2016 Volume 10 Issue 3 Pages 213-218
A 69-year-old male had been attending our department to receive treatment for vitiligo vulgaris and was prescribed topical medications for white patches on his face and bilateral forearms. After 2 years' treatment, he started daily treatment with a valsartan/hydrochlorothiazide compound drug for hypertension and noticed asymptomatic erythema on the sun-exposed lesions as well as irregular hypo- and hyperpigmented macules. Under a diagnosis of photoleukomelanoderma induced by the hydrochlorothiazide in the compound drug, we instructed the patient to discontinue taking the compound drug and avoid sun exposure. Thereafter, the leukomelanoderma lesions improved without any treatment, but the vitiligo lesions remained unchanged. A photochallenge test with the compound drug produced a positive result. Although there have been some case reports about leukomelanoderma patients that displayed phototoxic responses to hydrochlorothiazide, this is the first report about a patient who exhibited both photoleukomelanoderma and non-segmental vitiligo vulgaris. Herein, we present a rare case of vitiligo vulgaris case combined with photoleukomelanoderma and discuss the differences in the histological and immunohistochemical findings between the vitiligo and leukomelanoderma lesions.
