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A white spot since birth

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The lesion on the patient’s chest was asymptomatic. But what caused it—and could it be a problem?


 

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A 13-year-old Hispanic girl came into our skin clinic with her grandmother for evaluation of suspicious moles on her arms. The grandmother was also concerned about a hypopigmented lesion on the young woman’s chest.

The patient and her grandmother said that the chest lesion had been there since birth, but it had been slowly growing over the years. The lesion was asymptomatic—there was no pruritus, bleeding, or pain. The patient was otherwise healthy and was not taking any medications.

The patient and her grandmother indicated that no one in the family had a similar lesion. The patient had no fever or chills, nor any neurological, respiratory, cardiac, or gastrointestinal problems. The hypopigmented lesion on the patient’s chest had irregular borders and no scale (FIGURE 1).

There was no loss of sensation at the site and, upon applying pressure to the surrounding skin with a glass slide, the border between the lesion and normal skin disappeared.

FIGURE 1
Hypopigmented patch on chest

A 13-year-old patient had this white spot on her chest since birth, and it had gradually grown over the years. She had no pruritus, bleeding, or pain.

What is your diagnosis?
How would you manage this condition?

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