• Morphology

In 1985 and 1988, Gerard Guillet and Raymond Hélénon, with colleagues, described a novel acquired hypopigmentation disorder in dark-skinned immigrants from the Caribbean which they named progressive macular hypomelanosis (PMH).1 2 Over the past 20 years, many other terms have been coined for this condition, including cutis trunci variata, nummular and confluent hypomelanosis, Creole dyschromia, or idiopathic multiple large-macule hypomelanosis.3 More than 600 PMH patients have been reported in the literature with skin phototypes II–VI, but the debate about the aetiology of this disorder is still open.

We present an immunohistochemical and ultrastructural study on disseminated PMH extending beyond the trunk. No Propionibacterium colonisation of skin was found despite extensive examination. The evidence for a bacterial origin is discussed in consideration of the literature.

A 29-year-old Romanian female patient (skin phototype III), who had relocated to Germany 8 years earlier, presented with a mottled hypopigmentation of her skin that had progressed over the past 12 years. At the age of 17, macules started to appear on the abdomen and then spread gradually to the flanks, axillae and back. Over the past 2 years, the patient had noticed a rapid progression to the neck, décolleté and groin without any subjective symptoms. Physical examination revealed multiple partially coalescing oval or irregular hypopigmented …