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White Leaf-Shaped Macules: Earliest Visible Sign of Tuberous Sclerosis

White Leaf-Shaped Macules: Earliest Visible Sign of Tuberous Sclerosis Abstract White macules are present in more than 50% of the patients with tuberous sclerosis when no other visible lesions typical of tuberous sclerosis have appeared; the majority, if not all, of the white macules appear at birth. In fair-skinned infants the lesions may be easily overlooked and may only be detected with Wood's light. The configuration of the white macules may be oval or linear; the most characteristic outline, however, is the lance-ovate shape. Cytologically altered melanocytes and decreased tyrosinase activity and reduced melanin deposition on melanosomes are present in the hypomelanotic macules of tuberous sclerosis, whereas melanocytes are very rarely present in the hypomelanotic macules of vitiligo. Therefore, the cytological changes of the melanocyte system in the white macules of tuberous sclerosis are different from those present in the white macules of vitiligo. References 1. Butterworth, T., and Wilson, McC., Jr.: Dermatologic Aspects of Tuberous Sclerosis , Arch Derm 43:1-41 ( (Jan) ) 1941.Crossref 2. Chao, D.H.-C.: Congenital Neurocutaneous Syndromes in Childhood , J Pediat 55:447-459 ( (Oct) ) 1959.Crossref 3. Gold, A.P., and Freeman, J.M.: Depigmented Nevi: The Earliest Sign of Tuberous Sclerosis , Pediatrics 35:1003-1005 ( (June) ) 1965. 4. Harris, R., and Moynahan, E.J.: Tuberous Sclerosis With Vitiligo , Brit J Derm 78:419-420 ( (July) ) 1966. 5. Gold, A.P.: Discussion, in S. Gellis (ed.), Year Book of Pediatrics 1966-1967 , Chicago: Year Book Medical Publishers, Inc., 1967, pp 169-171. 6. Nickel, W.R., and Reed, W.B.: Tuberous Sclerosis: Special Reference to Microscopic Alterations in the Cutaneous Hamartomas , Arch Derm 85:209-226 ( (Feb) ) 1962.Crossref 7. Jarrett, A., and Szabó, G.: The Pathological Varieties of Vitiligo and Their Response to Treatment With Meladinine , Brit J Derm 68:313-326 ( (Oct) ) 1956.Crossref 8. Fitzpatrick, T.B., and Quevedo, W.C., Jr.: " Albinism ," in Stanbury, J.B.; Wyngaarden, J.B.; and Fredrickson, D.S. (eds.): The Metabolic Basis of Inherited Disease , ed 2, New York: The Blakiston Division, McGraw-Hill Book Co., Inc., 1966, pp 324-340. 9. Lerner, A.B.: Vitiligo , J Invest Drem 32(suppl to No. (2) ):285-310, 1959.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

White Leaf-Shaped Macules: Earliest Visible Sign of Tuberous Sclerosis

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Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1968.01610130007001
Publisher site
See Article on Publisher Site

Abstract

Abstract White macules are present in more than 50% of the patients with tuberous sclerosis when no other visible lesions typical of tuberous sclerosis have appeared; the majority, if not all, of the white macules appear at birth. In fair-skinned infants the lesions may be easily overlooked and may only be detected with Wood's light. The configuration of the white macules may be oval or linear; the most characteristic outline, however, is the lance-ovate shape. Cytologically altered melanocytes and decreased tyrosinase activity and reduced melanin deposition on melanosomes are present in the hypomelanotic macules of tuberous sclerosis, whereas melanocytes are very rarely present in the hypomelanotic macules of vitiligo. Therefore, the cytological changes of the melanocyte system in the white macules of tuberous sclerosis are different from those present in the white macules of vitiligo. References 1. Butterworth, T., and Wilson, McC., Jr.: Dermatologic Aspects of Tuberous Sclerosis , Arch Derm 43:1-41 ( (Jan) ) 1941.Crossref 2. Chao, D.H.-C.: Congenital Neurocutaneous Syndromes in Childhood , J Pediat 55:447-459 ( (Oct) ) 1959.Crossref 3. Gold, A.P., and Freeman, J.M.: Depigmented Nevi: The Earliest Sign of Tuberous Sclerosis , Pediatrics 35:1003-1005 ( (June) ) 1965. 4. Harris, R., and Moynahan, E.J.: Tuberous Sclerosis With Vitiligo , Brit J Derm 78:419-420 ( (July) ) 1966. 5. Gold, A.P.: Discussion, in S. Gellis (ed.), Year Book of Pediatrics 1966-1967 , Chicago: Year Book Medical Publishers, Inc., 1967, pp 169-171. 6. Nickel, W.R., and Reed, W.B.: Tuberous Sclerosis: Special Reference to Microscopic Alterations in the Cutaneous Hamartomas , Arch Derm 85:209-226 ( (Feb) ) 1962.Crossref 7. Jarrett, A., and Szabó, G.: The Pathological Varieties of Vitiligo and Their Response to Treatment With Meladinine , Brit J Derm 68:313-326 ( (Oct) ) 1956.Crossref 8. Fitzpatrick, T.B., and Quevedo, W.C., Jr.: " Albinism ," in Stanbury, J.B.; Wyngaarden, J.B.; and Fredrickson, D.S. (eds.): The Metabolic Basis of Inherited Disease , ed 2, New York: The Blakiston Division, McGraw-Hill Book Co., Inc., 1966, pp 324-340. 9. Lerner, A.B.: Vitiligo , J Invest Drem 32(suppl to No. (2) ):285-310, 1959.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jul 1, 1968

References