title: Efficacy and relapse rates of different treatment modalities for progressive macular hypomelanosis.
abstract: BACKGROUND
  Progressive macular hypomelanosis is an acquired disorder characterized by hypopigmented macules mostly on the trunk and upper extremities. Although many treatment modalities have been proposed for this condition with variable success rates, there are few reports comparing their efficacy and relapse rates.
  
  
  OBJECTIVE
  To compare the efficacy and relapse rates of different treatment modalities for progressive macular hypomelanosis.
  
  
  METHODS
  Case records of patients diagnosed with progressive macular hypomelanosis and treated in National Skin Centre for a six year period between 2008 and 2014 were reviewed. Patient demographics, distribution of hypopigmented macules, treatment efficacy and relapse rates were noted.
  
  
  RESULTS
  A total of 108 patients were seen for progressive macular hypomelanosis over the study period; of these, 40 opted for no treatment but were followed up. Thirty-six were treated with topical antimicrobials and 32 with phototherapy. Of those untreated, 23% recovered spontaneously while 38% in the antimicrobial group and 90% in the phototherapy had remission of their hypopigmentation. After 2 years of follow-up, relapse occurred only in the phototherapy group.
  
  
  CONCLUSIONS
  The main limitation is the retrospective design whereby diagnosis is dependent on the attending dermatologist.
  
  
  CONCLUSIONS
  Narrow-band ultraviolet B therapy appears to be the most effective treatment for progressive macular hypomelanosis but also has the highest potential for relapse. Response rates for antimicrobial therapy are lower and slower, but patients who responded did not relapse. A combination of topical/systemic antimicrobials with narrow-band ultraviolet B therapy might be the best option to hasten recovery and minimize relapse.
authors.affiliation: National Skin Centre; Department of Material Science and Engineering, Nanyang Technological University, Singapore.
authors.forename: Steven T G
authors.initials: ST
authors.lastname: Thng
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Valencia S H
authors.initials: VS
authors.lastname: Long
authors.affiliation: National Skin Centre, Nanyang Technological University, Singapore.
authors.forename: Sai Yee
authors.initials: SY
authors.lastname: Chuah
authors.affiliation: National Skin Centre, Nanyang Technological University, Singapore.
authors.forename: Virlynn W D
authors.initials: VW
authors.lastname: Tan
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017496:Hypopigmentation / Q000175:diagnosis* / Q000628:therapy*; D008266:Macula Lutea / Q000187:drug effects / Q000473:pathology*; D008297:Male; D010789:Phototherapy / Q000639:trends*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents