Generalized Mottled Hyperpigmentation in a 28-Year-Old Filipino Woman

A 28-year-old Filipina presented with a 20-year history of multiple hyper- and hypopigmented macules on the face, trunk and extremities. The lesions, noted to be nonpruritic and nontender, simultaneously appeared, initially on the trunk and spread gradually to the upper and lower extremities. Involvement of the face was noted 1 year prior to consult. Previous treatment with topical miconazole and oral itraconazole proved futile. She was also diagnosed clinically as a case of hypopigmented mycosis fungoides in another dermatology clinic, for which she underwent narrow band UVB phototherapy for 20 sessions. The patient was born to non-consanguineous parents. Similar skin lesions were also present in her two (maternal) aunts, an uncle and two male cousins (Fig. 14.1).