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What Causes White Patches Around Wrist?

Posted on Mon, 9 Jun 2014

Question: My husband has developed white patches around his wrist. He painted the house and he had some paint stains on his hands and wrist. He complained burning, then he put some moisturizer and slept, In 3 weeks he went to Chile for work and one day he woke up these white patches on his wrist, Doctor took a white lamp test and there is no pigment left, Is it a vitiligo or post inflammatory hyperpigmentation, what should we do next ? He is not taking any medicines yet he has just changed his diet

Answered by Dr. Ilyas Patel (20 minutes later)

Brief Answer:
Please answer and post the photos of the lesion.

Detailed Answer:
Hi,

The white patches on the wrist of your husband may be post inflammatory hypomelanosis or vitiligo. Before comming to some conclusion, I would like to ask few questions.

1) is there family history of vitiligo?

2) can you desribe the lesion?

3) is there any systemic disease?

4) is there any symptom like itching or burning on the patches?

5) you gave history of contact with paint. After contact,did he develop irritation, reddness, burning or itching?

6) does he take any medicine at present?

Please answer and post the photos of the affected parts of your husband, so that i can help you in better ways.

Thanks.

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ilyas Patel (1 hour later)

to answer your questions,

1) he doesnt have any family history of vitiligo for 6 generations

2) Lesions are white in color which looks light white but turned bright white now and sometimes it looks pink in color, they are irregular in shape with defined outline mostly.

3) there is no desease involved, he had his routine done recently and he is healthy otherwise

4) he complained itching and burning on the same day that he had paint but afte that he had little bot of itching but nothing considerable.

5) He had burning after he washed his hands. He said that paint was hard to remove so he had to wash it several times and he said he sweated a lot during painting as well.

6) He is not taking any medicines just natural stuff like putting some natural paste on the patches.

Answered by Dr. Ilyas Patel (13 hours later)

Brief Answer:
It is a vitiligo.

Detailed Answer:
Hi XXXXXXX

Welcome back and thanks for answers and photos.

I read your answers and saw the photos. I came to diagnosis of vitiligo. Vitiligo is an autoimmune skin disease and considered as idiopathic..i.e. without cause. Paint might be the precipitating factor, but it is not the cause. There is a genetic factor in this disease also,but in your husband case no family history is found. Genetic mutation may be considered. I think disease process is active at present. So, it is likely that the vitiligo paches might spread to other areas. Koebner phenomenon is found in this disease in which the vitiligo patches occur at the site of injuries. So, please avoid even trivial injuries,scratching or any form of trauma to skin. Tell your husband to avoid scratching,rubbing or burn. Avoid to apply chemicals like soap, cosmetic,deodarant or other. He may take following treatment.

1) tab. Trioxalen 25 mg daily in morning.( like neosoralen forte)

2) tab. Levamisol 50 mg two tab at night ( like dicaris)

3) tacrolimus 0.1% oint. ( Like tacroz forte oint.) Rub the oint daily at night on the lesions.

4) trioxalen lotion (like neosoralen lotion) apply lotion on affected area at 12 noon and expose the area to sun for 5 to 10 min. only. If he feels irritation or develops bulla ...avoid it for few days then restart. Reddness in areas occur first then black color may be there.

He may take above treatment for long time till satisfactory result is there. Still, after one month you may ask for follow up therapy with queries,response of treatment and posting photos..

I hope you might be satisfied with my answer. Still any query..please feel free to ask...ok

Thanks and have good health.

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ilyas Patel (3 hours later)

How can It be seen from the pictures that it is in active stage ? also this was seen more than a month ago.
Mutation meaning Genes were different or altered at that time, Will the genes be same and spread the desease? Is there any way that can be controlled ? I was reading some threads and papers on the same, when the actuation is because of some chemicals then avoiding the chemicals can limit the spread, Is that true ?

Please reply

Answered by Dr. Ilyas Patel (2 hours later)

Brief Answer:
Vitiligo may be controlled and improved.

Detailed Answer:
Hi,

Welcome back.

Small new lesions suggest the activity of the disease. If the lesions remain stable for few months without development of new lesions than, it may be considered stable vitiligo.

Genetic factor is very complicated and confusing. Please do not think about it and do not waste the time.

I hope you understand my view.

If you want to have control and improvement in the lesions, start the treatment. You may consult nearby dermatologist and take treatment under his observation.

Long term treatment may improve the disease.

I hope you got my answer.

Wishing you healthy life.

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ilyas Patel (25 minutes later)

Well he hasn't seen any new lesion. He has a cut from shave which is healing slowly

Answered by Dr. Ilyas Patel (1 hour later)

Brief Answer:
Vitiligo

Detailed Answer:
Hi,

Photos you posted shows small and large lesions on wrist and palm. And the lesions are of vitiligo. Remember,vitiligo may occur at the site of injury,after long time.I would like to advise you to start treatment without thinking more.

Best luck.

Dr. Ilyas Patel MD

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Yogesh D