Idiopathic Hipomelanoza gutata

Leucodermie Hipomelanoza is a benign idiopathic gutata, winner of unknown etiology. Este mai frecventa la femeile de virsta mijlocie, cu piele deschisa la culoare, dar este descrisa si la ambele sexe, alaturi de persoanele cu piele inchisa la culoare cu expunere prelungita la soare. It is more common in middle-aged women with lighter skin, but is described and in both sexes, people with dark skin exposed to sunlight.
Se dezvolta pe picioarele pacientului si se poate extinde si la alte zone expuse la soare . It develops the patient's legs and can spread to other areas exposed to sunlight. Fata nu este afectata. The girl is not affected. Consta din aparitia de macule circulare discrete, mici. Acestea sunt acromice . Consisting of occurrence of discrete circular patches, small. They are acromice. Distributia este strins legata de expunerea pielii la soare. Distribution is closely related to skin exposure to sunlight.
Terapia medicala cuprinde administrarea de corticosteroizi si retinoizi . Medical therapy includes corticosteroids and retinoids. Se pot practica si tehnici chirurgicale prin crioterapie sau dermoabraziune. And surgical techniques can be practiced by cryotherapy or dermoabraziune. Profilactic se vor folosi creme de protectie solara. Prophylactic will use sunscreen.
Patogenie si cauze Pathogenesis and causes
Deoarece pigmentarea pielii se datoreaza integrarii melanocitelor si functiei keratinocitelor, un defect cistigat al melaninei epidermice va determina hipopigmentarea observata in aceasta conditie patologica. Because skin pigmentation is due to the integration of melanocytes and keratinocytes function, epidermal melanin won a defect will cause hypopigmentation observed in this pathological condition. Cauzele exacte ale aparitiei afectiunii nu sunt cunoscute dar se considera a fi legate de expunerea la ultraviolete. The exact causes of disease emergence are not known but is believed to be related to UV exposure.

Semne si simptome Signs and symptoms
Aceasta conditie este asociata cu lipsa protectiei solare si expunerea la soare decit cu inaintarea in virsta. Femeile cu piele deschisa la culoare dezvolta afectiunea precoce, apoi cu inaintarea in virsta ambele sexe par a fi afectate egal . This condition is associated with lack of sun protection and sun exposure than with age. Women with lighter skin disease develops early, then with age appear to be affected both sexes equally. Tipic hipomelanoza gutata se dezvolta mai intii pe picioare. Typically hipomelanoza gutata then develops first leg. Mai tirziu se va extinde si la alte zone expuse la soare, brate si trunchi superior. Later it will expand to other areas exposed to the sun, arms and upper trunk. Fata este in mod inexplicabil evitata. The girl is inexplicably avoided. Sa decsris o tendinta familiala a bolii. Decsris was a family tendency to the disease.
Afectiune se caracterizeaza prin aparitia de macule discrete, angulare sau circulare cu diametrul de 1-3 mm. Totusi leziunile pot masura pina la 10 mm. Disease is characterized by the appearance of discrete patches, angular or circular with a diameter of 1-3 mm. But injuries can measure up to 10 mm. Aceste macule mai deschise la culoare decit pielea sunt albe, hipopigmentate sau acromice . These patches lighter skin than are white or hypopigmented acromice. Sunt observate prima data pe suprafata anterioara a membrelor inferioare. I first observed the anterior surface of the lower limbs. Tardiv in evolutie apar si pe brate. Appear late in evolution and arms. Distributia pare sa fie fotomediata. Distribution seems to be fotomediata.

Diagnostic Diagnosis

Examen histologic. Histological examination. Microscopia electronica arata un tablou patologic caracteristic. Electron microscopy shows a characteristic pathological picture. Elementele histologice tipice sunt distrofia epidermica de tip actinic, scaderea numarului sau absenta melanocitelor, hiperkeratoza in valuri. Elements are typical histological type epidermal actinic dystrophy, a loss or absence of melanocytes, hyperkeratosis in the waves.
Diagnosticul diferential se face cu urmatoarele afectiuni pitiriazis alba , vitiligo , verucile nongenitale, eruptiile lichenoide, pinta, hipomelanoza dupa intepaturile de insecte. The differential diagnosis of these diseases is pityriasis alba , vitiligo , warts nongenitale, lichenoid eruptions, pint, hipomelanoza after insect stings.

Tratament Treatment
Terapia medicala include corticosteroizii topici sau intralezionali sau retinoizii topici. Tehnicile chirurgicale de crioterapie si dermoabraziune au fost incercate cu diferite grade de succes. Medical therapy includes topical or intralesional corticosteroids or topical retinoids. Cryotherapy and surgical techniques have been tried dermoabraziune with varying degrees of success. Se indica aplicarea zilnica de creme de protectie solara. Enter the daily application of sunscreen. Evitarea bronzarii este importanta deoarece expunerea solara accentueaza procesul si intensifica contrastul pigmentar. Autobronzantele artificiale cu dixidroxiacetona reprezinta o alternativa utila. Avoid tanning sun exposure is important because it emphasizes the contrast and enhance pigment. Autobronzantele artificial dixidroxiacetona represents a useful alternative. Aceasta conditie progreseaza cu expunerea la soare si involueaza o data cu virsta. This condition progresses with exposure to sun and involute with age.