Clinicopathological Study of Pityriasis Alba in Libyan Patients

Abstract

Abstract: Pityriasis alba is a common, benign skin disorder occurring predominantly in children and adolescents. Most patients have a history of atopy, and pityriasis alba may be a minor manifestation of atopic dermatitis. It is characterized by ill-defined macules and patches or thin plaques, round or oval, often with mild scaling, and sometimes with mild pruritus. The lesions initially may be mildly erythematous, and over time they become hypopigmented. They are most commonly located on the face (especially the cheeks), arms, and upper trunk, and they are more noticeable in people with darker skin types. Sun exposure accentuates the lesions. Pityriasis alba resolves spontaneously, with a gradual return of normal skin pigmentation.                                                      Aim of the Study: To assess the etiological and physical characteristics  in Libyan pityriasis alba patients Participants and Methods: One hundred patient attending to dermatology department outpatient clinic, Alwahda hospital-Derna-Libya are included in this descriptive  study. Diagnosis of PA is done by dermatological clinical  examination. Detailed history of age, gender ; history of atopy, sun exposure, frequency of bathing , with  physical examination of site, number of lesion is recorded.                                                  Results: The study included 100 Libyan pityriasis alba  patient, 69(69%) male, 31 (31%) female, their age ranged from 2-19 years. 89% of patient’s lesions were on face only , 8% on face and extremities and 3% on face and neck. The number of pityriasis alba lesions ranged from 2 to 12 lesions, scales were evident in only 73% of patients and 27% had no scaly lesions. The duration of the disease ranged from 1 week to 2 years. 66% were Fitzpatrick skin type IV and 34% skin type III. Xerosis presented in 70%.  History of atopic dermatitis was +ve in 11% and -ve in the other 89%. History of atopy +ve in 55%, -ve in 45% of patients  Family Hisory of atopy + ve in 90% and -ve in 10% . In 37% of Pityriasis alba patients, the lesions were recurrent and 63% had no hisory of recurrence. Only 4% of our patients were using sunscreens, Sun exposure hrs per day ranged between 1 to 6 hrs. The times of bathing per week ranged from 1 to 7 times per week.                                                     Conclusion: Our data suggested that pityriasis alba is more prone in children of skin type IV with strong family history of atopy, and strong association with skin xerosis,Sun exposure and neglected sunscreen usage. To the best of our knowledge, this is the first publication about pityriasis alba from our country.