My 10-month-old kid has pale white patch in her eyelid and forehead. What could this be?

Hello,

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I saw the photos (attachment removed to protect patient identity). Based on the appearance, I can provide you a differential diagnosis. Now it could be P.alba, nevus depigmentousus or vitiligo. P. Alba is a type of mild dermatitis that can be easily managed with one cream and moisturizer. Nevus depigmentosus is a birthmark, that usually appears at birth or may after a few months of birth. Vitiligo is an autoimmune condition but in child, it is mild and can be treated very easily. Now to make a definitive diagnosis I need to ask you few questions. Is it spreading or increasing in size? Or is it stable? Do you see any dryness or scaling on the patch? Does he have a similar kind of patch anywhere else on the body? Kindly help me with these questions so I can help you with the diagnosis.

Hello,

Welcome back to icliniq.com.

Now scaling is not visible on any patch (attachment removed to protect patient identity). As you mentioned that it is not increasing in size so it is good. Now the main diagnosis are Nevus pigmentosum and vitiligo. Nevus pigmentosum as I said is a type of birthmark and it either appears at birth but sometimes it is not apparent at birth and gradually appears as the child grows. It increases in size with the growth of the body of child and then remains stable for life. Vitiligo can appear at any age at it usually increases in size. As Nevus depigmentosus does not cross midline and vitiligo has a tendency to cross midline. In photos, I can see these patches are not crossing the midline of forehead so most likely diagnosis is Nevus depigmentosus only. So what we need to do is to keep this patch under observation and notice if it is crossing midline or increasing in size. For treatment, apply sunscreen and moisturizer. We can also start very mild topical steroid cream for a few days and multivitamin syrup.