- Postinflammatory hypomelanosis is always related to loss of melanin.

It is a special
feature of pityriasis
versicolor (Fig. 13-13, see also Section 25), in
which the hypopigmentation may also remain for
weeks after the active infection has disappeared.
_ Hypomelanosis is not uncommonly seen in atopic
dermatitis, psoriasis (Fig. 13-14), guttate parapsoriasis,
and pityriasis lichenoides chronica.
_ It may also be present in cutaneous lupus
erythematosus (Fig. 13-15), alopecia mucinosa,
mycosis fungoides, lichen striatus, seborrheic
dermatitis, and leprosy.
_ Hypomelanosis may follow dermabrasion and
chemical peels; in these conditions there is
a “transfer block,” in which melanosomes are
present in melanocytes but are not transferred
to keratinocytes, resulting in hypomelanosis. The
lesions are usually not chalk white, as in vitiligo,
but “off” white and have indiscrete margins.
_ A common type of hypopigmentation is associated
with pityriasis alba (Fig. 13-16). This is a
macular hypopigmentation mostly on the face of
children, off-white with a powdery scale. Relatively
indistinct margins under Wood light and scaling
distinguish this eczematous dermatitis from
vitiligo. It is self-limited.
_ Hypomelanosis not uncommonly follows intralesional
glucocorticoid injections; but when the
injections are stopped, a normal pigmentation
develops in the areas.
_ Depending on the associated disorder, postinflammatory
hypomelanosis may respond to oral
PUVA photochemotherapy.