Facial Pityriasis Alba, Polymorphous Light Eruption, and Vitiligo in Children: A Dermoscopic Distinction

Abstract

Background: Hypopigmentary skin disorders are the most worrisome complaints from Indian and Indian subcontinent people. Pityriasis alba (PA), polymorphic light eruption (PLE), and vitiligo are clinically look-alike conditions commonly seen in children. Objectives: We attempted to characterize the dermoscopic features of PA and PLE and differentiate them from vitiligo in the facial region in skin of color. Methods: Dermoscopic evaluation was done using a handheld dermoscope at 10X magnification on facial lesions of a total of 60 patients with PA, PLE, and vitiligo. Dermoscopic features of all three conditions were compared and correlated with histological features. Results: Out of 60 patients, 30 (50%), 20 (33.33%), and 10 (16.66%) patients were diagnosed with PA, PLE, and vitiligo clinically and histologically, respectively. Dermoscopy of PA showed white structureless areas (100%), ill-defined margins (86%), faint brownish pigmentation (70%), and fine scales (70%) (P value = 0.001). Besides, 70% of PLE cases showed white structureless areas and ill-defined margins, and 10% showed faint brownish pigmentation (P value = 0.0001). Coarse scales and clustered dots were the most common findings (75%) in PLE lesions, followed by light brown background (60%), crusts (40%), and yellow clods (30%) (P value = 0.0001). Also, 40% and 35% of the PLE cases showed white and brown course scales, respectively (P value = 0.0001). Moreover, 13.33% of PA cases showed coarse white scales, and 3.33% showed a light brown background. All vitiligo cases showed a white glow appearance (100%), followed by perifollicular pigmentation, leukotrichia, and koebnerization shown by 40% of the cases (P value = 0.0001). Finally, 20% of the cases showed perilesional pigmentation and satellite lesions. Conclusions: PA lesions are dermoscopically characterized by ill-defined white areas with fine branny scales, whereas PLE shows coarse brown scales, ring scales, crusts, and yellow clods along with the above findings. Vitiligo lesions are devoid of scales with various pigment network abnormalities, perilesional and perifollicular pigmentation, and leukotrichia.

Usage of Dermoscopy as an Effective Diagnostic Tool in Pityriasis Alba: A Prospective Observational Study Among Children in a Suburban Hospital in South India

“…In addition, 30% demonstrated erythema within and surrounding the patches [ 9 ]. In a recent study by Ankad et al, white structureless areas were seen in all of their 30 (100%) patients with Pityriasis alba, with indistinct borders in 86% and fine scales in 70% [ 10 ]. They have also reported that 70% of their patients showed fine brown pigmentation while one patient (3.3%) demonstrated a satellite lesion.…”