A child with multiple hypopigmented macules on abdomen: JAMA
A child presented with multiple, asymptomatic, scattered white macules on the lower abdomen and pubic area, which were present at birth and had gradually increased in size and number. Physical examination revealed multiple, well-demarcated, hypopigmented 1- to 5-mm macules on the lower abdomen and pubic area.

There was no history of any systemic disorder and no family history of similar lesions. Direct microscopic examination of scales soaked in potassium hydroxide did not reveal hyphae. Wood light examination revealed no accentuation. A punch biopsy specimen was obtained for further evaluation.

Histopathological examination revealed mild hyperkeratosis and acanthosis, and scattered clear cells in the epidermis. On histochemical and immunohistochemical evaluation, the Fontana-Masson stain did not indicate any reduction in melanin level, and the melan-A stain revealed that the melanocyte number was normal. The clear cells were positive for cytokeratin AE1/AE3 and 7, carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA).In contrast, the cells did not stain positively for the S-100 protein.

Final diagnosis: Clear cell papulosis

Read more here: https://jamanetwork.com/journals/jamadermatology/article-abstract/2697564