What is the differential diagnosis (DDX) for pruritic hypopigmentation?

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Last updated: May 22, 2025View editorial policy

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Differential Diagnosis for Pruritic Hypopigmentation

Single Most Likely Diagnosis

  • Pityriasis alba: A common, benign condition characterized by hypopigmented patches, often accompanied by mild pruritus, typically seen in children and young adults.

Other Likely Diagnoses

  • Pityriasis versicolor: A fungal infection caused by Malassezia species, leading to hypopigmented or hyperpigmented macules, often with pruritus.
  • Nummular dermatitis: A type of eczematous dermatitis presenting with coin-shaped, hypopigmented patches, usually pruritic.
  • Seborrheic dermatitis: An inflammatory skin condition causing hypopigmented or erythematous patches, often with pruritus, typically on the scalp, face, and torso.

Do Not Miss Diagnoses

  • Hansen's disease (Leprosy): A chronic bacterial infection that can cause hypopigmented skin lesions with pruritus, loss of sensation, and potential for severe disability if left untreated.
  • Sarcoidosis: A systemic granulomatous disease that may present with hypopigmented skin lesions, pruritus, and other systemic symptoms, requiring prompt diagnosis and treatment.

Rare Diagnoses

  • Idiopathic guttate hypomelanosis: A rare condition characterized by multiple, small, hypopigmented macules, often without pruritus, but can be itchy in some cases.
  • Progressive macular hypomelanosis: A rare condition presenting with hypopigmented macules, usually without pruritus, but can be associated with mild itching in some cases.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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