Surg Cosmet Dermatol. 2011;3(3):219-225
Introduction: Progressive macular hypomelanosis is a common skin hypopigmentation
found in all ethnicities, yet it is seldom diagnosed. It affects young adults, especially
women, and is often mistaken with pityriasis alba and pityriasis versicolor. It is character-
ized by symmetric, well-defined, non-desquamative nummular hypopigmented macules
in body areas with a greater concentration of sebaceous glands (trunk, thorax, abdomen
and lumbar regions). Its etiology is poorly understood, and there is no effective treatment.
A red fluorescence has recently been discovered in the lesion, suggesting the presence of
porphyrin, produced by Propionibacterium acnes.
Objective: To compare the efficacy of 100 mg/day minocycline vs. placebo in the treat-
ment of progressive macular hypomelanosis.
Methods: Patients over 18 (n = 20), who had suffered from the condition for more than
3 months (without treatment in the previous 3 months), who did not have an allergy to
tetracycline, were randomized to receive minocycline or placebo. Wood''''''''s Lamp examina-
tions and clinical evaluations (with descriptions and classifications using a color scale), and
standardized picture records were conducted at baseline and 30 and 90 days after treatment.
Results: Eighteen patients completed the study. The group treated with minocycline pre-
sented a statistically significant improvement (p < 0.05) compared to the control group.,br>
Conclusion: 100 mg/day minocycline for 30 days was effective in treating progressive
macular hypomelanosis, meaning that Propionibacterium acnes probably has a role in the
condition''''''''s pathogeny.
Keywords: MINOCYCLINE, HYPOPIGMENTATION, PLACEBO EFFECT, TREATMENT