SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

Information for Patients

View all Images (15)

Postinflammatory hypopigmentation in Adult
Other Resources UpToDate PubMed

Postinflammatory hypopigmentation in Adult

Contributors: Elyse M. Love MD, Steven M. Nwe DO, Oyetewa Oyerinde MD, Callyn Iwuala MD, Susan Burgin MD
Other Resources UpToDate PubMed


Postinflammatory hypopigmentation is the presence of partial or total loss of pigmentation that occurs after resolution of cutaneous inflammation or after trauma.

Postinflammatory hypopigmentation can occur in patients of all ages, sexes, and skin types, and is more visibly pronounced in those with darker skin phototypes. It can be seen as a sequela of many inflammatory skin diseases (atopic dermatitis, seborrheic dermatitis, psoriasis, lichen striatus, pityriasis lichenoides chronica, lichen planus, sarcoidosis, discoid lupus erythematosus), infections (zoster, pityriasis versicolor, impetigo), procedures (chemical peels, laser, dermabrasion), and burns.

Time to resolution of hypopigmentation is dependent on the underlying cause and severity of inflammation, ranging from a few weeks in minimally hypopigmented lesions to several years in depigmented lesions (eg, discoid lupus erythematosus and burns).

Related topic: Drug-induced hypopigmentation


L81.9 – Disorder of pigmentation, unspecified

277787003 – Post-inflammatory hypopigmentation

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Differential diagnosis for hypopigmented lesions include:
  • Pityriasis alba – Scaly, oval, ill-defined macules and patches with mild hypopigmentation; more common in children.
  • Tinea versicolor – Coppery orange under Wood's lamp; potassium hydroxide (KOH) prep of scale shows a characteristic "spaghetti and meatballs" appearance.
  • Sarcoidosis – Histology will reveal dermal noncaseating granulomas.
  • Progressive macular hypomelanosis – Punctiform red fluorescence under Wood's lamp.
  • Leprosy – Associated with hypoesthesia.
  • Cutaneous T-cell lymphoma – Early-stage variant involving hypopigmentation on the trunk and extremities that may be pruritic.
  • Scleroderma – Circumscribed hypopigmentation with perifollicular pigment retention.
  • Tumor of follicular infundibulum
  • Hypopigmented lesions in Extramammary Paget disease
  • Drug-induced hypopigmentation – Particularly high-potency topical and intralesional corticosteroids.
  • Bier spots (physiologic anemic macules) – Transient, irregularly shaped, hypopigmented macules on the extremities due to physiologic vascular abnormalities; most often seen in young adults.
  • Idiopathic guttate hypomelanosis (IGH) – Rare in children and young adults. Sharply demarcated, hypopigmented (and sometimes depigmented) macules on the extremities.
  • Chronic Arsenical keratosis – Hypopigmented lesions resemble IGH but are scattered on a hyperpigmented base.
  • Leukoderma syphiliticum (see Secondary syphilis)
Differential diagnosis for depigmented lesions include:
  • Vitiligo – Pigment loss is total.
  • Discoid lupus erythematosus – Pigment loss, often in the center of lesions with a rim of hyperpigmentation; associated with cutaneous atrophy / scarring.
  • Chemical leukoderma – History of bleaching agents, phenol-containing cleaners, and glues.
  • Depigmented Extramammary Paget disease
  • Idiopathic guttate hypomelanosis – See above.
  • Leukoderma punctata – Rare phototherapy-induced eruption; clinically similar to IGH but presents in younger patients and resolves with phototherapy discontinuation.

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Reviewed:12/12/2019
Last Updated:01/28/2020
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Postinflammatory hypopigmentation in Adult
Print E-Mail Images (15)
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Postinflammatory hypopigmentation in Adult
A medical illustration showing key findings of Postinflammatory hypopigmentation
Clinical image of Postinflammatory hypopigmentation - imageId=95540. Click to open in gallery.  caption: 'A close-up of an oval white patch.'
A close-up of an oval white patch.
Copyright © 2024 VisualDx®. All rights reserved.