorder: nevus anemicus



Ash-leaf macule in Tuberous Sclerosis


Source of Information: Sy 17. Pigmentation Disorders: From Vitiligo to Hyyperpigmentation. 2011 (10) – 20th Annual Congress of the EADV (European Academy of Dermatology and Venerology) – Lisbon (Lisboa), Portugal