Question 10. Whitish and depigmented patches on skin...?

Question 10. Whitish and depigmented patches on skin: how can I know what they are?

Key points

  • Not all whitish patches on the skin are vitiligo.
  • Depigmented patches on the skin, other than vitiligo, are named leukodermas; they can be “occupational”.
  • Occupational and drug-related forms of depigmentation can be manifested as vitiligo.
  • Common disorders with similar manifestation include Nevus Depigmentosus, Piebaldism, etc.

No, not all white patches are vitiligo, but white patches resembling vitiligo are not unusual on human skin. They are called leukodermas. Chemical leukoderma can be induced by dyes, perfumes, detergents, cleansers, insecticides, rubber condoms, rubber slippers, black socks and shoes, eyeliners, lipliners, lipsticks, toothpaste, antiseptics with phenolic derivatives, and mercuric iodide-containing ‘‘germicidal’’ soap.

Occupational vitiligo may occur in those individuals who work with depigmenting substances, such as hydroquinone, para-tertiary butyl catechol, para-tertiary butyl phenol, para-tertiary amyl phenol, and hydroquinone monomethyl ether.

Depigmentation has also been reported in shoemakers and after contact with arsenic containing compounds. Nevus depigmentosus is a segmental hypopigmentation detectable in the first year of life and stable in size in proportion to the child’s growth. With a Wood’s lamp, the contrast between lesional and normal skin is less marked than in vitiligo.

Piebaldism is an autosomal dominant disease presenting at birth, with anterior midline depigmentation and a white forelock (poliosis). Many other types of leukoderma have been described. The diagnosis and treatment of leukodermas requiress an expert approach. The only way to know if a depigmented patch on the skin is vitiligo or not is to consult a Dermatologist with special interest in Pigmentary Disorders of the skin.

Author: Prof. Torello Lotti, MD

Please be advised that all information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician or health practitioner. Users are warned against changing any aspects of their treatment, diet or lifestyle based on this information without first consulting a registered medical practitioner. While every precaution is taken to ensure accuracy, VR Foundation makes no warranty as to the reliability, accuracy, timeliness, usefulness or completeness of the content which reflect personal opinion of the authors.

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