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Pityriasis Alba

Pityriasis Alba is a topic covered in the 5-Minute Clinical Consult.

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  • Characterized by one or more poorly marginated, pale pink, or tan/white patches and plaques that commonly appear on the cheeks, neck, and lateral arms of children and young adults
  • Variants: classic (CPA: most common; endemic and atopic subtypes), extensive (EPA: teenagers, females > males, larger lesions >2 cm, trunk, shoulders, neck); pigmenting (PPA: only seen on dark skin, bluish lesions, 1.5-cm lesions, female > male, forehead, cheeks more common locations)
  • System(s) affected: skin/exocrine
  • Synonym(s): pityriasis streptogenes; pityriasis simplex faciei; impetigo sicca; pityriasis maculata; pseudoleucoderma atopicum


  • Ranges from 1.9% to 5.2%, more common in dark skin phototypes, male = female (some variants more common in females)
  • Predominant age: 90% of affected patients are aged 6 to 12 years; rare >25 years

Etiology and Pathophysiology

  • Possibly tyrosinase inhibition by Malassezia furfur, postinfectious inflammation leading to hypopigmentation, low levels of serum copper (important in melanin production) (1)
  • Atopic-dermatitis-related type likely due to eczema exacerbation and postinflammatory hypopigmentation (2)
  • Other implicated causes: xerosis, excessive sun exposure, inappropriate skin care, excessive washing which reduces skin defenses and protecting factors

  • Associated with carriers of a loss-of-function mutation in the gene for filaggrin, important for structural integrity and hydration of the epidermis
  • Mutations in this gene are also associated with atopic dermatitis.

Risk Factors

Young age, dark skin, atopic dermatitis, low socioeconomic status, overexposure to light, frequent bathing, exfoliation

General Prevention

No known preventive measures (Sun protection may minimize visibility of lesions.)

Commonly Associated Conditions

Atopic dermatitis

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Stephens, Mark B., et al., editors. "Pityriasis Alba." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116458/all/Pityriasis_Alba.
Pityriasis Alba. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116458/all/Pityriasis_Alba. Accessed August 19, 2019.
Pityriasis Alba. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116458/all/Pityriasis_Alba
Pityriasis Alba [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 August 19]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116458/all/Pityriasis_Alba.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pityriasis Alba ID - 116458 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116458/all/Pityriasis_Alba PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -