Vititligo and my son

I was dianosed with vitiligo 2 years ago after many years of hairdressing and post child birth whenI had post partum hyperthyroid.  Luckily, it has stayed confined to my hands which suffered from all the haircoloring I had done.  My son is 22 months and he has two areas of hyperpigmentation on his face which I first noticed at 6 months.  I have taken him to several dermatologists and a top geneticist (to rule out cafe au lait spots and nf1) and they all determined that these were just hyperpigmentation areas.  I noticed the other day that my son has a area on his forehead (about the size of a dime) of lighter pigment.  I took him to a dermatologist who studied him under a woods lamp and told me that it looked like it was post inflammatory hypopigmentation. My vitiligo glowed under the woods lamp. My son's patch did not.  My only question is that I don't remember him getting hurt there.  He does have some mild eczema and had some really bad mosquito bites there.  The dermatologist said he was almost 100% sure it wasn't vitiligo.  Can a wood's lamp be pretty diagnostic?  How much of a greater chance does my son have of developing this?  I am the only one in my family to ever have this and I think alot of it was damage done by years of hairdressing.  One more question, is there any connection to the hyperpigmented areas and the new hypopigmented area?  The doctor gave him protopic 1% but  I am not using it because of the black box warning and my son's age.  Please help, I am so worried for my son.

[Alan Rockoff, MD]

Yes, the Wood's light examination is very reliable, and it showed what the doctor said it did--that what your son has is probably not vitiligo.  Also, the location you describe on your son is not typical for vitiligo but is common in eczema and other inflammatory conditions--even if you don't remember there being any inflammation there.

Vitiligo is very common.  In the vast majority of cases, it is not associated with autoimmune and other systemic conditions.  I really don't think you have anything to worry about.  As for treatment, my advice would be to let th spot on your son's forehead go away by itself, which it is likely to do, because it is does not sound as though it is vitiligo.

Take care.

Dr. Rockoff