The vitiligo is more common, although not harmful to health, but because of the impact on the aesthetic and cause distress to patients, many people see white spots, the first thought of vitiligo, in fact, the performance of white spots of a wide variety of skin diseases, because it is easy to confuse, in the clinic and online consultation of patients, especially the common performance of white spots of skin diseases summarized into a text, I hope it will help you!
A. Vitiligo
The performance of pigment loss spots, typical color like white paper white, surrounding pigment slightly darker than normal skin, but early white spots can be depigmented incomplete.
Segmental vitiligo: unilateral band distribution along the right side of the face.
Vitiligo: most of the skin turns white and only a small amount of normal skin remains (deepened pigmentation).
Vitiligo: causes hair whitening, whitening of hair on the white spots is one of the features of vitiligo that can help to confirm the diagnosis.
Vitiligo: in the recovery phase, pigmented islands are visible in the white patches.
Trichromatic vitiligo: there is a brown band of uniform color between the white spots and normal skin. There are also tetrachromatic and pentachromatic vitiligo.
Halo nevus: vitiligo that occurs around a mole, more halo nevus over 40 years old, to exclude the possibility of melanoma in other parts
Vitiligo is divided into: two types, two categories and two phases. Two types: common type and segmental type, the latter with banding along one side Two types: complete leukoplakia and incomplete leukoplakia, the latter being easily misdiagnosed but at an early stage and better treated. Two stages: progressive stage and stable stage, with different treatment methods and different treatment responses in different periods.
Second, anemic nevus
It has nothing to do with anemia, but only local abnormal blood vessel function. It is a hypopigmented spot, only the pigment becomes lighter and will not be as white as white paper. Most of them are present at birth, but they can also occur later in life, and generally do not change after appearing and will not further become larger or whiter. When rubbing the white spot and the surrounding area, the surrounding skin becomes red, the white spot is not red, and the white spot looks more obvious. If pressed with a slide, the white spot becomes inconspicuous. wood lamp examination: anemic nevus disappears.
Anemic nevus: when rubbing the white spot and the surrounding area, the surrounding skin becomes red, the white spot does not, and the white spot looks more obvious.
Anemic nevus: If the skin is pressed, the white spot becomes inconspicuous.
C. Anaplastic nevus
Anaplastic nevus often appears at birth or soon after birth, it can be patchy, segmental (distribution similar to segmental vitiligo) or swirling distribution, manifesting as hypopigmented spots, not as white as vitiligo, and no deepening of pigment around, with vague and irregular borders, often serrated. It continues unchanged throughout life and does not turn further white.
Non-pigmented nevus: the border is fuzzy and irregular.
Non-pigmented nevus: segmental distribution, as hypopigmentation, irregular formation, and unclear boundary.
Non-pigmented nevus: swirling distribution.
D. Pemphigus foliaceus
Also known as “pityriasis pilaris”, caused by Malassezia furfur. It is generally manifested as light brown spots or gray-white spots on the skin, with very thin scales on the surface, without itching or pain. Preferably in the sebum-rich parts, especially the chest and back, face and neck, often multiple, symmetrical distribution. When it appears as grayish-white spots, be careful not to mistake it for “vitiligo”. The actual fact is that you can get a lot more than just a few of these.
The most important thing is that it is not only a good idea to have a good look.
Bier spots
It is also known as Marshall-White syndrome, caused by abnormal vascular function, which occurs in the extremities, and is a multifaceted pale white spot with a diameter of 1 to 2 cm, surrounded by normal or pink skin, which is obvious when the limb is drooping and becomes lighter or disappears after elevation.
Bier spot: for the diameter 1 ~ 2cm large multiple light white spot, limb droop when obvious, after elevation becomes light or disappears.
Six, white furfuraceous rash
Also known as simple furfuraceous rash, commonly known as “peach fungus”, “worm spot”, but has nothing to do with parasitic infection such as roundworm. Commonly in children and adolescents from 3 to 16 years old, can be self-healing. It is red or pink in the early stage, but later it becomes light white with fine scales on the surface. It is often multiple, but can also occur singly. Mostly seen in the face, a small amount can occur in the trunk extremities. The etiology is unclear, some think with Malassezia furfur related.
White furfuraceous rash: manifestation is light white, surface has fine scales.
White furfuraceous rash: facial best hair, but sometimes can be sent to the trunk extremities.
VII. Idiopathic punctate leukoplakia and senile leukoplakia
These two diseases may be the same disease, both manifesting as pinhead to bean-sized milky white spots with no pigment deepening at the edges, and in senile leukoplakia, the white spots are slightly depressed. Despite manifesting as depigmented patches (same as vitiligo), once they appear, the size remains the same and the number increases with age.
Idiopathic punctate leukoplakia: manifests as pinhead to bean-sized milky white patches, often increasing with age, but not increasing in size.
Eight, post-inflammatory hypopigmentation (white spots)
It is often found in the damage sites of trauma (including burns or post-ulcer scar, etc.), lupus erythematosus, lichen planus, sclerosing atrophic moss, etc.
IX. Other.
In addition to the above common skin diseases manifesting as leukoplakia, there are many others, such as pemphigus, albinism, symmetrical progressive leukoplakia, pseudo-syphilitic leukoplakia and some syndromes with leukoplakia.
The majority of the above skin diseases that manifest as white spots, including vitiligo, the white spots do not affect health, only when it affects the aesthetics need to be treated, for those that can heal themselves, such as pityriasis albuginea, there is generally no need to treat.