Adult female presented with unchanged, asymptomatic and untreated white lesions at lip since 2 years (Figures 1-2). On examination she had hypo pigmented lesions at leg. She was not aware about these spots (Figures 3-4). What will be your clinical diagnosis? Are the same disease or different? Thank you.

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Dr. Pankaj Jagirdar, Good case Here first 2 visual shows greyish with hypomelanosis on contact areas of the lips may be Prolong exposure of Sun exposure or Contact allergens like vaseline or lipstick. The 3rd and 4th visuals showing hypopigmented patches with hyperpigmented hairbuds may be due to forcible pulling of hairs ( waxing) may lead to inflammation of hair buds with depigmentation. I hope it could be temporary . With good treatment, we can reverse these spots to normal coloured skin. So this is my impression doctor. Now You respond .

Dear Dr P. Kishore Kumar Thank you for your valuable reply. My clinical impression when I saw the patient is as follows. Provisional clinical diagnosis: 1 Lichen Sclerosus at lip 2 Hansen’s disease – Indeterminate at leg With regards pankaj jagirdar
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Provisional clinical diagnosis: 1 Lichen Sclerosus at lip 2 Hansen’s disease – Indeterminate at leg Proposed investigations: 1 Skin biopsy at leg 2 Will avoid biopsy at lip 3 Optional investigation: Borrelia Burgdorferi antibodies

Vitiligo (?)

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? Vitiligo

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Vitiligo

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VERY VERY EARLY DOT HYPOPIGMENTED DIT LIKE LESIONS AT THE SITE OF ANGLES OF MOUTH MAY BE EARLY VITILIGO

Vittilago

Vitiligo

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Starting stage Vitiligo

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Vitiligo

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