White spots on the legs
Last reviewed: 07.06.2024
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It is often possible to observe white spots of small size on the human body, especially on tanned legs. There is a fear that this is something contagious. But in most cases, such defects of the epidermis do not pose a threat of infection to other people, although the infectious nature of such symptoms is not excluded.
Epidemiology
Between 1% and 8% of the world's population is known to suffer from vitiligo alone. Adding to this number people with other diagnoses manifested by white spots on the body, you can imagine how many we are talking about.
Causes of the white spots on the legs
Highlight the most common causes of white spots on the legs:
- drop-shaped hypomelanosis - discolored spots on the human body in the form of drops up to 10mm in diameter, not harmful to human health. It is most likely a cosmetic defect. In young people, these "marks" arise from excessive exposure to the sun or in a solarium, with age (after 30-40 years) the human skin is subjected to photo-aging, which also leads sometimes to focal violation of its pigmentation; [1]
- vitiligo, leukopathy - dermatologic diseases from the group of skin dyschromia, in which the skin loses its pigment in different areas of the body; [2]
- Depigmented nevus - congenital or acquired benign neoplasm with missing pigment due to melanin destruction; [3]
- fungal diseases - certain types of lichen planus. [4]
Risk factors
It is believed that one of the risk factors for white spots is genetic predisposition. It is also proven that ultraviolet rays, scrubbing the skin accelerate the development of the disease. Gender is also important: women are more prone to such skin defects, especially those with fair skin.
Vitiligo is often triggered by strong shocks, taking certain medications. Leukopathy is mainly caused by sexual infections, including syphilis. [5]
Pathogenesis
As you know, melanin is responsible for the intensity of skin coloration. It is a brown pigment contained in the skin cells melanocytes. It protects the epidermis from solar radiation by absorbing ultraviolet light. For the above reasons, there is either an accelerated destruction of it or a lack of formation.
Symptoms of the white spots on the legs
Depending on the diagnosis, white spots have different configurations and appear at different ages. Thus, the first signs of drop-shaped hypomelanosis mainly occur at the age of 35-45 years, but in those who abuse ultraviolet light, they can be found even earlier.
Localization of hypopigmentation first occurs on the flexor surface of the knee joints, which is not immediately detected. The white spots are droplet-shaped and are not interconnected.
Gradually they spread to other body surfaces: fingers and various parts of the legs, arms, less often to the trunk and almost never to the face. There are no unpleasant symptoms such as itching, burning or soreness.
Vitiligo can manifest itself at a young and even childhood age, and the spots come in different sizes and shapes, often merging into one single spot devoid of pigment.
White spots on toenails
White spots on the toenails are caused by a disturbance in the keratinization of the nail plate, which has a layered structure. Air bubbles get between the layers, forming voids. Such a disease is called leukonychia. One of the rare varieties of pathology is the formation of spots only on the big toes.
It may be caused by internal or external factors: lack of vitamins and minerals (occurs in persons on a strict diet or suffering from anorexia), diseases of the digestive organs, anemia, chronic renal and heart failure, stress, depression, mechanical damage.
Red and white spots on the legs
Variegated or pityriasis may provoke slightly different spots on the legs. At first, the fungus, "eating" the upper layer of the epidermis along with melanin, leaves a slightly reddish or brownish color, which gradually turns white. At the same time, exfoliating scales resembling bran are formed. Such white spots on the legs itch and peel, causing discomfort to the person.
White spots on legs in pregnancy
Often pregnant and postpartum women complain that they have white spots on the skin of their legs, especially noticeable against the background of tanned skin. This is due to stress, which is essentially the birth, or hormonal fluctuations. Over time, after breastfeeding is completed, it goes away.
Hormonal restructuring can also cause the appearance of papillary rash.
A white spot on a child's leg
White dry patches on the legs, while the skin is dry and scaly, may indicate white lichen planus. This disease most often affects children. For others, it is not dangerous, since it is not transmitted by contact. It is believed to be caused by the fungus Malassezia, which prevents ultraviolet rays from penetrating the skin.
Among other factors of the appearance of white spots on the leg in a child are the same as in adults: vitiligo, drop-shaped hypomelanosis, papillary lichen, leukoderma.
Complications and consequences
Of all possible types of white spots, unpleasant complications come from lichens: without timely treatment, the area of their localization increases, which spoils the aesthetic appearance and causes a lot of inconvenience. In addition, with close contact, it can infect other people.
Diagnostics of the white spots on the legs
Only a dermatologist can understand the causes of white spots on the legs. In addition to external diagnostics, if there is a suspicion of lichen, scales will be taken for analysis, and sometimes a biopsy will be performed.
From the instrumental diagnosis, a voodoo lamp emitting ultraviolet rays of black color is used. The discolored areas are examined under it.
Differential diagnosis
Differential diagnosis of white spots on the legs is carried out between all possible diseases that cause these signs: vitiligo, drop-shaped hypomelanosis, some forms of shingles, leukoderma and some other diseases.
Who to contact?
Treatment of the white spots on the legs
Of all the listed diagnoses, some do not require or have no treatment options. For example, in drop-shaped hypomelanosis, vitiligo can only slow the spread of the process, but not cure because of the uncertainty of etiology. Appeared spots remain on the body for the rest of life. If the process of pigment loss spreads rapidly, the doctor may prescribe for ingestion immunosuppressants, corticosteroids.
Lichens require antifungal therapy both systemically and externally, sometimes for long periods of time.
There are many antifungal medications that are used in case of lesions of lichen planus: ketoconazole, clotrimazole, fluconazole, inraconazole.
Fluconazole is an azole antifungal agent, used depending on the dosage form: capsules swallowed whole, intravenously administered by drip. In the case of variegated lichen planus, the recommended dose is 300-400mg once a week for one to three, or 50mg daily for a course of 2-4 weeks.
The drug is capable of causing such side effects as nausea, headache, dizziness, tremor, insomnia or drowsiness, flatulence, dyspepsia, dry mouth. Contraindicated in hypersensitivity to its constituents, as well as pregnant, lactating women. Interaction of fluconazole with other drugs should be studied according to the instructions for the drug, because their list is very large.
As an external remedy use clotrimazole - ointment or cream. It is applied to the discolored area with a thin layer once or twice a day. Do not apply to children, during carrying (especially in the first trimester) and nursing. May cause skin irritation, rash, swelling, allergic reaction accompanied by hives, shortness of breath.
Exoderil is an antifungal cream, applied to the clean surface of the lesions, covering the healthy areas 1cm around, twice a day. After the disappearance of symptoms should be continued for another 2 weeks to avoid recurrences. It is not recommended for children, pregnant women, during lactation. Of the adverse reactions in single cases, local ones in the form of itching, redness were observed.
Hydrocortisone is a hormonal agent, white spots of hypomelanosis are smeared with ointment 2-3 times a day, a course of 2-3 weeks. The drug is contraindicated in fungal, bacterial, viral skin lesions, open wounds, ulcers. It is not prescribed for children under 2 years of age, with caution to pregnant women and during lactation. The ointment may cause local reactions: swelling, itching.
When white spots appear on the legs, vitamin therapy with vitamins A, C, E, D, PP, B group preparations is appropriate. In addition to ingestion resort to pricking the foci of lack of pigmentation. Popular is also micro- and macroelement therapy with copper sulfate, zinc, iron, sulfur.
In vitiligo apply such physiotherapeutic procedures as laser, PUVA therapy (irradiation with ultraviolet radiation, previously using drugs that improve their perception), electrophoresis with 0.5-1% copper sulfate. This sometimes leads to the disappearance of skin defects, but not always.
In the folk treatment of white spots on the body, phytotherapy prevails. The recipes use herbs that have the property to strengthen the immune system, fight pathogens: echinacea, St. John's wort, marsh cassava, yarrow, wheatgrass, aira root. From collections of these and other plants are prepared infusions, decoctions and drink them for a long time.
The main goal of homeopathy is to stop the process of pigment spreading, strengthen the body's defenses, which eventually leads to the restoration of melanocytes. Depending on the character, constitution, psycho-emotional state of a person, a homeopathic doctor can prescribe bromium, syphilinum. Often such homeopathic preparations include potassium carbonate, silicic acid, nitric acid, phosphorus, sodium chloride and other components.
Surgical intervention is extremely rare and involves transplanting epidermis or introducing melanocytes into the skin, which will then produce pigment.
Prevention
Reduce the risk of various skin defects on the legs, including white spots, can limit sun exposure, the use of protective cosmetics from ultraviolet light. It is also important to eat a full balanced diet, which contains all the vitamins and minerals necessary for the functioning of the body.
It is also worth remembering that stress, hypothermia can shake the immune system, they should also be avoided.
Forecast
White spots on the legs do not pose an immediate threat to life, but the prognosis for their disappearance in most cases is unfavorable.