Wood s light examination could be helpful in revealing unsuspected involvement. Dopa staining can be useful because dopa-positive melanocytes are decreased. Typical histologic findings are epidermal atrophy, patchy absence of melanocytes and melanin, flat rete ridges, and basket weave hyperkeratosis. Medical therapy includes corticosteroids, either topical or intralesional, and retinoids, typically topical tretinoin. Avoiding sun tanning is an important adjunct because tanning accentuates the process and intensifies the pigmentary contrast.
Artificial tanning using dihydroxyacetone-containing topical agents is a good alternative.
Surgical techniques from cryosurgery to dermabrasion have been tried with some success. In doubtful cases a consultation with a dermatologist would precede any lab or biopsy studies. Retinoids - Chosen perhaps because of its action in other actinic conditions. Precautions Sun exposure should be avoided. As this would be an off label use of tretinoin, its use might not be covered by some pharmacy plans.