The FP made the diagnoses of atopic dermatitis (especially in the popliteal fossae) and pityriasis alba, which was seen on the child’s face and arms. Pityriasis alba is very common in children (especially in those who also have atopic dermatitis), but it can occur in children without atopic dermatitis, as well. The condition is characterized by hypopigmented patches of skin and is of cosmetic concern only.
The FP prescribed 2.5% hydrocortisone ointment for both conditions and told the mother that she would need to apply it once to twice daily, as needed. The FP explained that the hypopigmentation would take longer to resolve than the inflammatory erythema. Fortunately, atopic dermatitis in children typically resolves by adulthood.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine R, Finklea L. Atopic dermatitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill;2013:584-590.
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