Diagnose It: Hypopigmented Patches

NEWS/ QUIZ

1 MIN QUIZ

A 10-year-old African American boy was referred by his pediatrician to a dermatologist. The patient has hypopigmented patches on his check and chin. He has experienced erythematous lesions followed by areas of nonpruritic smooth scales that vary in size. Normally the patches are not as noticeable as they are now; however, with sun exposure during the summer months, they become prominent in color. The boy has a family history of atopic dermatitis.

What is the diagnosis?

Select the correct answer

A) Pityriasis alba

B) Discoid eczema

C) Psoriasis

D) Pityriasis rosea

CORRECT

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INCORRECT

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Answer is: A

Pityriasis alba (PA) is a benign, common skin disorder that mainly affects children and adolescents.^1,2 The typical age of onset is 3–16 years of age, with approximately 90% of cases occurring in children younger than 12 years.^1,2

The name of the disease is descriptive: Pityriasis means "fine scales," and alba refers to hypopigmentation.¹ It is common worldwide but is seen more often in darker-skinned individuals, with an estimated 5% of children in the United States affected.^1,2 Its main characteristic features include round or oval macules and thin plaques that can have mild scaling or pruritus. The patches go through many stages and occur spontaneously. They are located most often on the face but can occur on the arms, neck, and upper trunk, and they become hypopigmented over time.^1,2 The blemishes are not harmful, and patients and their families are normally more concerned with the cosmetic appearance of the lesions.¹Pityriasis alba usually resolves spontaneously, and most cases completely resolve within a year.¹ The etiology is poorly understood, but there are known triggering factors, including sun, exfoliation, and frequent baths.^1,2 A family history of atopy is common in patients diagnosed with PA, and signs of atopic dermatitis may be present.^1,2

References:

1. Givler DN, Basit H, Givler A. Pityriasis alba. In: StatPearls. November 5, 2021. StatPearls Publishing; 2022. [pg 1/para 3/ln 1; pg 1/para 1/ln 1-2; pg 1/para 5 (Epidemiology)/ln 1; pg 1/para 3/ln 1-2; pg 1/para 5 (Epidemiology)/ln 1-2, 4; pg 1/para 3 (Introduction)/ln 3-5; pg 2/para 2/ln 1-4; pg 2/para 8; ln 1-2; pg 1/para 4 (Etiology)/ln 1-5; pg 2/para 2/ln 2-3; pg 2/para 3/ln 3]

2. Maymone MBC, Watchmaker JD, Dubiel M, Wirya SA, Shen LY, Vashi NA. Common skin disorders in pediatric skin of color. J Pediatr Health Care. 2019;33(6):727-737. doi:10.1016/j.pedhc.2019.04.019 [pg 731/col 1/para 3/ln 1-4; pg 729/table 2; pg 731/col 1/para 3/ln 1-2; pg 731/col 1/para 4/ln 1-6; pg 731/para 6/all; pg 731/col 1/para 5/ln 1-3]

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