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What is the treatment of white patches all over the body?

Q: My 8 years old cousin has white patches visible all over his body. One dermatologist said it is para-psoriasis and recommended photo therapy, while another dermatologist said that it is Pityriasis lichenoids chronica and advised to apply coconut oil or a moisturiser on the whole body, and it may take 6 months or 2-3 years for it to heal. Whose advice should we follow?

A:Pityriasis lichenoides is the name given to a rare disease of unknown cause. Its mild form is known as pityriasis lichenoides chronica (PLC). The more severe form is known as pityriasis lichenoides et varioliformis acuta (PLEVA). It is probably a hypersensitivity reaction to a microorganism. However, no specific bacteria or virus has yet been identified. It is not considered to be contagious. The lesions are small firm red-brown spots, 3 to 18 mm in diameter. They are non-irritating and have mica-like adherent scale, which can be scraped off to reveal a shiny brown surface. The spot flattens out over several weeks to leave a brown/hypo pigmented marks which fades over several months. Treatment consists of:

  • Local application of steroids
  • Photo therapy - Ultraviolet A & sometimes UV-B therapy
  • Antibiotics (Erythromycin & Tetracycline) for a few weeks
  • Natural Sunlight etc.
My view is that you should try photo therapy if local applications don't help you.

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