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Disseminated hypopigmented keratoses

A rare condition with multiple, small, hypopigmented macules that have a slightly keratotic or scaly surface.

Idiopathic guttate hypomelanosis

A very common, benign condition with multiple, small (2-5 mm), discrete, porcelain-white "confetti-like" macules on sun-exposed shins and forearms.

Leukoderma punctata

Small, punctate white spots that can develop within a resolving psoriatic plaque.

Lichen sclerosus

While often causing large atrophic white plaques, it can also present with smaller, guttate (tear-drop shaped) white macules.

Onchocerciasis

A parasitic infection ("river blindness") that can cause a "leopard skin" appearance with patchy hypopigmentation and atrophy.

Pityriasis lichenoides chronica

A benign inflammatory disorder that can heal leaving behind transient, post-inflammatory hypopigmented macules.

Scleroderma

A "salt-and-pepper" pattern of depigmentation (guttate hypopigmentation within a background of hyperpigmentation) is characteristic of systemic sclerosis.

Tuberous sclerosis

A genetic disorder characterized by "ash-leaf" spots, which are hypopigmented macules that can be leaf-shaped, polygonal, or guttate.

Xeroderma pigmentosum

A genetic DNA repair disorder that leads to severe sun sensitivity and the development of mottled hyper- and hypopigmentation resembling extensive freckling and "guttate" white spots.

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