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Case Reports
. 2020 Jul;6(4):244-246.
doi: 10.1159/000507899. Epub 2020 Jun 2.

Thymol-Induced Chemical Leukoderma Successfully Treated with 308-Nanometer Excimer Laser

Maximillian A Weigelt  1 , Alexander T Herbst  1 , Antonella Tosti  1 , Hadar Lev-Tov  1
Affiliations
Case Reports

Thymol-Induced Chemical Leukoderma Successfully Treated with 308-Nanometer Excimer Laser

Maximillian A Weigelt et al. Skin Appendage Disord. 2020 Jul.

Abstract

Introduction: Chemical leukoderma (CL) is an acquired depigmenting disorder caused by repeated exposure to chemical compounds. Thymol is a phenol derivative used as a preservative or antiseptic in many commercially available products. Here, we present the second reported case of CL caused by a thymol-containing compound.

Case presentation: A 48-year-old woman presented with a 4-month history of depigmentation of the nail folds of all ten fingers. This occurred after 1 month of twice-daily application of a thymol-containing compound intended for the removal of gel nails. No improvement was noted after the product was discontinued. There was no family history of vitiligo or other autoimmune disorders. On physical exam, depigmentation of all ten proximal and lateral nail folds was seen, with accentuation on Wood's lamp exam. Partial re-pigmentation was achieved after 32 treatments with 308-nm excimer laser.

Discussion: A thorough history and physical exam are instrumental in differentiating CL from other causes of depigmentation. Avoidance of the offending agent is an essential part of management. It is important to note that many cosmetic products are not tightly regulated by the FDA. Excimer laser is an effective treatment for CL with a favorable side-effect profile.

Keywords: Chemical; Contact; Depigmentation; Laser; Leukoderma.

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Conflict of interest statement

The authors have no relevant disclosures.

Figures

Fig. 1
Fig. 1
Depigmentation of all ten nail folds after 1 month of twice-daily application of a thymol-containing product for removal of gel nails.
Fig. 2
Fig. 2
Partial re-pigmentation of the nail folds after 32 biweekly treatments with 308-nm excimer laser, starting at 250 mJ/cm2 and gradually increasing to 1,190 mJ/cm2.
See this image and copyright information in PMC

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