Whitish And Depigmented Patches on Skin: How Can I Know What They Are?

Whitish and depigmented patches on skin:  how can I know what they are? 

Key points

• Not all whitish patches on the skin are vitiligo. 

• Depigmented patches on the skin other than vitiligo are named leukodermas, they can be  “occupational”. 

• Occupational and drug-related forms of depigmentation can be manifested as vitiligo. 

• Common disorders with similar manifestation include Nevus Depigmentosus, Piebaldism, etc. 

Answer 

No, not all white patches are vitiligo, but  white patches resembling vitiligo are not  unusual on human skin. They are called  leukodermas. Chemical leukoderma can be  induced by dyes, perfumes, detergents,  cleansers, insecticides, rubber condoms,  rubber slippers, black socks and shoes,  eyeliners, lipliners, lipsticks, toothpaste,  antiseptics with phenolic derivatives, and  mercuric iodide-containing "germicidal" soap. 

Occupational vitiligo may occur in those  individuals who work with depigmenting  substances, such as hydroquinone, para-tertiary butyl catechol, para-tertiary butyl  phenol, para-tertiary amyl phenol, and  hydroquinone monomethyl ether.

Depigmentation has also been reported in  shoemakers and after contact with arsenic -  containing compounds. Nevus depigmentosus  is a segmental hypopigmentation detectable  in the first year of life and stable in size in  proportion to the child’s growth. With a  Wood’s lamp, the contrast between lesional  and normal skin is less marked than in vitiligo.  Piebaldism is an autosomal dominant disease  presenting at birth with anterior midline  depigmentation and a white forelock  (poliosis). Many other types of leukoderma  have been described. The diagnosis and  treatment of leukodermas needs expert  approach. The only way to know if a  depigmented patch on the skin is vitiligo or  not is to consult a Dermatologist with special  interest in Pigmentary Disorders of the skin.