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Leucoderma: White spots on the skin

What is leucoderma?

Leucoderma implies white skin. It is a condition of the skin characterised by the presence of white spots and patches on the skin. White patches result from total or partial skin pigmentation loss (hypomelanosis or hypopigmentation). Leucoderma is not a contagious or dangerous skin disease. These patches may be prominent in individuals with a darker complexion and may lead to embarrassment or depression if they are on the hands or the face.

Vitiligo Vs. Leucoderma

Vitiligo is widely used incorrectly as a substitute for the term leucoderma. However, vitiligo is a specific form of leucoderma and is primarily attributed to autoimmune-mediated white skin patches. Leucoderma is a much broader category which refers to white patches originating due to any cause.

Approximately, 2-3% of the Indian population is believed to suffer from leucoderma. The rates are higher in Andhra Pradesh, Kerala and West Bengal.

Causes

The exact causes of leucoderma are not known. However, some of the perceived causes include:

  • Emotional stress
  • Sunburns
  • Idiopathic guttate hypomelanosis (It is the presence of small light white to slightly brown patches on forearms and shins in females over the age of 40)
  • Tinea versicolor infection
  • Pityriasis alba
  • Post leprotic changes
  • Changes in the immune system
  • Injury
  • Genetic factors
  • Exposure to certain chemicals

Diseases like diabetes, hyperthyroidism, and pernicious anaemia can aggravate the condition.

Symptoms

Leucoderma usually begins with some parts of the skin losing their colour with the formation of white patches on those regions. These patches are due to melanin loss, the pigment which is responsible for the skin colouration. Over time, these white patches may merge into one another and form broader patches, and in some instances, cover most of the body.

Diagnosis

By examining the skin, your doctor can diagnose leucoderma. Personal history may be considered. Examination of the skin under UV light (Wood’s light) that makes the white spots glow in the dark may confirm the diagnosis.

Sometimes blood tests and skin biopsy may be done to rule out other causes and detect autoimmune conditions.

Treatment

Treatment options for leucoderma includes both topical and oral medication:

  • Sun protection: The physician may recommend suitable sun protection and sunscreens to protect the skin against sunburns and skin damage.
  • Camouflage creams: The aim here is to cover up the white spots using tanning lotions or camouflage.
  • Medication: Topical antifungals may be used to treat infection due to Tinea versicolor. Depending on the cause, the corticosteroid and/or immunosuppressant creams may be prescribed.
  • Phototherapy: Light therapy as they are commonly known, can be used in conjunction with medication or alone. It can include the use of UV-B therapy.
  • Surgical approach: Normal skin grafts may be used to cover up a white patch.
  • Depigmentation: It aims to remove the remaining pigmentation on the skin where the skin is bleached so that the rest of the skin and the leucoderma patches all appear similar in colour.

Prevention

There are no known ways to prevent leucoderma. Taking measures to protect the skin from sunburns can be helpful in preventing skin damage.

Complications

  • People with less melanin are prone to sunburns.
  • Leucoderma in individuals can lead to low self-esteem, social withdrawal, depression and other psychological issues.

Red Flags

Seek immediate medical attention on noticing sudden discolouration or increase in the size of your skin patches.

Consult a top Dermatologist

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References

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  • Kaur S, Singh HP, and Dhir K. A Review on Leucoderma. October – December 2013 RJPBCS Volume 4 Issue 4 Page No. 700-707.
  • Leukoderma. DermNet NZ. http://www.dermnetnz.org/colour/leukoderma.html. Accessed 17 May 2016.
  • Leucoderma – White Spots and Patches on Skin. Disable World. http://www.disabled-world.com/artman/publish/leucoderma.shtml. Accessed 17 May 2016.

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