Hypomelanosis of Ito
Incontinentia pigmenti achromians; HMI; Ito hypomelanosisHypomelanosis of Ito (HMI) is a very rare birth defect that causes unusual patches of light-colored (hypopigmented) skin and may be associated with eye, nervous system, and skeletal problems.
Hypopigmented
Abnormally dark or light skin is skin that has turned darker or lighter than normal.
Read Article Now Book Mark ArticleCauses
Health care providers do not know the exact cause of HMI, but they believe it may involve a genetic condition called mosaicism. It is twice as common in girls as in boys.
Symptoms
Skin symptoms are most often visible by the time a child is about 2 years old.
Other symptoms develop as the child grows, and may include:
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Crossed eyes (strabismus)
Crossed eyes
Strabismus is a disorder in which both eyes do not line up in the same direction. Therefore, they do not look at the same object at the same time. ...
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- Increased body hair (hirsutism)
Hirsutism
Most of the time, women have fine hair above their lips and on their chin, chest, abdomen, or back. The growth of coarse dark hair in these areas (m...
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Scoliosis
Scoliosis
Scoliosis is an abnormal curving of the spine. Your spine is your backbone. It runs straight down your back. Everyone's spine naturally curves a b...
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Seizures
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
Read Article Now Book Mark Article - Streaked, whorled or mottled patches of skin on the arms, legs, and middle of the body
- Intellectual disability, including autism spectrum disorder and learning disability
Autism spectrum disorder
Autism spectrum disorder (ASD) is a developmental disorder. It often appears in the first 2 to 3 years of life. ASD affects the brain's ability to ...
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Exams and Tests
Ultraviolet light (Wood lamp) examination of the skin lesions may help confirm the diagnosis.
Wood lamp
A Wood lamp examination is a test that uses ultraviolet (UV) light to look at the skin closely.
Read Article Now Book Mark ArticleTests that may be done include any of the following:
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CT or MRI scan of the head for a child with seizures and nervous system symptoms
CT
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
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EEG to measure the electrical activity of the brain in a child with seizures
EEG
An electroencephalogram (EEG) is a test to measure the electrical activity of the brain.
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Treatment
There is no treatment for the skin patches. Cosmetics or clothing may be used to cover the patches. Seizures, scoliosis, and other problems are treated as needed.
Outlook (Prognosis)
The outlook depends on the type and severity of symptoms that develop. In most cases, skin color eventually turns to normal.
Possible Complications
Problems that may result from HMI include:
- Discomfort and walking problems due to scoliosis
- Emotional distress, related to the physical appearance
-
Intellectual disability
Intellectual disability
Intellectual disability is a condition diagnosed before age 18 that includes below-average intellectual function and a lack of skills necessary for d...
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When to Contact a Medical Professional
Contact your provider if your child has an unusual pattern of the color of the skin. However, any unusual patterns are likely to have another cause than HMI.
References
Joyce JC. Hypopigmented lesions. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 672.
Patterson JW. Disorders of pigmentation. In: Patterson JW, ed. Weedon's Skin Pathology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 11.
Review Date: 5/31/2023
Reviewed By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.