Vitiligo and Pityriasis are two skin conditions that can be confused with each other. Although they have some differences.
Together with the Dermatologist Marina Fantato we clarify and see the difference between Vitiligo, Psoriasis Versicolor and Pityriasis Alba.
What is Vitiligo?
We have already talked about it exhaustively on our site. Let’s look at some key points here.
It is not possible to say with certainty the origin of vitiligo, but most likely it is an autoimmune problem caused by an immense reaction of our immune system.The immune response attacks the melanin cells (which are responsible for the color of our skin) and as a result we see white patches appear on the body. It is therefore a problem of skin depigmentation.
Vitiligo is neither dangerous nor transmissible and does not cause pain. It usually occurs on the face, neck, hands and skin folds.
Only 1% of the world population is affected by this disease, without any distinction of sex, race and age.
However, Vitiligo most commonly affects people after the age of 20.
The diagnosis of vitiligo is normally given by the dermatologist after having done the physical examination and after having collected some additional information for the diagnosis
The questions that the dermatologist will ask you during the medical history may be the following:
- there is someone in the family who suffers from vitiligo
- the patient has family members with autoimmune diseases
- There have been wounds, rashes and sunburn in the affected skin areas
- how the skin reacts to the sun (tans or burns)
- what medications or treatments were carried out
- the affected areas of skin improve or worsen without treatment
The dermatologist may perform additional tests such as Wood’s lamp or specific blood tests.
Wood’s lamp is a simple examination which consists in observing and analyzing the skin under a special ultraviolet light.
In general, the dermatologist performs combined treatments. It begins with a pharmacological treatment and is accompanied by micro-phototherapy. The goal is to have a clear improvement, but we must remember that vitiligo is not cured one hundred percent.
So the patient may still notice the white spots, albeit to a lesser extent, as the attached melanin cells cannot regenerate.
What is Pityriasis Versicolor?
To see the differences between vitiligo and pityriasis versicolor, let’s now define the latter. We are talking about a skin infection caused by fungi. It is characterized by changes in skin pigmentation.
The spots that appear are irregular, well defined and brown or brown in color. They are light spots compared to the surrounding healthy skin in cases of dark skin as the yeast of the fungus interferes with the production of melanin.
Usually the parts that are most affected are the arms, chest, face, shoulders and neck but in any case the patches can also be localized on other parts of the body.
Usually it is asymptomatic mycosis and therefore, at times, it could occur. This disease has no immune response and neither does it produce it unlike what is thought of vitiligo.
Usually the diagnosis is made by the Dermatologist and is a clinical diagnosis based on the observation of the alterations that are present on the patient’s skin.
In cases of uncertainty and doubts, in order not to be confused with other similar diseases, the Dermatologist performs the examination called the Wood’s lamp, an examination that is not considered invasive and takes place with control of the dermis under ultraviolet light and which helps to highlight certain characteristics.
This examination highlights elements that would not be noticed with other diagnostic tools such as the normal magnifying glass.
The tinea versicolor spots are highlighted during the examination with a yellow-green fluorescence.
If we are faced with other types of diseases, such as, for example, vitiligo or other fungal infections, the fluorescence will show a different color.
Tinea versicolor therapy
The suggested therapy is definitely a daily cleaning of the skin with acid pH soap, combined with the use of antifungal drugs.
Normally all of this is prescribed by the dermatologist or general practitioner. However, the therapy does not give the certainty of a complete recovery. In fact, the treatment is not able to fully reproduce the pigmentation that has in the meantime been blocked by the infection.
What is pityriasis alba?
Finally we see the Pityriasis alba. We are talking about a disease which is also a skin pigmentation disorder and which manifests itself with more or less extensive areas of hypomelanosis.
Pityriasis alba predominantly affects children and adolescents. Male subjects are more affected than women.
The parts of the body most often affected are the face and limbs, however the disease may also extend to the whole body.
This malaise is not contagious and causes only mild itching, often heals spontaneously and without any treatment.
Diagnosis of pityriasis alba
The diagnosis is made by a dermatologist with careful observation so as not to confuse it with the other diseases we have just seen, namely vitiligo and pityriasis versicolor.
The diagnosis must be very accurate given the similarities in the manifestation and causes between vitiligo and pityriasis alba (and also versicolor).
The examination of the scales that are collected from the lesions is often done. In order to definitively exclude diseases caused by infections.
Treatment of pityriasis alba
Pityriasis alba heals spontaneously with the total disappearance of all signs and symptoms.
The time required for complete healing can take anywhere from a few months to up to a year.
Yet dermatologists always recommend using adequate moisturizers, particularly during the cold seasons to avoid the recurrence of the spots. But also to moderate skin dryness.
On the other hand, for the summer, the use of a protective sunscreen with a high protection factor is recommended.
These are basically the differences between Vitiligo and Pityriasis. For any doubts, find the contacts of our centers of excellence for the treatment of Vitiligo in Milan and Rome.