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Child had typhoid. Now having white spot on upper eyelid. How to overcome this problem?

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My six year old daughter has white spot on the upper surface of eye lids. First it was appeared seven month ago on right eye as said and now spread around its corner. It also appeared on right eye lid surface before two months.
She was suffered from typhoid last year in June2012 with repeation in August2012.
Kindly advise.
Posted Mon, 6 May 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 2 hours later

Thanks for sending your query to us.

I have gone through the images attached. The milky white lesions over your daughter's eye lids probably looks like vitiligo.

Vitiligo lesions in children and that too over face has good prognosis. To treat such limited lesion we usually give a combination of either of these drugs
- Steroid cream( mild potency as lesion is over eyelid)
- Tacrolimus or pimecrolimus
- Placentrex gel
- Basic fibroblast growth factor like melgain

Usually the response is good and lesions may resolve in two to three months time.

Another diagnosis could be post inflammatory hypopigmentation. It occurs if there was any preceding skin lesion at the site of hypopigmentation.

I would suggest that you consult a dermatologist nearby to get the diagnosis confirmed and start with appropriate treatment.

Hope that helped. Let me know if you need clarifications.
Take care
Above answer was peer-reviewed by
Follow-up: Child had typhoid. Now having white spot on upper eyelid. How to overcome this problem? 18 hours later
A dermatologist in XXXXXXX ,Delhi has checked my daughter three month ago and
advised to apply a mild gel for one month. She was in opinion for pre-Vitiligo.
However,another doctor cheked and told that as there is no definite boundries
of spots and mixed irregularly with skin,it may be common phtrisis XXXXXXX
We are not genetic with vitiligo from both husband and wife sides ,as vitiligo is
associated with genetic problem. The spot are shined in light and appeared a little pinkished in room.
I want to know the a clear difference between Vitiligo and Phtyris XXXXXXX so that
both can be differenciated.
Suggest a good dermatologist in East/Central/South Delhi.
Answered by Dr. Kalpana Pathak 23 hours later
Vitiligo is not always of genetic occurence. In thirty percent patients of vitiligo we usually get a family history.

Vitiligo is completely depigmented lesion when lesions are not completely depigmented we label it as pre vitiligo. So I do agree with the consultant in XXXXXXX
The mild gel that was prescribed could have been a steroid( desonide / hydrocortisone or fluticasone) or another immunomodulator( tacrolimus or pimecrolimus).

Pityriasis XXXXXXX is slightly dry,scaly, eczematous, hypopigmented lesion seen in children usually over the cheeks. Personally my clinical acumen does not allow me to think of your child's lesion as P XXXXXXX

I would advise that you keep your child under the XXXXXXX consultant's follow up. Vitiligo takes time to respond, all you need is good compliance and perseverance.

To look for good doctors in your locality you may use the link mentioned below

Hope that helped.
Take care
Above answer was peer-reviewed by
Follow-up: Child had typhoid. Now having white spot on upper eyelid. How to overcome this problem? 5 hours later
Previously,the cream prescribed was ViTix,containing Propylene Glycol etc.But no effect is seen. As adviced, I consulted the same doctor in XXXXXXX today. She now predicted the spot as Vitiligo and prescribed the following--
1) To apply MELGAIN lotion,containg Deca-Peptide in morning and before bed with exposure to sun light in morning.
2) To apply desonide cream in the after noon.
3) to take tablet-DICARIS,containing Lavanisole Hydrocloride 50 mg on two continous day in a week.
4) Zincovit and Ferrum syrup twice in a day
5) To avoid the Katta food and non-veg.
- The above treatment is for one month at present.
Kindly comments for the direction of treatment.
Can the strong possibility exits for complete cure,as she is in child state?
Is there any factor for this spot due to face of typoid fever?
With regards.
Answered by Dr. Kalpana Pathak 1 hour later
I really appreciate that you consulted your dermatologist!

Vitix is basically a plant extract based product for repigmentation. As the lesions were of pre vitiligo your doctor prescribed a mild product.

The treatment prescribed is good and I hope it would induce repigmentation.
Melgain and desonide( a steroid) helps in repigmentation.
Dicaris or levamisole is an immunomodulator, prescribed in vitiligo as vitiligo has an autoimmune basis too( diseases where our body's own immune cells destroy or act against our body). Zincovit contains zinc which too has immunomodulatory action. Ferrum has been prescribed as sometimes anemia too can induce vitiligo

As far as dietary factors are concerned there is no conclusive study which implicates sour food or non veg food for vitiligo. So do not devoid your child of fruits or non veg food particularly in case if she eats these fondly.

Usually vitiligo in children and that too over face responds well. Initially response begins as small areas of repigmentation that would be seen as dark brown dots over depigmented area. Later on these dots increase in size number and coalesce to cover the whole area.
Typhoid has no correlation with the same.

I would advise that you follow your doctor's advise and continue treatment. Sometimes treatment needs to be continued for an year to get satisfactory results. Desonide is a steroid, so should always be used under doctor's follow up. So keep a contact with the treating doctor.

Wishing Ishna a speedy recovery.
Take care.
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