White Patches on Cheeks - Neither 'Worms' Nor 'Calcium Deficiency'

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"Doctor, please do something for these white patches that appear on his cheeks I have started giving him oral calcium supplements but it didn't help. Do you think it is because of worms?" a mum was request me anxiously. She was worried about the light-colored circular patches that had appeared on the cheeks of her son. This is a very base complaint encountered in pediatric patients. Mostly parents join together it with either a scantness of calcium or due to worm infestation; while some go to the extent of considering it a pre-vitiligo stage. The worried mothers empirically start treating the child with some Otc drugs, without knowing what is it actually?

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What Is It:

Pityriasis alba, is a base skin disease, predominantly affecting children of 3-16 years of age [boys affected more than girls] and affects approximately 8-10% of children at least once in their lifetime. The word 'pityriasis' denotes the finely scaled appearance while the word 'alba' is Latin for white, the color of the patches. The patches are right on not permanent and the condition is known to be self-limiting, resolving on its own after a obvious period. There is no evidence that it progresses to vitiligo in future, since pathophysiologically, both are wholly distinct entities.

The Cause:

Pityriasis alba falls under idiopathic dematosis, which means the cause is yet unknown.

Clinical Presentation:

It is determined as a superficial dermatitis, that is usually seen in atopic [prone to allergy] children and presents with dry-scaled, light colored patches on the face - especially nearby the mouth. Due to its color it seems accentuated while the summer. It might itch while the early stage of appearance.

It is most likely to be mistaken with vitiligo or leucoderma, where there is a complete absence of the dark pigmentation. The pityriasis alba lesions do not usually have a well-defined borders [like in vitiligo] and they do not coalesce [as in tinea versicolor].

Treatment:

Ideally treatment is not necessary for pityriasis alba, but one should consult a doctor to rule out the other causes of hypopigmentation, which might need treatment. Anti-fungal ointments have shown revising in some patients.

Homeopathy can help these patients with its constitutional treatment advent as per the estimation of personel psycho-somatic disposition.

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