Supplementary Material for: Acquired speckled acrofacial hypomelanosis: A novel case report

Speckled, confetti, or guttate pigmentary disorders include conditions with overlapping features and diagnostic challenges. A 9-year-old Saudi female presented with a 1-year history of skin lesions involving the face, forearms, hands, legs, and feet. The microscopic examination, including special DOPA staining, revealed normal melanin pigmentation in the basal keratinocyte layer and normal to focal slightly reduced numbers of basal melanocytes, along with a focal sparse superficial perivascular mononuclear inflammatory cell infiltrate. Based on clinicopathological correlation, a diagnosis of acral speckled guttate hypomelanosis was made. Unique findings include facial involvement, and no hyperpigmentation were present in this case.The patient responded well to pimecrolimus cream.

Keywords: pigmentary disorders; pediatric; speckled; acrofacial: hypomelanosis.