title: Vitiliginous lesions induced by amyl nitrite exposure.
abstract: Chemical (or contact) leukoderma is a condition induced by local cutaneous exposure to chemicals or medicaments that are toxic to melanocytes and/or koebnerize preexisting vitiligo vulgaris. Chemicals known to induce leukoderma include phenol/catechol derivatives (eg, hydroquinone), sulfhydryls, contact sensitizing agents (eg, squaric acid dibutylester), and more recently imiquimod, among others. We report the case of a 37-year-old black man with human immunodeficiency virus who developed chemical leukoderma in the nasal and perioral areas within 4 weeks of spilling liquid amyl nitrite, which he had been inhaling as a recreational drug, on his lower face. The depigmented regions were treated with a biweekly regimen of 308-nm excimer laser treatment for a total of 78 sessions. More than 90% cutaneous repigmentation was achieved. Amyl nitrite-induced vitiliginous lesions are rare. We also discuss potential mechanisms of hypopigmentation from chemical agents and therapeutic options for chemical leukoderma.
authors.affiliation: Department of Dermatology, St. Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Vine
authors.forename: Marc
authors.initials: M
authors.lastname: Meulener
authors.forename: Sherry
authors.initials: S
authors.lastname: Shieh
authors.forename: Nanette B
authors.initials: NB
authors.lastname: Silverberg
mesh_terms: D000328:Adult; D005148:Facial Dermatoses / Q000139:chemically induced / Q000473:pathology / Q000628:therapy; D015658:HIV Infections / Q000150:complications; D006801:Humans; D017496:Hypopigmentation / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009566:Nitrates / Q000008:administration & dosage / Q000009:adverse effects*; D000439:Pentanols / Q000008:administration & dosage / Q000009:adverse effects*; D012880:Skin Pigmentation; D016896:Treatment Outcome; D014820:Vitiligo / Q000139:chemically induced / Q000473:pathology / Q000628:therapy
chemical_list: D009566:Nitrates; D000439:Pentanols; C036285:amyl nitrate