What Do White Patches Indicate After Recovering From Lichens?
(1) I want to know if I should use any special precautions since I have that white patch on my leg? If I am out in the sun for an extended period should I put on extra sunscreen on that portion of my leg?
(2) I was recently in the sun for an extended period & I put some sun screen on that leg. I just noticed a small red dot in the area that is now white - is that any cause for concern?
Kindly upload a few images
Hello. Thank you for writing to us.
I am Dr. Kakkar (Dermatologist). I have noted your concern
Perhaps you have a depigmentation secondary to inflammation (post inflammatory depigmentation that can sometimes happen in thick plaques of hypertrophic lichen planus) or it is due to use of potent topical steroids for an extended period of time. I request you to kindly upload a few images in "Reports Section" so that I am able to guide you better.
Thank you. I have received the image.
I can see a depigmented patch of 'Vitiligo' with perifollicular repigmenation and repigmentation from the edges of the patch.
If the patch is normally covered with clothing than there is no need to use a sunscreen.
Over the patch, I suggest you to use tacrolimus 0.1% ointment, twice a day. Rub it in. It is a prescription medication. Treatment is long term and I suggest regular follow up at intervals.
1. why do you recommend the use of tacrolimus 0.1%? what are your specific concerns?
2. for how long should I XXXXXXX this medications?
3. is there anything else I should watch for ?
Tacrolimus 0.1% ointment is a non-steroidal topical immunomodulatory drug that is used for inducing repigmentation in depigmented patches of vitiligo. Response is visible as early as 1-2 months but may take 3-4 month for compete repigmentation.. It has no side effects as such except a mild smarting sensation.
Vitiligo may progress and present as additional white spots elsewhere on the body or it may remain stable and be non progressive.
Dr do you also believe there is an increased risk of skin cancer in that part of my leg due to this condition? If so what can I do to prevent such an outcome?
Thank you for your assistance.
Vitiligo can start at the site of trauma (koebnerization) - vigorously scratching due to an underlying eczema like lichen planus can induce vitiligo at the site of scratching.
There is no increased risk of skin cancer unless it is chronically sun exposed and untreated. Leg is usually covered with clothing for most part of the day so you need not worry about skin cancer.