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Suggest treatment for symptoms of nevus depigmentosus on leg

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Posted on Tue, 26 May 2015
Question: Hi
My daughter is 7 months old and looks healthy
She got hypo pigmentation on her knee at 3 months and now again she got two more spots on the same leg
I m really concerned what these are
I mean Nevus pigmentation or vitiligo or something v v serious like ash leaf macule
I m attaching pics please let me know what these look like to take second opinion
Also does ash leaf macula mean
Regards
doctor
Answered by Dr. Johny Chacko (16 hours later)
Brief Answer:
Could be Nevus depigmentosus

Detailed Answer:
Hello,

Welcome to healthcare magic forum.

I understand from your query that you are concerned about hypopigmented spots on your infant's leg.

I have seen the pictures that you have attached.

From your history and the pictures, I would consider the possibility the possibility of nevus depigmentosus.

They do not appear to be vitiligo lesions.

They do not look like "typical" Ash leaf macules. However, if you have a family history of seizures/ tuberous sclerosis, I would advise you to check with your doctor if she requires any early screening procedures. I do not mean to cause unnecessary anxiety to you. But since this is an online forum and I am unable to examine the child directly, I would not want to completely rule it out.

You could get your child examined under a wood's lamp which will be available at your dermatologist's clinic. This will help to delineate the lesions better.

Hope this helps you.

If you have any more queries, please let me know.

Regards,
Dr. Johny Chacko




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Johny Chacko (4 minutes later)
My family does not have history of seizure or tuberous sclerosis
Neither I see anything like that in my daughter
But these spots is the only thing
Can these spots be identified with woods lamp?
Do they look like ash leaf or ND spots ?
doctor
Answered by Dr. Johny Chacko (14 minutes later)
Brief Answer:
Looks more like nevus depigmentosus

Detailed Answer:
Hello,

The spots look more like nevus depigmentosus.

Wood's lamp helps to delineate the lesions more clearly and also to spot any hidden lesions which are not very visible at the moment.

Ash leaf macules can occur even without any other associations like tuberous sclerosis. It is completely normal in many individuals. If you do not have a family history of tuberous sclerosis, there is nothing to worry about.

Hope this helps you.

Take care.

Regards,
dr. Johny Chacko
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Johny Chacko (2 hours later)
Can woods lamp differentiate nd and vitiligo ?
Also if there is no family history of tuberose then there is no concern of tuberose ?
doctor
Answered by Dr. Johny Chacko (9 hours later)
Brief Answer:
Wood's lamp can help in differentiating the lesions

Detailed Answer:
Hello,

Wood's lamp can help in differentiating nevus depigmentosus and vitiligo. The vitiligo lesions become more prominent ( Chalky white colour) when seen under wood's lamp.

If there is no family history of Tuberous sclerosis, the possibility of tuberous sclerosis is very rare.

Hope these have cleared your queries.

Regards,
Dr. Johny Chacko
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Johny Chacko (3 hours later)
My doctor told me also after seeing from woods lamp that it looks like ND as spots were not very white
But he told me baby cannot get 3 spots of ND in 7 months is it true ?
I feel may be I did not spot other two before as they may be small and as the baby gained height n weight I couldn't see them
Also they appeared in same right lower leg
He told me to put melgain? Is it safe n what will it do ?

Secondly if in worst scenario it is indeed vitiligo
Then can it stop here or it will definitely spread I mean is there a possibility that vitiligo does not spread ?
Secondly will it respond to melgain treatment ?
All three spots came on the same leg and j m really worried about my daughters face ?
Is there any treatment for vitiligo ?
doctor
Answered by Dr. Johny Chacko (9 hours later)
Brief Answer:
Do not worry about vitiligo

Detailed Answer:
Hello,

I am glad you could visit a dermatologist who could examine your child and give you a clearer picture.

You have mentioned that the doctor examined under wood's lamp and told you that it does not appear as vitiligo. So i feel you do not have to worry about it.

The possibility of 3 lesions of nevus depigmentoses occuring is rare but is not impossible.

The other possibility is mild eczema called P. XXXXXXX This is very common on the face but can sometimes occur on other sites like trunk and limbs. It is common inchildren with slightly dry skin and with a family history of allergies ( like nasal allergies/ wheezing/ skin allergies, etc).

If it is nevus depigmentoses, there is no need of treatment at all. Melgain also is not required.

In my opinion, please use a good moisturizer like Cetaphil restoraderm lotion 2 times a day for about 2 months and see if it lightens or disappears. If not, for your satisfaction, you could get a skin biopsy done. If I were your treating dermatologist, I would approach in this manner keeping P. XXXXXXX and nevus in mind.

As far as your second query is concerned, it is difficult to predict the behaviour of vitiligo and it varies from individual to individual. There are lots of treatments available for vitiligo. However, at present, do not worry about it as the lesions do not appear as vitiligo.

Hope this reassures you.

Take care.

Regards,
Dr. Johny Chacko


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Johny Chacko

Dermatologist

Practicing since :2005

Answered : 1916 Questions

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Suggest treatment for symptoms of nevus depigmentosus on leg

Brief Answer: Could be Nevus depigmentosus Detailed Answer: Hello, Welcome to healthcare magic forum. I understand from your query that you are concerned about hypopigmented spots on your infant's leg. I have seen the pictures that you have attached. From your history and the pictures, I would consider the possibility the possibility of nevus depigmentosus. They do not appear to be vitiligo lesions. They do not look like "typical" Ash leaf macules. However, if you have a family history of seizures/ tuberous sclerosis, I would advise you to check with your doctor if she requires any early screening procedures. I do not mean to cause unnecessary anxiety to you. But since this is an online forum and I am unable to examine the child directly, I would not want to completely rule it out. You could get your child examined under a wood's lamp which will be available at your dermatologist's clinic. This will help to delineate the lesions better. Hope this helps you. If you have any more queries, please let me know. Regards, Dr. Johny Chacko