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• W1997768461 abstract "Topical minoxidil has been reported to be associated with sudden death [1], hair disolouration [2], local irritation and contact dermatitis [3]. We herein describe 2 patients who developed leucoderma after the application of 2% minoxidil lotion.Case No. 1 a young male aged 26 years, developed leucoderma over the frontal scalp region (fig. 1) after about 2.5 months of application of 2% minoxidil prescribed for androgenetic alopecia.On careful examination, seborrhoeic dermatitis and other possibilities of leucoderma/postinflammatory hypopigmentation were ruled out. Histopathology after haematoxylin-eosin staining showed loss of melanocytes and melanin incontinence in the dermis, which was substantiated by dopa staining. The patient was instructed to stop minoxidil immediately. Repigmentation of the leucodermic area was observed after about 3.5 months of stoppage of minoxidil.Case No. 2, a man of 32 years, presented with leucoderma of the centroparietal scalp within 7 weeks of application of minoxidil. Other possibilities of leucoderma were ruled out. Repigmentation of the area occurred within 3 months of discontinuation of minoxidil.In none of the 2 patients were there preceding signs of inflammation. Therefore, no ‘patch testing’ was done with minoxidil. Vitiligo was ruled out: in both patients the lesion started after the application of minoxidil and the scalp is a very unusal site for vitiligo. The most common presentation of vitiligo is a bilateral, symmetrical depigmentation of the face, neck, torso, extensor surfaces or bony prominences of the hands, wrists and legs, axillae, orifices or mucosal surfaces [4]. Repigmentation of the leucoderma in our cases after discontinuation of minoxidil further differentiated it from vitiligo. In addition, leucoderma was absent elsewhere on the body in both patients. Oral minoxidil has been reported to change hair colour [2]. Rebora and Guarrera [2]reported yellowish discolouration of a 71-year-old white-haired woman after application of minoxidil lotion. As the body hair was spared in this case, they opined the discolouration to be due to the local effect of minoxidil lotion. Minoxidil lotion may turn yellowish on standing. However, it is unlikely that yellowish discolouration of the hair has been noticed in the hundreds of persons treated with topical minoxidil in research works and has not been reported.The dark hair of a black patient turned reddish [5]. In 3 white patients treated with oral minoxidil, dark hair acquired a salt-and-pepper appearance, and white hair turned yellowish [6].The topical application of several chemicals, including catechols and phenols, e.g. hydroquinone and monobenzyl ether of hydroquinone, may result in a decrease in or loss of skin pigmentation [7]. There are many reports [8, 9]of similar pigmentary changes in patients exposed to phenol-containing germicides, hydroquinone photographic developer and a variety of rubber products treated with monobenzyl ether of hydroquinone. The chemical structure of these phenolic compounds is very similar to that of the melanin precursors, and their cytotoxic effects on pigment cells are also quite similar. Chemical leucoderma can mimic vitiligo, both clinically and histologically. Minoxidil is a piperidinopyramadine derivative [3]and a potent vasodilator. Whether this compound has cytotoxic effects on pigment cells is not known, but it is a fact that leucoderma occurred in our patients after application of minoxidil and we have excluded other possibilities of pigmentary changes." @default.
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• W1997768461 date "2000-01-01" @default.
• W1997768461 modified "2023-10-11" @default.
• W1997768461 title "Leucoderma Associated with the Use of Topical Minoxidil: A Report of Two Cases" @default.
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• W1997768461 doi "https://doi.org/10.1159/000018450" @default.
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