What is Pityriasis Alba?
It is a common problem of the skin in which a mild form of eczema gives rise to scaly patches. It is usually seen in children, between the ages of 3 and 16, and young adults. In Greek, the term “pityriasis” refers to a skin covered by fine bran of grain called “pityron”. In simple words, flaking of the skin gives it a fine scaly appearance along with development of pallor patches. However, the word “Alba” is derived from a Latin word called “albus” meaning white.
Pityriasis Alba Incidence
The condition is more common in males than females. Lighter-skinned individuals are normally more susceptible to dry patches as well as other abnormal dermatological disorders than those with a dark, rather black skin.
Pityriasis Alba Stages
The inflammatory skin rashes may progress through the following 3 stages:
The lesions appear red and elevated, but may go unnoticed due to the formation of lighter spots on the skin.
In this stage, the papules are raised and pale red.
The final stage of the condition is marked by smooth, flat, dull patches on the skin.
Pityriasis Alba Symptoms
Affected patients usually develop hypopigmented, round-to-oval, scaly patches on the face, arms, neck, and shoulders. In certain cases, the condition may affect the legs and trunk. The size of the lesions may vary between 0.5 cm and 2 cm. The larger ones may grow up to 4 cm. There could be 4 to 20 lesions on a particular site of the body. During winter, the erythematous patches become dry, and are prone to further scaling and itching. The faint patches are, however, more pronounced following sun exposure during summer due to tanning of the surrounding normal skin. Patients are initially unaware of the condition on account of the minimal serous crusting of the lesions at the erythematous stage.
Pityriasis Alba Causes
Although the skin ailment is of unknown origin, some medical experts believe it to be a manifestation of some other conditions. These may include:
It is a severe form of allergic hypersensitivity that affects infants and young children. Low humidity, use of caustic soaps and detergents, and cold are the common triggers of this skin condition. Apart from redness, blistering, and swelling, the ailment is characterized by crusting and scaling.
Chronic inflammation of the bronchial tubes as a result of heightened sensitivity to some allergens may induce mild eczema, which in turn leads to red scaly patches on the skin.
Few potent stimulators of allergy like pollen grains, dust or factory chemicals can evoke inflammation of the nasal lining. Symptoms of the condition frequently include eye itching, redness, sneezing and scaly skin patches.
Application of creams, lotions, and cosmetics may cause serious skin irritation in the form of dry, scaly patches or rashes. This is more likely to occur in patients who are severely allergic to certain ingredients in the topical cosmetics or medications.
Pityriasis Alba Diagnosis
Age is a big factor for determining the underlying cause of dry, fine-scaled, pale patches on the skin. During physical diagnosis, doctors do a detailed study of the distribution pattern of the lesions. Atopic dermatitis-affected patients may show significant signs like cheilitis, hives and infra-auricular fissures. Skin biopsy is not necessary but could be conducted to know the nature of the lesions. However, the test may reveal low number of active melanocytes in the patchy areas. Potassium hydroxide examination is often carried out to exclude some fungal infections of the skin. Histopathological assessment of the lesions may show irregular or reduced pigment by melanin of the basal layer.
Pityriasis Alba Differential Diagnosis
The differential diagnosis is mandatory for distinguishing the condition from other ailments of the skin, such as:
- Cutaneous T-Cell Lymphoma
- Tinea Versicolor
- Pityriasis Rosea
How to treat Pityriasis Alba?
Medical treatment is generally not required since the condition has a benign outlook. The frequent episodes of erythema, scaling, and itching should receive hydrocortisone, desonide or mild emollients. A bland tar paste can be applied on the lower extremities for instant relief. Use of tacrolimus ointment and pimecrolimus cream helps in the remission of the lesions. PUVA therapy is effective for chronic cases. Natural remedies to cure the mild eczema include ayurvedic therapy. In fact, application of coconut oil may resolve the symptoms. Some patients prefer homeopathy to conventional treatment. Adequate protection from sun keeps abnormal darkening of skin at bay. As the cosmetic appearance of the skin worsens under sunlight, use of make-up creams or powders camouflages the scaly patches.
Pityriasis Alba Prognosis
The duration of the condition varies from 1 month to a year, after which the lesions completely disappear. Nonetheless, the affected areas may undergo hypopigmentation despite the resolution of the dry, crusty patches.
Pityriasis Alba Photos