When you find your child’s skin white spots, many parents are very anxious to know if they are suffering from vitiligo, to identify with those diseases? If it is diagnosed as vitiligo, what treatment should be used? The following I will talk to you about the characteristics of vitiligo and the clinical characteristics of the diseases that need to be differentially diagnosed with children’s vitiligo: white fur, anemic nevus, anemic nevus, lichen planus, Ito hypomelanosis, and finally about the treatment methods of children’s vitiligo.
1, the clinical characteristics of vitiligo: vitiligo is most commonly manifested as pigment-free patches or patches, the color is usually uniform milk white, surrounded by normal skin. The white patches are mostly round, oval or line shaped. They may later enlarge or fuse with each other into large irregular shapes, but the edges of the white patches are always clearly visible. In patients with lighter skin tones, the white spots are not very visible, but can be clearly identified under Wood’s lamp. The most frequent occurrence of vitiligo is in the exposed parts of the body, especially the face, neck, waist and abdomen, forearm and finger back.
2, white furfurace: also known as simple furfurace, is one of the most common diseases of children. Mostly seen in the face of children and adolescents from 3 to 16 years old, a small number can occur in the trunk extremities. Is light white, the surface has fine scales. It often occurs more often.
3.Anti-pigmented nevus: Anti-pigmented nevus often appears at birth or shortly after birth, and can be flaky, segmental or swirling in distribution. They appear as hypopigmented spots, which are not as white as vitiligo and do not have deepened pigmentation around them, with vague and irregular borders, often jagged. It continues unchanged throughout life and will not turn further white.
4.Anemic nevus: This is a kind of congenital hypopigmentation spot, only the pigmentation becomes lighter, will not be as white as white paper, most of them are born, but can also occur later. It is round or irregular in shape, with clear boundaries, and can occur in any part of the skin. It usually does not change after appearing and does not become further larger or whiter. When the affected area is rubbed with force, the surrounding skin becomes red, but the white spots are not red, and the white spots look more obvious. If the surrounding skin is pressed with a slide to make it ischemic, the boundary between the lesion and the surrounding skin disappears, and the white spot becomes inconspicuous. And vitiligo is congested by rubbing the diseased area with force. Wood lamp examination: anemic nevus disappears.
5, lichen planus: also known as “lichen bruise”, caused by Malassezia. It is generally manifested as a light brown or grayish-white spot on the skin with very thin scales on the surface, which is not itchy or painful. Preferably in the sebum-rich parts, especially the chest and back, face and neck, often multiple, symmetrical distribution. When manifested as grayish white spots, be careful not to mistake it for vitiligo. Especially in infant cases, occurring on the face, due to frequent scrubbing scales less easily confused as early vitiligo. You can do fungal examination to confirm the diagnosis. wood lamp examination: a yellowish or light brown fluorescence.
6, non-pigmented pigment incontinence: the disease and Ito hypomelanosis. More than half of the cases develop at birth or in infancy. The etiology may belong to autosomal dominant inheritance. The most occurring in the trunk or extremities, visible linear or band-like pigment loss spots, clear boundaries, strange shape, similar to the pigment incontinence ink-like spots, can be accompanied by other developmental abnormalities, such as strabismus, dental abnormalities, mental retardation, epilepsy, etc.
7, children’s vitiligo treatment: mainly according to the distribution and age of the white class and use different treatment programs. For limited white class, if the child is less than 2 years old, generally can be treated with topical medium-acting corticosteroids, using intermittent therapy, that is, with 4 weeks, stop 2 weeks, no response within 2 months may be ineffective, need to switch to other treatments. For children older than 2 years, topical medium- or strong-acting hormones may be used. Topical topical vitamin D3 derivatives may enhance the efficacy of hormones. Topical calcineurin inhibitors tacrolimus ointment and pimecrolimus ointment are more effective in children with vitiligo. 308nm excimer laser can be used in children younger than 2 years of age.
For generalized vitiligo, if the age is greater than 9 years old and the lesion area is greater than 20% of the body surface area, narrow spectrum medium wave ultraviolet light treatment can be used. Rapidly progressive vitiligo in children can be treated with low-dose oral hormone therapy, with oral prednisone 5 to 10 mg per day for 2 to 3 weeks recommended. The treatment can be repeated for 1 more course after 4 to 6 weeks if necessary.