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Changes in Skin Color: Clinical Perspectives

The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
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Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
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Pityriasis lichenoides: the differences between children and adults.

S Wahie1, E Hiscutt, S Natarajan

  • 1Department of Dermatology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK. shyamalwahie@hotmail.com

The British Journal of Dermatology
|September 15, 2007
PubMed
Summary

Pityriasis lichenoides (PL) in children often presents with more widespread lesions and dyspigmentation, leading to a prolonged, unremitting course compared to adults. Conventional treatments show poorer efficacy in pediatric cases, highlighting a need for further research.

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Published on: September 26, 2019

Area of Science:

  • Dermatology
  • Pediatric Dermatology
  • Clinical Research

Background:

  • Pityriasis lichenoides (PL) is a rare skin condition affecting both children and adults.
  • Anecdotal evidence suggests PL is more benign and self-resolving in children, but comparative studies are lacking.

Purpose of the Study:

  • To compare clinicopathological features, treatment efficacy, and disease outcomes of PL in pediatric and adult populations.
  • To provide the first published study directly comparing Pityriasis lichenoides in children versus adults.

Main Methods:

  • Retrospective review of 57 patients (25 children, 32 adults) diagnosed with PL over an 8-year period (1998-2006).
  • Data collected included demographics, lesion characteristics, symptoms, histopathology, treatments, responses, and remission duration.
  • Statistical analysis was performed to compare differences between pediatric and adult cohorts.

Main Results:

  • Children exhibited greater lesional body involvement (trunk/legs, face) and significantly more dyspigmentation than adults.
  • Topical corticosteroids showed limited efficacy in both groups; antibiotics were more effective in adults.
  • Ultraviolet B (UVB) phototherapy yielded high clearance rates in both children and adults, but relapse rates were higher in children.
  • Complete remission was achieved in only 20% of children versus 78% of adults after a median of 30 months.

Conclusions:

  • Pityriasis lichenoides in children tends to follow a more persistent and unremitting course than in adults.
  • Pediatric PL is characterized by wider lesion distribution, increased dyspigmentation, and reduced response to conventional therapies.
  • Findings underscore significant differences in PL presentation and prognosis between pediatric and adult patients.