Pityriasis alba
Pityriasis alba (also known as Pityriasis alba Pityriasis simplex faciei or as designated ) is a common, non-contagious and usually harmless skin disease that occurs mainly in children. It is manifested by dry, finely scaly, bright spots that occur mainly on the face. The disease usually heals by itself and requires only the use of moisturizer.
The name of the disease is derived from the fine - scaly appearance ( from Ancient Greek πίτυρα / pityra: the bran ) and from the pallor of the spots from (from the Latin alba: white, although the stains not completely depigmented, but are hypopigmented ). Pityriasis alba is the minimum variant of atopic eczema.
Dissemination
Pityriasis alba occurs most often in children 3-16 years of age, while more common in boys than in girls. Perhaps it is more common in fair-skinned people, but it is more visible in patients with darker skin color.
The skin disease occurs almost every third American school child up to age 18 at least once, the period prevalence is thus about 30%. When determining the distribution at a given point in time ( point prevalence ), the values between 8.4 % were in North India and 31% in Mali. Other studies showed point prevalence rates of 13.49% in Egypt, 12 % in Turkey, which examined children showed a higher prevalence of poor socio -economic conditions, 9.9 % in Brazil, 5.1% in Romania, and only 1% in school children in Hong Kong.
Cause
The exact cause of pityriasis alba is unknown. A Healed atopic eczema sometimes leaves also pale skin. This sequence is also observed in the excessive use of corticosteroid cream to treat eczema. The occurring in pityriasis alba hypopigmentation (decreased pigment formation in the skin) is a consequence of reduced activity of melanocytes, which give fewer and smaller melanosomes.
Clinical manifestations
In winter, the dry scaly appearance of pityriasis alba occurs due to dry air at home most clearly. In summer, the pale coloration of Pityriasis alba patches through the tanning of the surrounding skin is particularly visible.
The individual spots ( lesions) develop in three stages, and sometimes generate this itching:
The spots are round or oval, with a diameter between 0.5 and 2 cm. Spots on the body (as opposed to spots on the face ) can be up to 4 inches tall. The number of spots on the entire body is usually 4 to 5, but may be more than 20. The spots are dry and finely scaly. They most often occur on the face (especially on the lateral cheeks ), but 20% of patients also have spots on the upper arms, neck or shoulders.
Treatment
Treatment is not necessary, since the spots heal by itself after some time. Since the Pityriasis alba patches are not subject to the normal skin tanning in the sunlight and remain light, an effective sunscreen the entire skin is the best way to minimize the aesthetically desired color difference between the spots and the surrounding skin. If necessary, the stains can be cosmetically covered.
Redness, flaking or itching occur, these can be treated with simple palliatives. Sometimes the weak steroid hydrocortisone (trade name, among others Fenistil Hydrocort ®) is employed. The use of tacrolimus ( Protopic ® trade name ) can accelerate the healing process, but should be carried out because of side effects and suspicion of carcinogenicity only as a reserve drug. The Patients should also be older than two years, treatment should only be short or at intervals with small amounts of active ingredient. In particularly severe cases PUVA therapy can be applied, which combines long -wave UV light with which are naturally occurring psoralen.
Cure views
The problems caused by pityriasis alba pigmentation can last between one month and ten years. Spots on the face usually stick to a year or more.
History and cultural aspects
Pityriasis alba was first described in 1860 by the French physician Camille Melchior Gibert as scaly skin disease. Although there is no clinically serious disease, pityriasis alba aesthetic aspects is important because usually the face is affected by this skin disease, and young children are the main group of patients. Pityriasis alba is studied since the 19th century, its etiology still applies as not fully understood.