Overview
Pityriasis refers to the characteristic fine scale, and alba to its pale colour (hypopigmentation) so, Pityriasis alba is a low-grade type of eczema/dermatitis mainly seen in children and adolescents aged 3 to 16 years, but can occur in older and younger people. It affects boys and girls equally. The condition perhaps is more common, in dark skin compared to white skin. It often presents following sun exposure, perhaps because tanning of surrounding skin makes affected areas more prominent. People with pityriasis alba get round, oval, or irregularly shaped patches of pale pink or red skin. The patches are usually scaly and dry. No treatment is necessary for asymptomatic pityriasis alba but people with pityriasis alba develop red or pink patches on their skin that are usually round or oval. The patches usually clear up with moisturizing creams or go away on their own. However, they often leave pale marks on the skin after the redness has faded.

Causes
Doctors don’t know what causes pityriasis alba. It may be related to another skin condition called atopic dermatitis or eczema that causes a skin rash. People whose skin is very sensitive or who get a lot of sun may be more likely to get the condition.

Symptoms
People with pityriasis alba get round, oval, or irregularly shaped patches of pale pink or red skin. The patches are usually scaly and dry. They may appear on the:
face, which is the most common place
upper arms
neck
chest
back
Pityriasis alba evolves through several stages.

Slightly scaly pink patch or plaque with a just palpable papular surface.
Hypopigmented patch or plaque with fine surface scale.
Then post-inflammatory hypopigmented macule without scale.
Resolution.

Diagnosis

Pityriasis alba is usually a clinical diagnosis but may be confused with several other disorders that cause hypopigmentation.

To exclude these, investigations may include:

Wood lamp examination: the hypopigmentation of pityriasis alba does not enhance, and there is no fluorescence
Scrapings for mycology: microscopy and fungal culture are negative in pityriasis alba
Skin biopsy: biopsy is rarely required, but may reveal mildly spongiotic dermatitis and reduction in melanin.
Risks for pityriasis alba

Pityriasis alba is most common in children and adolescents. It occurs in approximately 2 to 5 percent of children. It’s most frequently seen in children between the ages of 6 and 12 years. It’s also very common in children with atopic dermatitis, an itchy inflammation of the skin.

Pityriasis alba often appears in children who take hot baths frequently or who are exposed to the sun without sunscreen. However, it’s unclear if these factors cause the skin condition. Pityriasis alba isn’t contagious.

Treatment

No treatment is required for pityriasis alba. The patches usually go away with time. Your doctor may prescribe a moisturizing cream or topical steroid cream such as hydrocortisone to treat the condition. In some cases, your doctor may prescribe a nonsteroid cream, such as pimecrolimus. Both types of creams can help reduce skin discoloration and relieve any dryness, scaling, or itchiness. Even if you’ve had treatment, the patches can return in the future. You may need to use the creams again. In most cases, however, pityriasis alba goes away by adulthood. The development or prominence of pityriasis alba can be reduced with sunscreen use to minimise sun tanning.

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The most common disease among sports person in general is skin disease.These dermatological disorders include infections, inflammatory conditions, traumatic entities, environmental encounters, and neoplasms.  Direct and indirect transmission of infectious agents occurs readily by the shear nature of contact competition in the sports environment. So it is important that we recognise  common and uncommon skin disorders of the athlete.

Skin infections

Skin infection can disrupt both individual and team activities.Below are some of the common skin infections

Herpes gladiatorum
The herpes simplex virus (HSV) causes a recurrent cluster of tender, burning blisters on or around the mouth or lips. In wrestlers, HSV often appears in other places on the body including the neck, torso, and extremities and is commonly referred to as “herpes gladiatorum.” When it affects the fingertip, it is known as “herpetic whitlow.”
Antiviral medications can reduce recurrent infections.

Tinea corporis gladiatorum (Ringworm)
Tinea corporis presents as a circular or ring-shaped, scaly, raised plaque .Tinea corporis, or ringworm, has become a common nuisance in competitive wrestling. Although it is a fairly benign infectious skin disease, it has significant effects on the ability of a wrestler to compete because of infection control issues.
Ringworm of the skin makes the skin itchy and red and creates a round patchy rash that has raised borders and a clear center.Ringworm of the nails may affect one or more nails on the hands or feet. The nails may become thick, white or yellowish, and brittle.
Heaps of sweaty clothes are part of lives of sports persons and so is the risk of getting fungal skin infections.Other fungal infections include is Tinea pedis (athlete’s foot).It  affects the soles and interdigital spaces(between toes and fingers) of the feet. It is commonly associated with peeling, cracking, scaling.Athletes are at increased risk to this condition due to a warm, moist environment inside occlusive footwear, shared pools and treatment tubs, and communal showers.
Treatment for patients with tinea pedis consists of topical antifungal cream unless infection is severe or extensive, in which case oral antifungal therapy is required.

Impetigo
Patients with impetigo develop clusters of red, round, scaly patches with scalloped borders. These patches are often covered with yellow, honey-colored “crust” .There is no burning or tingling sensation in the area before the patches appear. Impetigo typically appears on the lower face, but can quickly and easily spread to the extremities and torso.
It may be transmitted by skin-to-skin contact, by using something infected with the bacteria like an infected towel or sports equipment. Wearing infected clothing is another way to get impetigo.
The treatment of infected athletes requires a dual-pronged approach with both topical and oral antibiotics. Topical mupirocin twice daily in addition to oral dicloxacillin or cephalexin clears impetigo.

Furunculosis
Furunculosis is a deeper infection of the hair follicle generally which presents as  hot, tender inflammatory nodule (boil) from which pus can be expressed.
Treatment of patients with any of these growths includes incision and drainage, use of warm compresses and sterile dressings, and appropriate restriction from sports. Use of antibiotics is optional in treatment unless cellulitis is also present, but antibiotics are required for return to sports participation. 

Other diseases

Anaphylaxis is a serious, life-threatening allergic reaction.Athletes who develop exercise-induced anaphylaxis may prevent outbreaks by avoiding food before exercise and extreme temperatures while they exercise.
Almost all sports enthusiasts are at risk of developing traumatic entities such as nail dystrophies, calluses and blisters.
Other more unusual traumatic skin conditions, such as talon noire, jogger’s nipples and mogul’s palm, occur in specific sports.
Winter sport athletes may develop frostbite and swimmers in both fresh and saltwater may develop swimmer’s itch or seabather’s eruption, respectively. Swimmers with fair skin and light hair may also present with unusual green hair that results from the deposition of copper within the hair.
Finally, athletes are at risk of developing both benign and malignant neoplasms. Hockey players, surfers, boxers and football players can develop athlete’s nodules. Outdoor sports enthusiasts are at greater risk of developing melanoma and non-melanoma skin cancer.
Several techniques and special clothing exist to help prevent traumatic skin conditions in athletes. Almost all athletes, to some degree, interact with the environment.Athletes spend a great deal of time outdoors, typically during peak hours of ultraviolet exposure. The frequent use of sunscreens and protective clothing will decrease the athlete’s sun exposure.

Vitiligo is a dermatological condition which causes the skin to lose its natural colour and  as a result, uneven white patches appear on the body. It is not medically dangerous  or life threatening.Also it is not contagious and affects about 1% of people in the world.Apart from skin,vitiligo may cause depigmentation in the hair on the scalp, mouth,eyelashes or eyebrows.It is not a form of skin cancer and  in fact, most of the people with vitiligo are every bit as healthy as a normal person.

 

Vitiligo is due to the melanocytes of skin being destroyed. Melanocytes are the cells within skin that produce melanin,which gives the pigment to the skin.Melanin also protect the skin from sun’s UV rays.The destruction of melanocytes is thought to due to an autoimmune problem where the immune system attacks healthy  tissues.
People with an autoimmune disease, such as Hashimoto’s disease,Addison disease,pernicious anemia,diabetes or alopecia areata, are at an increased risk of developing vitiligo. Vitiligo is also seen to run in families.
Although vilitigo affects any race equally,but it tends to be more more noticeable in darker skinned people due to the contrast.

Types of Vitiligo

There are three types of vitiligo, depending on the extent and location on the body:

• Focal vitiligo: A person has a few vitiligo spots in a single area.
• Generalized vitiligo: This is the most common type.In this type,the person affected has patches all over the body in a symmetrical pattern on right and left sides
• Segmental vitiligo: This type of vitiligo causes patches only one part/side of the body.This is the least common among the three.It usually starts at a younger age,progresses for about 2 years and then stop.

Vitiligo can happen anywhere on the body, but it’s more likely to develop in some areas:

• skin that’s exposed to the sun, such as the face or hands
• skin that has folds, such as the elbows, knees, or groin
• skin around the eyes, nostrils, belly button, and genital areas

Signs and Symptoms

Symptoms usually appear as depigmented areas where lot of sun exposure is received such as face ,arms and hands but may also appear in the groin area, in the armpits, and around the belly button.

Some signs of vitiligo include

• Premature graying of hair
• Eyelashes or eyebrows losing color and turning white
• Change of color in the retina of the eye
• Color loss in the nose and mouth
• Photo sensitiveness on the affected parts.

Vitiligo may also lead to inflammation in the iris or hearing loss.

Diagnosis and Treatment

Mostly,dermatologists identify the condition visually.Some dermatologists request for further testing like a skin biopsy,which will show whether melanocytes are present in the skin. He may also test for a blood test to see if you have another autoimmune disease.

• Topical medicine applied to the skin:Corticosteroid creams, when applied to white patches very early in the disease may help to bring some color back to the skin by decreasing the inflammation that leads the skin to have fewer pigment cells
• Light treatment:Uses light to restore lost color to the skin
•  Photochemotherapy also known as PUVA light therapy:Uses a medicine called psoralen and UVA light to restore skin color.
• Narrow-band ultraviolet B (UVB) therapy. This treatment is more widely used than PUVA. It’s similar, except that the ultraviolet light used is UVB instead of UVA. UVB treatment doesn’t require psoralen.
• Surgery:Different surgical procedures are available. Most involve removing skin with your natural color or skin cells and placing these where you need color.
• Unconventional treatment:Some vitamins, minerals, amino acids, and enzymes have been reported to restore skin color in people who have vitiligo.
• Depigmentation:This treatment removes the remaining pigment from the skin.Very few patients opt for this treatment.Removing the rest of the pigment leaves a person with completely white skin.

Vitiligo is more than a cosmetic condition and needs attention. Vitiligo can greatly impact the self esteem of affected person.Combined medical and mental health treatment can elevate the quality of affected individual.

For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com .

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