Joshi Rajiv
Department of Dermatology, P. D. Hinduja Hospital, Mahim, Mumbai, India.
Indian J Dermatol. 2014 Nov;59(6):571-4. doi: 10.4103/0019-5154.143516.
Biopsy findings in 55 cases of idiopathic guttate hypomelanosis (IGH) are reported. Most cases had a flat epidermis with loss of the rete pattern and a thickened orthokeratotic basket weave stratum corneum. The epidermis had markedly decreased to absent melanin in the basal layer and reduced numbers of melanocytes at the dermoepidermal junction. One-third of patients had a sparse perivascular lymphocytic infiltrate, whereas the rest had no significant dermal inflammation. These findings are in concordance with current literature. However, small foci of retained melanin in the basal layer (skip areas) alternating with larger areas of melanin loss were present in almost 80% of cases. This finding has not been reported earlier and appears to be quite specific to IGH and may be used as a clue to differentiate IGH from other similar conditions such as vitiligo and guttate morphea.
报告了55例特发性点滴状色素减退症（IGH）的活检结果。大多数病例的表皮扁平， rete模式消失，正角化篮状编织角质层增厚。表皮基底层黑色素明显减少至缺失，真皮表皮交界处黑素细胞数量减少。三分之一的患者有稀疏的血管周围淋巴细胞浸润，其余患者无明显的真皮炎症。这些发现与当前文献一致。然而，几乎80%的病例中存在基底层黑色素保留的小病灶（跳跃区域）与较大的黑色素缺失区域交替出现的情况。这一发现此前未见报道，似乎是IGH所特有的，可作为将IGH与其他类似疾病如白癜风和点滴状硬斑病相鉴别的线索。
