Pigmentary Skin Disorder

Question 1

What determines skin color?

Answer 1

The amount of melanin in the skin.

Question 2

What are the types of pigmentary skin disorders?

Answer 2

Albinism, vitiligo, melasma, post-inflammatory hyperpigmentation, hyperpigmentation, hypopigmentation.

Question 3

What is vitiligo?

Answer 3

An acquired pigmentary disorder characterized by circumscribed, depigmented macules and patches.

Question 4

Which autoimmune disorder is most strongly associated with vitiligo?

Answer 4

Thyroid disease.

Question 5

What is the prevalence of vitiligo?

Answer 5

Affects 0.5-2% of the population.

Question 6

Which racial group has the lowest prevalence of vitiligo?

Answer 6

Han Chinese people.

Question 7

At what age does vitiligo typically begin?

Answer 7

20-24 years, but can occur at any age.

Question 8

How is vitiligo inherited?

Answer 8

Polygenic with a 23% monozygotic twin concordance.

Question 9

Which autoimmune diseases are associated with vitiligo?

Answer 9

Thyroid disease, rheumatoid arthritis, IDDM, pernicious anemia, Addison’s disease, systemic lupus erythematosus (SLE).

Question 10

How does vitiligo typically present?

Answer 10

White or depigmented macules and patches, well-demarcated, round, oval, or linear in shape.

Question 11

Where does vitiligo most commonly appear?

Answer 11

Hands, forearms, feet, face (perioral, periocular).

Question 12

What diagnostic tests are used for vitiligo?

Answer 12

Clinical exam, Wood’s lamp, skin biopsy, thyroid function tests, ANA, B12 levels.

Question 13

What are the goals of vitiligo treatment?

Answer 13

Stop progression (stabilization) and achieve repigmentation.

Question 14

Which areas of the body respond poorly to vitiligo treatment?

Answer 14

Hands, feet, and areas with white hair.

Question 15

What topical treatments are used for vitiligo?

Answer 15

Corticosteroids, calcineurin inhibitors (tacrolimus, pimecrolimus), vitamin D derivatives (calcipotriol).

Question 16

What systemic therapies are used for vitiligo?

Answer 16

Systemic steroids, methotrexate, mycophenolate mofetil, oral minocycline.

Question 17

What surgical options exist for vitiligo?

Answer 17

Depigmentation therapy, skin grafting.

Question 18

How does trauma affect vitiligo?

Answer 18

Cuts, grazes, or scratches may trigger new vitiligo patches.

Question 19

What psychosocial support is recommended for vitiligo patients?

Answer 19

Counseling, cosmetic camouflage, and support groups.

Question 20

What is albinism?

Answer 20

A condition with little or no melanin pigment in the eyes, skin, or hair.

Question 21

What are the two main types of albinism?

Answer 21

Oculocutaneous albinism (OCA) and ocular albinism (OA).

Question 22

Which enzyme is deficient in albinism?

Answer 22

Tyrosinase.

Question 23

How is albinism inherited?

Answer 23

Mostly autosomal recessive.

Question 24

What is the estimated carrier rate for albinism?

Answer 24

About 1 in 70 people carry a gene for albinism.

Question 25

What are common skin problems in albinism?

Answer 25

Easily sunburned, increased risk of skin cancer (squamous cell carcinoma, basal cell carcinoma).

Question 26

What are common eye problems in albinism?

Answer 26

Photophobia, nystagmus, strabismus, impaired vision.

Question 27

What precautions should people with albinism take?

Answer 27

Wear protective clothing, sunglasses, and use SPF 50+ sunscreen.

Question 28

What is hyperpigmentation?

Answer 28

An increase in skin pigmentation due to excess melanin.

Question 29

What are the two types of hyperpigmentation?

Answer 29

Generalized and localized.

Question 30

What are causes of generalized hyperpigmentation?

Answer 30

Addison’s disease, hemochromatosis, metastatic melanoma, afamelanotide.

Question 31

What are causes of localized hyperpigmentation?

Answer 31

Melanocytic nevi, post-inflammatory hyperpigmentation, skin cancers, chronic pigmentary disorders.

Question 32

What conditions cause post-inflammatory hyperpigmentation?

Answer 32

Eczema, fixed drug eruptions, previous infections (pityriasis versicolor, erythrasma).

Question 33

What is melasma?

Answer 33

A chronic hyperpigmentation disorder, often triggered by sun exposure and hormonal changes.

Question 34

What treatments are available for hyperpigmentation?

Answer 34

Sunscreen, hydroquinone, retinoids, corticosteroids, glycolic acid, azelaic acid, vitamin C.

Question 35

What procedures can treat hyperpigmentation?

Answer 35

Chemical peels, laser therapy, dermabrasion, cryotherapy.

Question 36

What is hypopigmentation?

Answer 36

A reduction in skin pigmentation due to loss of melanin.

Question 37

What are the two types of hypopigmentation?

Answer 37

Generalized and localized.

Question 38

What are causes of generalized hypopigmentation?

Answer 38

Albinism, pituitary failure (MSH deficiency).

Question 39

What are causes of localized hypopigmentation?

Answer 39

Pityriasis alba, pityriasis versicolor, post-inflammatory hypopigmentation, syphilitic leukoderma, leprosy.

Question 40

What is leukoderma?

Answer 40

Localized white depigmented patches of skin.

Question 41

What are causes of leukoderma?

Answer 41

Halo nevus, vitiligo, idiopathic guttate hypomelanosis, lichen sclerosus, systemic sclerosis, scarring, contact leukoderma.

Question 42

How is hypopigmentation treated?

Answer 42

Most cases resolve on their own if the underlying cause is treated.

Question 43

What is idiopathic guttate hypomelanosis?

Answer 43

A common condition presenting as small white macules on sun-exposed skin, more common in older adults.

Question 44

What is contact leukoderma?

Answer 44

Depigmentation caused by repeated exposure to certain chemicals.

Question 45

Which infections can cause hypopigmentation?

Answer 45

Leprosy, syphilis, pityriasis versicolor.

Question 46

What is the prognosis for vitiligo treatment?

Answer 46

Highly variable, with some patches responding well while others remain unchanged.

Question 47

Which pigmentary disorder is most associated with autoimmune diseases?

Answer 47

Vitiligo.

Question 48

Which pigmentary disorder is most associated with sun exposure?

Answer 48

Melasma.

Question 49

What common drug is used to treat hyperpigmentation?

Answer 49

Hydroquinone.

Question 50

What is the role of sunscreen in treating pigmentary disorders?

Answer 50

Prevents further darkening in hyperpigmentation and protects hypopigmented areas from sun damage.

Question 51

What is the main cosmetic approach for vitiligo patients?

Answer 51

Camouflage makeup and skin-tone-matching products.

Question 52

What is the difference between hyperpigmentation and hypopigmentation?

Answer 52

Hyperpigmentation is increased melanin, while hypopigmentation is reduced melanin.

Question 53

What is the most effective prevention for UV-induced pigmentation disorders?

Answer 53

Broad-spectrum sunscreen with SPF 50+.

Question 54

Which type of albinism primarily affects the eyes?

Answer 54

Ocular albinism.

Question 55

What is the most common form of albinism?

Answer 55

Oculocutaneous albinism (OCA).

Question 56

What pigmentary disorder presents with a 'halo' around a mole?

Answer 56

Halo nevus.

Question 57

Which pigmentary disorder is associated with hormonal changes during pregnancy?

Answer 57

Melasma.

Question 58

What pigmentary disorder is more common in patients with Addison’s disease?

Answer 58

Generalized hyperpigmentation.