White spots on the legs

Small white spots can often be seen on the human body, especially on tanned legs. There is a fear that this is something contagious. But in most cases, such epidermal defects do not pose a threat of infecting other people, although the infectious nature of such symptoms is not excluded.

Epidemiology

It is known that from 1% to 8% of the world's population suffers from vitiligo alone. Adding to this number people with other diagnoses that manifest themselves as white spots on the body, one can imagine what number we are talking about.

Causes white spots on the legs

The most common causes of white spots on the legs are:

• Guttate hypomelanosis – discolored spots on the human body in the form of drops up to 10 mm in diameter, not causing harm to human health. Most likely, this is 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), human skin is subject to photoaging, which also sometimes leads to focal disruption of its pigmentation; [ 1 ]
• vitiligo, leukopathy - dermatological diseases from the group of skin dyschromia, in which the skin loses its pigment in various areas of the body; [ 2 ]
• depigmented nevus - a congenital or acquired benign neoplasm with absent pigment due to the destruction of melanin; [ 3 ]
• fungal diseases - certain types of lichen. [ 4 ]

Risk factors

It is believed that one of the risk factors for the appearance of white spots is genetic predisposition. It has also been proven that ultraviolet rays and skin scrubbing accelerate the development of the disease. Gender also matters: women are more susceptible to such skin defects, especially those with fair skin.

Vitiligo is often triggered by severe shocks and the use of certain medications. Leukopathy is mainly caused by sexually transmitted infections, including syphilis. [ 5 ]

Pathogenesis

As is known, melanin is responsible for the intensity of skin color. This is a brown pigment contained in skin cells called melanocytes. It protects the epidermis from solar radiation by absorbing ultraviolet light. For the above reasons, either its accelerated destruction or insufficient formation occurs.

Symptoms white spots on the legs

Depending on the diagnosis, white spots can have different configurations and appear at different ages. Thus, the first signs of guttate hypomelanosis usually occur at 35-45 years of age, but in those who abuse ultraviolet radiation, they can be detected earlier.

Localization of hypopigmentation initially occurs on the flexor surface of the knee joints, which is not immediately detected. White spots are drop-shaped and not connected to each other.

Gradually they spread to other surfaces of the body: fingers and various parts of the legs, arms, less often to the body and almost never to the face. At the same time, there are no such unpleasant symptoms as itching, burning or pain.

Vitiligo can appear in young people and even children, and the spots can be of different sizes and shapes, often merging into one single spot, devoid of pigment.

White spots on toenails

White spots on toenails appear due to a violation of the keratinization of the nail plate, which has a layered structure. Air bubbles get between the layers, forming voids. This disease is called leukonychia. One of the rare varieties of pathology is the formation of spots only on the big toes.

The reason for this may be due to internal or external factors: lack of vitamins and minerals (occurs in people 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 legs

Versicolor or pityriasis versicolor can provoke slightly different spots on the legs. At first, the fungus, "eating away" the upper layer of the epidermis together with melanin, leaves a slightly reddish or brownish color, which gradually turns white. At the same time, peeling scales are formed, resembling bran. Such white spots on the legs itch and flake, causing discomfort to a person.

White spots on legs during pregnancy

Pregnant and postpartum women often complain about white spots on their legs, which are especially noticeable against the background of tanned skin. This happens due to stress, which is essentially what childbirth is, or hormonal fluctuations. Over time, after breastfeeding is finished, this goes away.

Hormonal changes can also cause the appearance of pityriasis versicolor.

White spot on child's leg

White dry spots on the legs, while the skin is dry and scaly, may indicate white lichen. This disease most often affects children. It is not dangerous for others, because it is not transmitted by contact. It is believed that the cause of its occurrence is the fungus Malassezia, which does not allow ultraviolet rays to penetrate the skin.

Other factors that cause white spots on a child's leg are the same as those in adults: vitiligo, guttate hypomelanosis, versicolor lichen, leukoderma.

Complications and consequences

Of all the possible types of white spots, unpleasant complications come from lichen: 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 white spots on the legs

Only a dermatologist can understand the reasons for the appearance of white spots on the legs. In addition to external diagnostics, if lichen is suspected, they will take a scale for analysis, sometimes a biopsy is performed.

From the instrumental diagnostics, a Voodoo lamp is used, emitting ultraviolet rays of black color. Discolored areas are examined under it.

Differential diagnosis

Differential diagnostics of white spots on the legs is carried out between all possible diseases that cause these symptoms: vitiligo, guttate hypomelanosis, certain forms of lichen, leukoderma and some other diseases.

Treatment white spots on the legs

Of all the listed diagnoses, some do not require or have no treatment. Thus, with guttate hypomelanosis, vitiligo can only slow down the spread of the process, but not cure it due to the uncertainty of the etiology. The spots that appear remain on the body for the rest of life. With rapid spread of the pigment loss process, the doctor can prescribe immunosuppressants and corticosteroids for oral administration.

Lichens require antifungal therapy both systemically and externally, sometimes for a long time.

There are many antifungal drugs that are used in case of ringworm infection: ketoconazole, clotrimazole, fluconazole, inraconazole.

Fluconazole is an azole antifungal agent, used depending on the dosage form: capsules are swallowed whole, intravenously administered through droppers. For pityriasis versicolor, the recommended dose is 300-400 mg once a week for one to three weeks, or 50 mg daily for 2-4 weeks.

The drug can cause side effects such as nausea, headache, dizziness, tremor, insomnia or drowsiness, flatulence, dyspepsia, dry mouth. Contraindicated in case of hypersensitivity to its components, as well as pregnant and lactating women. The interaction of fluconazole with other drugs must be studied according to the instructions for the drug, since their list is very large.

Clotrimazole is used as an external agent - ointment or cream. It is applied to the discolored area in a thin layer once or twice a day. Do not use on children, during pregnancy (especially in the first trimester) and breastfeeding. May cause skin irritation, rash, swelling, allergic reaction accompanied by urticaria, shortness of breath.

Exoderil is an antifungal cream, applied to the clean surface of the lesions, covering healthy areas 1 cm around, twice a day. After the symptoms disappear, continue for another 2 weeks to avoid relapses. Not recommended for children, pregnant women, during lactation. Of the side effects, in isolated cases, local itching and redness were observed.

Hydrocortisone is a hormonal agent, white hypomelanosis spots are lubricated with ointment 2-3 times a day, for a course of 2-3 weeks. The drug is contraindicated in fungal, bacterial, viral skin lesions, open wounds, ulcers. It is not prescribed to children under 2 years old, with caution to pregnant women and during breastfeeding. The ointment can cause local reactions: swelling, itching.

When white spots appear on the legs, vitamin therapy with vitamins A, C, E, D, PP, and group B preparations is appropriate. In addition to oral administration, injections are used to treat areas of lack of pigmentation. Micro- and macroelement therapy with copper sulfate, zinc, iron, and sulfur is also popular.

For vitiligo, physiotherapeutic procedures such as laser, PUVA therapy (ultraviolet radiation, after taking medications that improve their perception), electrophoresis with 0.5-1% copper sulfate are used. This sometimes leads to the disappearance of skin defects, but not always.

In folk treatment of white spots on the body, phytotherapy prevails. The recipes use herbs that have the property of strengthening the immune system, fighting pathogenic microorganisms: echinacea, St. John's wort, duckweed, yarrow, immortelle, calamus root. Infusions and decoctions are prepared from collections of these and other plants and drunk for a long time.

The main goal of homeopathy is to stop the process of pigment spreading, strengthen the body's defenses, which ultimately 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, nitric acid, phosphorus, sodium chloride and other components.

Surgical intervention is performed extremely rarely and involves transplanting epidermis or introducing melanocytes into the skin, which will then produce pigment.

Prevention

Limiting sun exposure and using UV-protective cosmetics can reduce the risk of various skin defects on the legs, including white spots. Equally important is a complete, balanced diet that contains all the vitamins and minerals necessary for the body to function.

It is also worth remembering that stress and hypothermia can weaken 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.