eMedicine Specialties > Dermatology > Diseases of Pigmentation

Pityriasis Alba: Differential Diagnoses & Workup

Author: Bassam Zeina, MD, PhD, Consulting Staff, Department of Dermatology, Milton Keynes Hospital, UK
Coauthor(s): Nicole Sakka, MBBS, Senior House Officer, Department of Dermatology, Milton Keynes Hospital, NHS Foundation Trust, UK; Sohail Mansoor, MBBS, MSc, Dermatologist and Lead Physician in Dermatologic Surgery, Department of Dermatology, Barnet Hospital, UK
Contributor Information and Disclosures

Updated: Sep 2, 2009

Differential Diagnoses

Leprosy
Postinflammatory hypomelanosis
Postinflammatory hypomelanosis
Psoriasis, Plaque
Tinea versicolor
Vitiligo

Other Problems to Be Considered

Nevus depigmentosus
Postinflammatory hypomelanosis
Tinea versicolor
Discoid eczema
Hypopigmented mycosis fungoides12

Workup

Histologic Findings

Histologic changes are unimpressive. Acanthosis and mild spongiosis are observed, with moderate hyperkeratosis and patchy parakeratosis. Follicular plugging, spongiosis, and sebaceous gland atrophy may be observed.13 On electron microscopy, reduced numbers of active melanocytes and a decrease in number and size of melanosomes is observed in affected skin.14

More on Pityriasis Alba

Overview: Pityriasis Alba
Differential Diagnoses & Workup: Pityriasis Alba
Treatment & Medication: Pityriasis Alba
Follow-up: Pityriasis Alba
Multimedia: Pityriasis Alba
References
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References

  1. Sandhu K, Handa S, Kanwar AJ. Extensive pityriasis alba in a child with atopic dermatitis. Pediatr Dermatol. May-Jun 2004;21(3):275-6. [Medline].

  2. Watkins DB. Pityriasis alba: a form of atopic dermatitis. A preliminary report. Arch Dermatol. Jun 1961;83:915-9. [Medline].

  3. Gambichler T, Kramer HJ, Boms S, et al. Quantification of ultraviolet protective effects of pityriacitrin in humans. Arch Dermatol Res. Dec 2007;299(10):517-20. [Medline].

  4. Walker SL, Shah M, Hubbard VG, Pradhan HM, Ghimire M. Skin disease is common in rural Nepal: results of a point prevalence study. Br J Dermatol. Feb 2008;158(2):334-8. [Medline].

  5. Martin RF, Lugo-Somolinos A, Sanchez JL. Clinicopathologic study on pityriasis alba. Bol Asoc Med P R. Oct 1990;82(10):463-5. [Medline].

  6. Blessmann Weber M, Sponchiado de Avila LG, Albaneze R, Magalhaes de Oliveira OL, Sudhaus BD, Cestari TF. Pityriasis alba: a study of pathogenic factors. J Eur Acad Dermatol Venereol. Sep 2002;16(5):463-8. [Medline].

  7. Rigopoulos D, Gregoriou S, Charissi C, Kontochristopoulos G, Kalogeromitros D, Georgala S. Tacrolimus ointment 0.1% in pityriasis alba: an open-label, randomized, placebo-controlled study. Br J Dermatol. Jul 2006;155(1):152-5. [Medline].

  8. Di Lernia V, Ricci C. Progressive and extensive hypomelanosis and extensive pityriasis alba: same disease, different names?. J Eur Acad Dermatol Venereol. May 2005;19(3):370-2. [Medline].

  9. Guillet G, Helenon R, Gauthier Y, Surleve-Bazeille JE, Plantin P, Sassolas B. Progressive macular hypomelanosis of the trunk: primary acquired hypopigmentation. J Cutan Pathol. Oct 1988;15(5):286-9. [Medline].

  10. du Toit MJ, Jordaan HF. Pigmenting pityriasis alba. Pediatr Dermatol. Mar 1993;10(1):1-5. [Medline].

  11. Di Lernia V, Ricci C. Progressive and extensive hypomelanosis and extensive pityriasis alba: same disease, different names?. J Eur Acad Dermatol Venereol. May 2005;19(3):370-2. [Medline].

  12. Whitmore SE, Simmons-O'Brien E, Rotter FS. Hypopigmented mycosis fungoides. Arch Dermatol. Apr 1994;130(4):476-80. [Medline].

  13. Vargas-Ocampo F. Pityriasis alba: a histologic study. Int J Dermatol. Dec 1993;32(12):870-3. [Medline].

  14. Zaynoun ST, Aftimos BG, Tenekjian KK, Bahuth N, Kurban AK. Extensive pityriasis alba: a histological histochemical and ultrastructural study. Br J Dermatol. Jan 1983;108(1):83-90. [Medline].

  15. Harper J. Topical corticosteroids for skin disorders in infants and children. Drugs. 1988;36 Suppl 5:34-7. [Medline].

  16. Bassaly M, Miale A Jr, Prasad AS. Studies on pityriasis alba. A common facial skin lesion in Egyptian children. Arch Dermatol. Sep 1963;88:272-5. [Medline].

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  18. Fung WK, Lo KK. Prevalence of skin disease among school children and adolescents in a Student Health Service Center in Hong Kong. Pediatr Dermatol. Nov-Dec 2000;17(6):440-6. [Medline].

  19. Galan EB, Janniger CK. Pityriasis alba. Cutis. Jan 1998;61(1):11-3. [Medline].

  20. Hacker SM. Common disorders of pigmentation: when are more than cosmetic cover-ups required?. Postgrad Med. Jun 1996;99(6):177-86. [Medline].

  21. Lin RL, Janniger CK. Pityriasis alba. Cutis. Jul 2005;76(1):21-4. [Medline].

  22. Mevorah B, Frenk E, Wietlisbach V, Carrel CF. Minor clinical features of atopic dermatitis. Evaluation of their diagnostic significance. Dermatologica. 1988;177(6):360-4. [Medline].

  23. O'Farreli N. Pityriasis alba. Arch Dermatol. 1956;73:376-7.

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  25. Wolf R, Wolf D, Trau H. Pityriasis alba in a psoriatic location. Acta Derm Venereol. Sep 1992;72(5):360. [Medline].

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Further Reading

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Keywords

pityriasis alba, hypopigmentation, erythematous scaly patches, atopic dermatitis

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Contributor Information and Disclosures

Author

Bassam Zeina, MD, PhD, Consulting Staff, Department of Dermatology, Milton Keynes Hospital, UK
Bassam Zeina, MD, PhD is a member of the following medical societies: British Association of Dermatologists, British Medical Association, and Royal Society of Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Nicole Sakka, MBBS, Senior House Officer, Department of Dermatology, Milton Keynes Hospital, NHS Foundation Trust, UK
Disclosure: Nothing to disclose.

Sohail Mansoor, MBBS, MSc, Dermatologist and Lead Physician in Dermatologic Surgery, Department of Dermatology, Barnet Hospital, UK
Sohail Mansoor, MBBS, MSc is a member of the following medical societies: American Academy of Anti-Aging Medicine, American Academy of Dermatology, American Society for Dermatologic Surgery, Royal College of Physicians and Surgeons of Glasgow, and Royal College of Physicians of the United Kingdom
Disclosure: Nothing to disclose.

Medical Editor

Mark G Lebwohl, MD, Chairman, Department of Dermatology, Mount Sinai School of Medicine
Mark G Lebwohl, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Abbott Laboratories Honoraria Consulting; Actelion Honoraria Consulting; Amgen Honoraria Consulting; Astellas Honoraria Consulting; Centocor Honoraria Consulting; DermiPsor Honoraria Consulting; Galderma  Consulting; Genentech Honoraria Consulting; Helix BioMedix Honoraria Consulting; Medicis Honoraria Investigator

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Christen M Mowad, MD, Associate Professor, Department of Dermatology, Geisinger Medical Center
Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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