Differential Diagnosis for Hypopigmented Pruritic Lesions
Single Most Likely Diagnosis
- Pityriasis alba: A common, benign condition characterized by hypopigmented patches, often with a history of atopy and associated with mild pruritus. It's frequently seen in children and young adults.
Other Likely Diagnoses
- Vitiligo: An autoimmune condition leading to loss of melanocytes, resulting in well-defined hypopigmented patches. Pruritus can be present, especially in the early stages.
- Pityriasis versicolor: A fungal infection caused by Malassezia species, leading to hypopigmented or hyperpigmented macules, often with mild pruritus.
- Eczema (atopic dermatitis): A chronic inflammatory skin condition characterized by pruritus, dry skin, and hypopigmentation in some cases, particularly in individuals with darker skin tones.
Do Not Miss Diagnoses
- Leprosy (Hansen's disease): A chronic infectious disease caused by Mycobacterium leprae, which can present with hypopigmented skin lesions and pruritus. Early diagnosis is crucial to prevent long-term complications.
- Sarcoidosis: A systemic granulomatous disease that can manifest with skin lesions, including hypopigmented patches, and pruritus. It's essential to consider this diagnosis due to its potential for systemic involvement.
Rare Diagnoses
- Idiopathic guttate hypomelanosis: A condition characterized by small, discrete, hypopigmented macules, often on the extremities. It's usually asymptomatic but can be pruritic in some cases.
- Progressive macular hypomelanosis: A rare condition presenting with hypopigmented macules, typically on the trunk, and can be associated with pruritus. Its exact cause is unknown.
- Nevus depigmentosus: A congenital condition resulting in hypopigmented patches, which can be pruritic. It's essential to distinguish it from other conditions due to its benign nature.