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What Causes Vitiligo Patch On The Armpit And Legs?

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Posted on Wed, 28 May 2014
Question: Hi,

I have a vitilago patch in the armpit for almost 5 weeks now. Yesterday I saw a small patch on my legs, which I am not sure. I asked this question yesterday but am asking again to get a second opinion. I would like to know if this patch on the leg is a vitilago patch.

If it is a vitilago patch:

- Having a small patch in the armpit and now in legs : What does that tell me from your clinical experience. What kind of vitilago would be categorized as and what would be the chances I will start seeing this on my extremities. Pls note the patch in the armpit and the legs are on different sides of the body.

I understand that vitilago is unpredictable but I am trying to get your feedback from your experience treating patients with vitilago.

Thanks-
doctor
Answered by Dr. Kalpana Pathak (1 hour later)
Brief Answer:
details below

Detailed Answer:
Hi,
Thanks for writing to us.
Vitiligo is characterised by a white milky patch. Now the lesion in your arm pit looks like vitiligo. However the lesion over leg is still hypopigmented. So we may classify it as previtiligo. Also sometimes any trauma, irritation inflammation of skin may heal with post inflammatory hypopigmentation. So if there was any preceding lesion over leg, we could also put one differential as post inflammatory hypopigmentation.

If you go by my clinical opinion I would say you have vitiligo lesions. Though as the number is less and site is favourable, good response with medicine should be achieved.
These lesions would be classified as vitiligo vulgaris.
As the lesions are just two and small in size, these should definitely respond to treatment. In many people the lesions remain stable, however in some spread may be seen. So you have to keep a watch.
In such cases, I usually prescribe a topical steroid like mometasone once in a day and tacrolimus 0.01% twice in a day. The lesions might take few weeks to months to show response. If response is suboptimal, we may also add topical psoralen lotion for better results.

Should there be any query,please write back.
Take care

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Kalpana Pathak (9 minutes later)
Thank you.

I am worried more about the spread of this. I will surely keep applying protopic to this 2 patches that I have.

From your clinical experience have you seen people who start out like me and have major spread quickly ?

Seeing this 2nd patch after 5 weeks, is that a bad sign ? Or is this expected ?

What do you see would be my chances that this will spread further and how quickly would you estimate ?
doctor
Answered by Dr. Kalpana Pathak (41 hours later)
Brief Answer:
prognosis unpredicatable....

Detailed Answer:
Hi,
Thanks for writing to us.

There are cases where condition progresses. The chances are higher when people develop multiple lesions at a time which progress in size and shape over a period of few weeks to months. But it is difficult to comment about progression and prognosis of disease as it may vary from person to person.

In your case, possibly the prognosis should be good as you have 2 lesions only. Though I cannot assure you, but based on my experience I feel that the lesions might not progress.

Hope this helped.
Take care
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. Prasad
doctor
Answered by
Dr.
Dr. Kalpana Pathak

Dermatologist

Practicing since :2006

Answered : 2014 Questions

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What Causes Vitiligo Patch On The Armpit And Legs?

Brief Answer: details below Detailed Answer: Hi, Thanks for writing to us. Vitiligo is characterised by a white milky patch. Now the lesion in your arm pit looks like vitiligo. However the lesion over leg is still hypopigmented. So we may classify it as previtiligo. Also sometimes any trauma, irritation inflammation of skin may heal with post inflammatory hypopigmentation. So if there was any preceding lesion over leg, we could also put one differential as post inflammatory hypopigmentation. If you go by my clinical opinion I would say you have vitiligo lesions. Though as the number is less and site is favourable, good response with medicine should be achieved. These lesions would be classified as vitiligo vulgaris. As the lesions are just two and small in size, these should definitely respond to treatment. In many people the lesions remain stable, however in some spread may be seen. So you have to keep a watch. In such cases, I usually prescribe a topical steroid like mometasone once in a day and tacrolimus 0.01% twice in a day. The lesions might take few weeks to months to show response. If response is suboptimal, we may also add topical psoralen lotion for better results. Should there be any query,please write back. Take care