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What Causes Whitish Discoloration Of Skin On Legs?

Posted on Wed, 31 Dec 2014

Question: Hello doctor

My 2 months old baby just got a white colour patch on her leg since two days

She did not ve this at birth nor it's a birth mark

I m attaching the picture of the mark
i hope it is not vitiligo ?
or some serious problem like hypropigmentation along blaschko lines?

What could be this be?

Answered by Dr. Dr. Kakkar (35 minutes later)

Brief Answer:
Kindly upload a photo

Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic

I have gone through your query. Unfortunately I could not find the photograph.
Kindly click a digital photograph and mail me at YYYY@YYYY with the subject line as "Attn Dr. Kakkar".
Make sure that you click a good quality photo which clearly shows the area of concern.
Possibilities of a hypopigmented spot arising either at birth or in the immediate neonatal period are Nevus depigmentosus, Nevus anemicus, Ash Leaf Macule, Vitiligo etc.

Regards

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

Follow up: Dr. Dr. Kakkar (2 minutes later)

I ve uploaded the picture

Also when I feel her skin it does not feel like any swelling or scaling
It looks just like skin with different light colour
Can it be vitiligo ?

Answered by Dr. Dr. Kakkar (28 minutes later)

Brief Answer:
Visit a dermatologist for confirmatory tests

Detailed Answer:
Hi.

Thanks for the Image.
This could either be Nevus Anemicus Or Nevus Depigmentosus apart from Vitiligo.
A physical examination would be required to confirm either of these possibilities.
A Nevus anemicus blends with the surrounding skin on pressing the lesion and adjacent unaffected skin with a glass slide (diascopy)
Nevus depigmentosus may resemble Nevus anemicus but it can be distinguished from it with diascopy.
Vitiligo can be distinguished from the other two by Wood's Lamp examination. Woods light accentuates Vitiligo, which appears completely White whereas Nevus depigmentosus is not accentuated Or appears Off-White on wood's lamp examination.
I would suggest that you visit a dermatologist in your region for a confirmatory diagnosis.

Regards

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

Follow up: Dr. Dr. Kakkar (22 minutes later)

Can it be any fungal infection as the baby has done acne on her cheek also which is getting better ?

She has this mark on her right knee and if appeared just two dats back ?
It's only at one place

I hope it won't spread or if can ?

Answered by Dr. Dr. Kakkar (10 minutes later)

Brief Answer:
Visit a dermatologist in your region for confirmatory diagnosis

Detailed Answer:
Hi.

This does not look like a fungal infection.
Don't worry. It is likely either Nevus Depigmentosus Or Nevus Anemicus; these usually remain localized.

Regards

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

Follow up: Dr. Dr. Kakkar (2 minutes later)

Thanks doctor

Actually I m worried about vitiligo only

What is the difference between vitiligo and nevus de pigmentation ?
I mean can u confirm me by just looking if it's not vitiligo
And does vitiligo spread on whole body ?

Answered by Dr. Dr. Kakkar (10 minutes later)

Brief Answer:
This lesion resembles Nevus Depigmentosus

Detailed Answer:
Hi

Nevus depigmentosus is usually solitary and is non progressive. Same is with Nevus Anemicus.
Vitiligo on the other hand can spread. It has convex margins.
In my view this is most likely a nevus depigmentosus (ND). ND lesions classically are off-white in colour and have irregular, serrated, feathered, or geographic margins. The lesion which your daughter has conforms to these features.
However, Wood's lamp examination would be confirmatory.

Regards

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

Follow up: Dr. Dr. Kakkar (8 minutes later)

Thanks sir

What s convex margin ?

Secondly what is the cause of this problem and is there any treatment ?

Answered by Dr. Dr. Kakkar (11 minutes later)

Brief Answer:
Nevus depigmentosus

Detailed Answer:
Hi.

Convex margin is that which has a curve to the outside, as if it is spreading Or flowing into the surrounding skin. It is usually seen in vitiligo.
Nevus depigmentosus on the other hand has serrated, feathered, geographic or irregular margins.
Nevus Depigmentosus is a developmental defect of melanosomal migration from melanocytes to keratinocytes; Melanocytes are normal in number in Nevus Depigmentosus unlike in vitiligo in which melanocytes are absent.
Treatment is generally not required and neither is successful and most patients need just reassurance that it is not vitiligo.

Regards

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

Follow up: Dr. Dr. Kakkar (2 minutes later)

I understand doctor

I guess even I just want reassurance that it is not vitiligo and I hope from the picture it looks like nevus

Answered by Dr. Dr. Kakkar (1 minute later)

Brief Answer:
Nevus depigmentosus

Detailed Answer:
Yes, likely it is a nevus.

Regards

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

Follow up: Dr. Dr. Kakkar (6 minutes later)

thanks doctor
one last question

my wife went to a pediatrician today and he suspected pityriasis versicolor

i hope u rule out it is not the above mentioned ?

Answered by Dr. Dr. Kakkar (4 minutes later)

Brief Answer:
Visit a dermatologist

Detailed Answer:
Hi.

Absolutely not Pityriasis Versicolor. Visit a dermatologist for skin problem.

Regards

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

Follow up: Dr. Dr. Kakkar (3 minutes later)

thanks doctor

i hope this nevus depigmentosus wont cause any other problem in my daughter, i mean i hope its not a birth defect or symptom of other birth problems
otherwise my child looks fine?
and also i would like to know if there is any cosmetic treatment for this problem as well as for vitiligo?

Answered by Dr. Dr. Kakkar (6 minutes later)

Brief Answer:
No active intervention is required for ND

Detailed Answer:
Hi.

Nevus Depigmentosus is just a type of birth mark and it can be left as it is.
It may blend with surrounding skin and become less distinct with age.
Treatment modalities that have been tried are Narrow band-UV B phototherapy and suction blister grafting. These can be tried if desired once she is old enough to understand.

Regards

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

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