Differential Diagnosis for White Spots on Skin after Sunburn

Single Most Likely Diagnosis

• Post-inflammatory hypopigmentation: This condition occurs after skin inflammation, such as sunburn, leading to a loss of skin pigment. The peeling of the skin after sunburn can cause areas of hypopigmentation, appearing as white spots.

Other Likely Diagnoses

• Pityriasis versicolor: A common fungal infection that can cause hypo- or hyperpigmented patches on the skin, especially after sun exposure. The peeling of the skin from sunburn might exacerbate or reveal underlying pityriasis versicolor.
• Sun-induced depigmentation: Certain conditions like vitiligo can be exacerbated by sun exposure, leading to new or expanding areas of depigmentation.

Do Not Miss Diagnoses

• Lichen sclerosus: Although rare, this condition can cause white, patchy skin that is thinner than normal. It's essential to consider this diagnosis due to its potential to lead to significant scarring and increased risk of skin cancer if left untreated.
• Mycosis fungoides: A rare type of cutaneous T-cell lymphoma that can present with hypopigmented patches, especially in its early stages. Early diagnosis is crucial for effective management.

Rare Diagnoses

• Idiopathic guttate hypomelanosis: A condition characterized by small, discrete, hypopigmented macules, often on sun-exposed areas. It's more common in older adults and those with a history of significant sun exposure.
• Chemical leukoderma: A condition caused by exposure to certain chemicals that can destroy pigment-producing cells, leading to white patches on the skin. This would be an unusual cause of white spots following sunburn unless the individual was also exposed to specific chemicals.