Photo Rounds

Lighter skin on left cheek

An 11-year-old girl presented to her family physician (FP) with lighter skin over her left cheek. The mother said that it had been like this since birth, but that it was more noticeable when her daughter had been playing outside. The child was otherwise in good health.

What’s your diagnosis?


The FP made the diagnosis of nevus depigmentosus.

Nevus depigmentosus is usually present at birth or develops in early childhood. There is a decreased number of melanosomes within a normal number of melanocytes. The hypopigmented area typically has a serrated or jagged edge and has been compared to the appearance of a continent.

Nevus depigmentosus presents no danger or increased malignant potential. Excision, which is not an advisable option, is the only available treatment. Patients who want to camouflage the appearance of the hypopigmentation can use cover-up makeup.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Smith M, Usatine R. Benign nevi. In: Usatine R, Smith M, Mayeaux EJ, et al. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:945-952.

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