White spots appear on the child's face

The appearance of white spots on a child's face is most likely caused by a symptom called vitiligo. Vitiligo also has certain clinical manifestations, so if white spots appear on a child's face, parents can first use certain methods to determine whether the child has vitiligo. If so, they must go to the hospital for a comprehensive examination, and then carry out targeted and effective treatment based on the specific cause of the disease.

There is no significant difference in gender, and the disease can occur in all age groups, but it is more common in adolescents. The skin lesions are depigmented spots, which are often milky white but can also be light pink, with a smooth surface and no rash. The boundaries of the white spots are clear, the pigmentation of the edges is increased compared to normal skin, and the hair inside the white spots is normal or whitened. The lesions often occur in areas exposed to sunlight and damaged by friction, and are often distributed symmetrically. White spots are often distributed according to nerve segments and arranged in bands. In addition to skin lesions, the mucous membranes of the lips, labia, glans penis and inner foreskin are also often affected.

Most patients have no subjective symptoms, and a small number of patients experience local itching in the affected area before or during the onset of the disease. Vitiligo is often accompanied by other autoimmune diseases, such as diabetes, thyroid disease, adrenal insufficiency, scleroderma, atopic dermatitis, alopecia areata, etc.

It is often complicated by diabetes, pernicious anemia, alopecia areata, atopic dermatitis, thyroid disease, primary adrenal insufficiency, scleroderma, malignant tumors, etc.

In terms of clinical manifestations, vitiligo can be complicated or secondary to multiple diseases. There have been many reports of vitiligo cases combined with some autoimmune and endocrine diseases in clinical practice. Such as: combined with hyperthyroidism or hypothyroidism, diabetes, chronic adrenocortical insufficiency and chronic active hepatitis.

In addition, vitiligo is associated with pernicious anemia, halo nevus, alopecia universalis or alopecia areata, psoriasis, scleroderma, morphea, malignant tumors, drug rash, herpes zoster, bronchial asthma, atopic dermatitis, rheumatoid arthritis, myasthenia gravis, chronic subcutaneous candidiasis and eye diseases, as well as complications of dermatitis herpetiformis, acromegaly, parapsoriasis, chronic persistent erythema, porphyria cutanea tarda, lichen sclerosus and other diseases. There have also been recent reports of vitiligo occurring in HIV-infected people and people with myelodysplastic syndrome.

1. Medication

(1) Oral administration of psoralen and its derivatives such as methoxsalen followed by exposure to ultraviolet light.

(2) Long-term use of large doses of vitamins such as B vitamins, vitamin C, and vitamin P.

(3) Treatment can include taking copper-containing drugs, such as 0.5% copper sulfate solution orally.

(4) Oral immunomodulatory agent levamisole, intramuscular injection of freeze-dried BCG, oral administration of bovine placenta, etc.

(5) Topical application of skin irritants

It causes inflammatory reaction in the skin and promotes pigmentation. Commonly used ones include 30% psoralea corylifolia tincture, nitrogen mustard alcohol, phenol (pure carbolic acid), 25%-50% trichloroacetic acid, blister beetle tincture, etc. This method is only suitable for small skin lesions, and blisters may appear on the lesions after application.

(6) Corticosteroids: Various corticosteroids such as beclomethasone dipropionate ointment, halometasone cream, triamcinolone urea ointment, etc. are used for local packing treatment.

2. Surgery

Patients with stable skin lesions and no progression can undergo autologous epidermal transplantation.

3. Depigmentation therapy

It is suitable for those with large skin lesions that exceed more than half of the body surface area. 3% to 20% hydroquinone monobenzyl ether cream can be applied externally.

4. Physical therapy

Treatment is with narrow-wave ultraviolet light, long-wave ultraviolet light or 308nm excimer laser.