Dermatologic Manifestations of Pityriasis Alba 

  • Author: Bassam Zeina, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Dec 9, 2011
 

Background

Pityriasis alba is a nonspecific skin disorder of unknown etiology that causes erythematous scaly patches. These resolve and leave areas of hypopigmentation that slowly repigment to normal. Pityriasis alba commonly occurs in children and is considered a self-limited dermatosis.

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Pathophysiology

Pityriasis alba has been regarded as a manifestation of atopic dermatitis[1, 2] but is also known to occur in nonatopic individuals. Pityriacitrin, a substance produced by Malassezia yeasts, acts as a natural sunscreen, but much of the hypopigmentation results from a failure of melanin transfer from melanocytes to keratinocytes.[3]

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Epidemiology

Frequency

The frequency of pityriasis alba both in the United States and internationally is unknown.

International

A large study in a tropical region in schoolchildren showed that the prevalence of pityriasis alba was 9.9%. Another study in Nepal showed that the prevalence of pityriasis alba within a wide range of dermatoses was 5.2%.[4]

Mortality/Morbidity

Pityriasis alba is not associated with mortality. Pityriasis alba is usually a self-limited, asymptomatic disease.

Race

Pityriasis alba can affect persons of any race, but it may be more prominent and cosmetically more troublesome in dark-skinned patients.[5]

Sex

Both sexes are equally susceptible to pityriasis alba, but it is thought that males are affected more frequently.[6]

Age

Pityriasis alba occurs predominantly in children aged 3-16 years.[5] but can occur in adults.[7]

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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  Foundation Year 2, Royal Liverpool and Broadgreen University Hospital, Liverpool, 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.

Specialty Editor Board

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: Amgen/Pfizer Honoraria Consulting; Centocor/Janssen Honoraria Consulting; DermiPsor Honoraria Consulting; GlaxoSmithKline Honoraria Consulting; HelixBioMedix Honoraria Consulting; Novartis Honoraria Consulting; Ranbaxy Lectures; Can-Fite Biopharma Honoraria Consulting; DermaGenoma Honoraria Consulting; Biosynexus Honoraria Consulting

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.

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.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M 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, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Mohsin Ali, MBBS, FRCP, MRCP, to the development and writing of this article.

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. In SI, Yi SW, Kang HY, Lee ES, Sohn S, Kim YC. Clinical and histopathological characteristics of pityriasis alba. Clin Exp Dermatol. Jul 2009;34(5):591-7. [Medline].

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

  15. 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].

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

  17. Fujita WH, McCormick CL, Parneix-Spake A. An exploratory study to evaluate the efficacy of pimecrolimus cream 1% for the treatment of pityriasis alba. Int J Dermatol. Jul 2007;46(7):700-5. [Medline].

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

 
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