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What Causes Dry Skin With Light Colored Patches On Face Neck And Tummy?

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Posted on Mon, 5 May 2014
Question: Hi. My son is 7 months old now. He had dry skin early on and has developed light colored patches on face neck and tummy. But the one on neck has become very light all of a sudden. The other patches which appeared before remain the same. Just worried what this could be?
doctor
Answered by Dr. Dr. Kakkar (2 hours later)
Brief Answer: Nevus anemicus/Nevus depigmentosus Detailed Answer: Hello and welcome to healthcaremagic. I am Dr. Kakkar. I have gone through your query and I have understood it. Patients with dry skin can develop ill-defined hypopigmented patches on face, trunk and extremities etc known as Pityriasis XXXXXXX They can be somewhat scaly as well. The patch on abdomen seems to be Pityriasis XXXXXXX Regarding the patch on the neck, it is different. It is well defined with serrated/irregular margins. There are 2 possibilities: Nevus anemicus OR nevus depigmentosus. -Nevus anemicus is present at birth or appears shortly thereafter. It continues to grow with the child, and it remains asymptomatic. This lesion is not a true nevus (The melanocytes in nevus achromicus are normal and have normally pigmented melanosomes but these are unable to transfer their melanosomes to the keratinocytes); rather it is a congenital vascular anomaly with localized hypersensitivity to catecholamines. The vasoconstriction caused by this hypersensitivity results in skin pallor. When pressure is applied to the surrounding skin (diascopy),the border between the nevus and surrounding skin is lost due to blanching of surrounding skin. It has a benign nature. The size may increase proportionate with the size of the body -Nevus depigmentosus, also known as nevus achromicus, is a well-demarcated patch of hypopigmentation that tends to occur on the trunk or proximal extremities in a dermatomal pattern. It is a true nevus and pressure to the surrounding skin will not result in the loss of the border between the hypopigmented patch and surrounding skin. It also has a benign nature. The size may increase proportionate with the size of the body. Another differentiating point between the two is that, friction (produced by scratching), nor cold or heat application, induces erythema in the area of hypopigmentation due to nevus anemicus, but it does produce erythema in case of nevus depigmentosus. Treatment is not required nor if effective in either case regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (13 hours later)
Thank you for the reply doc. I am just wondering if i need to visit a dermatologist in person to rule out any other conditions? This patch on neck started around 4 months and got lighter at 7 months all of a sudden. I am not sure if its the saliva or milk flowing to this area that caused it ? The other patches on tummy and face started around 2 months and remain unchanged. What precautions should i be taking. Is sun exposure bad ? Many thanks
doctor
Answered by Dr. Dr. Kakkar (1 hour later)
Brief Answer: Nevus anemicus/nevus depigmentosus with P. XXXXXXX Detailed Answer: Hi. Sure you can get it checked in person with a dermatologist. I think the patch on neck is most likely a case of either nevus anemicus or nevus depigmentosus, which require no active intervention and can be just left as it is. Your dermatologist would confirm it. The patches on the abdomen (Pityriasis alba) are different and are due to underlying dry skin. I would recommend using a good moisturizer for him,twice daily application. You could use a mild topical steroid e.g hydrocortisone twice daily for the abdominal and facial patches, over and above the moisturizer, but for the nevus on neck nothing needs to be done. Saliva or milk is not the reason. The patch on neck is genetic. Sunexposure might make these patches stand out more clearly, due to tanning of the surrounding skin, thereby increasing the contrast but as such it has no direct role in the causation. regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (31 hours later)
Thanks again! Sounds like a big relief to me :)..just a last question. He gets rashes on this patch and they turned to normal skin color after healing. What does this mean
doctor
Answered by Dr. Dr. Kakkar (42 minutes later)
Brief Answer: Dermatitis/Atopy Detailed Answer: Hi. Must have been a mild form of dermatitis. Hereditary seems to play a significant role in those who have inherent dry skin. In allergy prone individuals, a condition or state of 'atopy' exists & these atopic individuals more often than not manifest with dry skin and rashes and can sometimes form dry patches spontaneously, specially in dry and cold weather. For the rashes, you can use a moisturizer along with a mild topical steroid e.g hydrocortisone regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (40 minutes later)
Since you said it might be nevus ie a birth mark i just realised that the small pimples on the neck patch turned into normal color and wondered if that could be possible. But Yes. I do have very dry skin and we live in europe and he was born in winter and mostly stayed inside the house with heaters and dry air inside. Thanks for all the help :)
doctor
Answered by Dr. Dr. Kakkar (10 minutes later)
Brief Answer: Nevus Detailed Answer: Hi. Yes, it does look like a nevus (nevus anemicus OR nevus depigmentosus). Though, you should visit a dermatologist for a confirmatory diagnosis. A dermatologist would be able to confirm it 100% on physical examination. Rashes turning into normal skin color could be explained as Post-inflammatory hyperpigmentation. Thanks for asking on healthcaremagic regards take care
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

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What Causes Dry Skin With Light Colored Patches On Face Neck And Tummy?

Brief Answer: Nevus anemicus/Nevus depigmentosus Detailed Answer: Hello and welcome to healthcaremagic. I am Dr. Kakkar. I have gone through your query and I have understood it. Patients with dry skin can develop ill-defined hypopigmented patches on face, trunk and extremities etc known as Pityriasis XXXXXXX They can be somewhat scaly as well. The patch on abdomen seems to be Pityriasis XXXXXXX Regarding the patch on the neck, it is different. It is well defined with serrated/irregular margins. There are 2 possibilities: Nevus anemicus OR nevus depigmentosus. -Nevus anemicus is present at birth or appears shortly thereafter. It continues to grow with the child, and it remains asymptomatic. This lesion is not a true nevus (The melanocytes in nevus achromicus are normal and have normally pigmented melanosomes but these are unable to transfer their melanosomes to the keratinocytes); rather it is a congenital vascular anomaly with localized hypersensitivity to catecholamines. The vasoconstriction caused by this hypersensitivity results in skin pallor. When pressure is applied to the surrounding skin (diascopy),the border between the nevus and surrounding skin is lost due to blanching of surrounding skin. It has a benign nature. The size may increase proportionate with the size of the body -Nevus depigmentosus, also known as nevus achromicus, is a well-demarcated patch of hypopigmentation that tends to occur on the trunk or proximal extremities in a dermatomal pattern. It is a true nevus and pressure to the surrounding skin will not result in the loss of the border between the hypopigmented patch and surrounding skin. It also has a benign nature. The size may increase proportionate with the size of the body. Another differentiating point between the two is that, friction (produced by scratching), nor cold or heat application, induces erythema in the area of hypopigmentation due to nevus anemicus, but it does produce erythema in case of nevus depigmentosus. Treatment is not required nor if effective in either case regards