Hypopigmentation

A 23-year-old African Caribbean man presents with a 2-year history of gradual patchy lightening of the skin. He denies any symptoms such as itching or irritation of his skin prior to the onset of the whitening patches. He has no previous history of skin problems but had suffered with mild asthma as a child. He is otherwise well and does not take medication. There is a family history of thyroid disease.

Examination 

There are multiple, well-demarcated, non-scaly macules of depigmentation in a symmetrical distribution, predominantly over the trunk. The periorbital, perioral and genital areas are also affected. Some of the macules have tiny pigmented spots within them.