Q. How can hypopigmentation be treated in an infant?

Answered by
Dr. Kakkar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 05, 2018 and last reviewed on: Oct 09, 2018

Hello doctor,

My 6-week-old daughter has got white hypopigmented areas on bilateral groins and both inner thighs more in the left groin. Also, they seem to be appearing near the umbilicus and upper chest. We are very worried about it and want to know if there is any treatment available for it. Your opinion will be appreciated. I have attached reports for your reference.

Dr. Kakkar

Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome to icliniq.com.

I have gone through the attachments (attachment removed to protect patient identity).

She seems to have trichrome vitiligo which is an indication of active disease.

I would like to know the duration.

  • Were they present at birth?
  • Is it spreading?
  • Did you notice any new patches appear in the past week?

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

She is 6 weeks old now. She was born 2 days after EDD. We started noticing after the 2nd week of birth.She had a bit of dark discoloration around the genitalia when she was born. Also, her skin was very dry. Later it started fading and progressed to white. Yes, it is progressing to other parts. Initially, it was only in groins and thighs. But now looks like it is spreading to the areas around the umbilicus and small patches on the chest.

  • Do you reckon will it spread to all over the body?
  • Is there any treatment for it especially a permanent cure for it?
  • Is there anything that can be done at this stage?
  • What do we have to do now?
  • Is there any advantage of seeing a specialist at this early stage?
  • Anything to prevent spreading like any steroid cream? What are the diagnostic methods?

Dr. Kakkar

Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

Medical treatment would be the mainstay of therapy for an infant with vitiligo.

The goal would be to induce repigmentation as well as arrest further progression.

I suggest you apply a moderately potent topical steroid e.g Fluticasone Propionate 0.05 % ointment, once daily, for the existing patches.

Topical steroids are first-line treatment options for vitiligo.

Another option that may be considered in her is narrowband UVB phototherapy.

NB-UVB phototherapy is safe for children. It induces durable repigmentation and also arrests further progression. These two are the safest and effective options for an infant like hers. You may visit a dermatologist in your area.

Vitiligo is unpredictable. It may progress slowly or rapidly or it may stay stable for years. If you are noticing new patches on other body areas that means it is spreading.

Though in adults, oral steroids are commonly prescribed to arrest the progression of vitiligo but I do not think it is a good option for an infant. For her, NB-UVB Phototherapy would be more preferable considering the efficacy and safety profile.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Hello doctor,

Thanks for your detailed information. We showed our daughter in a hospital. Initially, they started with steroid creams, Cortic -Ds 1% and Advantan fatty ointment. We have used those once daily for almost three weeks. We reckon those creams stopped the quick spreading of hypopigmented patches but not made any improvement in the existing spots. Now, she has hypopigmented areas on groins, bilateral inner thighs, right leg, around the umbilicus, a small one on the upper chest and left arm near the elbow. We had another visit to the dermatology team, and they reckon the steroid have no role. They think this is genetic and they called it segmental hypopigmentation. They also said that no treatment is available other than doing some tanning type of makeup. What is your opinion? As parents, we are concerned, and we would like to know if we can do something to cure or at least to make it better. We would appreciate your answer. Many thanks.

Dr. Kakkar

Dermatology HIV/AIDS Specialist Venereology
#

Hi,

Welcome back to icliniq.com.

Thank you for getting back to me. Yes, segmental hypopigmentation is a possibility, particularly hypomelanosis of ITO with either white patches and/or as streaks and whorls. The skin involvement may be either an isolated finding or associated with underlying developmental, neurological, musculoskeletal, ophthalmic, dental or ear abnormalities.

Therefore, they should be looked for and ruled out. I suggest you continue with the steroid cream for a further period of two to three weeks and if it still does not work, then stop it.

Skin involvement in hypomelanosis of ITO appears in the first year of life either unilaterally or on both sides of the body. There is no treatment, and the patches remain unchanged in childhood though they may fade or darken in adulthood.

For further doubts consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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