Gutate hypomelanosis is known as a pigment disorder that is part of skin photodamage and that at first glance appears to have only a pigment loss component.
They are usually not treated but they are very common.
The photo shows that the dermoscopy showed a clearly keratotic appearance and that the small area where the lesion did not disappear still has the same appearance as the initial lesion. It can also be seen that the untreated lesion, marked in yellow, did not change.
The procedure was performed with an Erbium-YAG laser vaporizing up to the plane seen in the photograph.
The patient was instructed to allow controlled doses of sun exposure in this area to stimulate some repigmentation.
The control photograph was taken one year after the procedure and the patient is not aware of the moment when this occurred.
The procedure has also yielded results with carbon dioxide laser, but it usually results in increased inflammation.
In these lesions, fractional lasers have not shown better results because their penetration is lower and complete coverage is required.