Vitiliginous lesions induced by amyl nitrite exposure
Vine, K.; Meulener, M.; Shieh, S.; Silverberg, N.B.
Cutis 91(3): 129-136
2013
ISSN/ISBN: 0011-4162 PMID: 23617083 Document Number: 669152
Chemical (or contact) leukoderma is a condition induced by local cutaneous exposure to chemicals or medicaments that are toxic to melanocytes and/or koebnerize preexisting vitiligo vulgaris. Chemicals known to induce leukoderma include phenol/catechol derivatives (eg, hydroquinone), sulfhydryls, contact sensitizing agents (eg, squaric acid dibutylester), and more recently imiquimod, among others. We report the case of a 37-year-old black man with human immunodeficiency virus who developed chemical leukoderma in the nasal and perioral areas within 4 weeks of spilling liquid amyl nitrite, which he had been inhaling as a recreational drug, on his lower face. The depigmented regions were treated with a biweekly regimen of 308-nm excimer laser treatment for a total of 78 sessions. More than 90% cutaneous repigmentation was achieved. Amyl nitrite-induced vitiliginous lesions are rare. We also discuss potential mechanisms of hypopigmentation from chemical agents and therapeutic options for chemical leukoderma.