White Patch
NOT EVERY WHITE PATCH IS VITILIGO!!
As a Dermatologist, I often get queries and requests for urgent consults by petrified parents for small hypopigmented patches on cheeks and body of their child. The most asked question is Doc, is this vitiligo???
Our society has stigmatised vitiligo to such an extent that every white lesion on the body is assumed to be a symptom of this disease. A simple hypopigmented lesion in a child can be due to several reasons like fungal infections, birthmarks, pityriasis alba, post inflammatory hypopigmentation, vitiligo etc. Only a dermatologist can differentiate and diagnose these conditions after proper physical examination and appropriate tests.
One of the commonest reasons for white patches in children and adolescents is pityriasis alba. Pityriasis alba (P.alba) presents as well demarcated hypopigmented flat lesions with minimal to no scaling ,commonly seen on cheeks .In some cases,they may occur on other parts of body. These lesions tend to become more prominent during summers as the surrounding skin tans which makes them stand out. Often the white patches are preceded by mildly erythematous, scaly lesions in light skinned patients.
A common misconception regarding these lesions is that they are due to calcium deficiency. Nothing could be farther from truth. Even though the exact etiology is unknown, p.alba is commonly associated with dry skin and is considered a minor manifestation of atopic dermatitis. These patients usually have a personal or family history of skin allergies.
Treatment involves use of liberal doses of moisturisers and topical calcineurin inhibitors like tacrolimus and pimecrolimus creams. Sometimes, your dermatologist may prescribe mild steroid creams for a short period of time to control the inflammation. These patches tend to improve spontaneously once the child enters adulthood.
