Skin Republic

Dear Dr. Jen,

My 10-year-old son has had a white mark on his arm since birth.  I've noticed that it has gotten bigger.  Should I be concerned that this is vitiligo?  I've seen it affect some children on the face and would like to prevent that from happening to my son.

Claire

Dear Claire,

A white lesion at birth can either be a white birthmark or a white mole.  Although rare, vitiligo may also appear at birth.  But judging from your description that the mark has gotten bigger, probably slowly and over a period of time, with no other areas being affected, it is not likely to be vitiligo.

If the birthmark isn't too noticeable and doesn't bother your child aesthetically, then there is no reason to intervene. However, if the mark bothers him a lot, then surgical excision is your best bet. If the area is too big, then you can discuss doing skin grafts with your surgeon. Best of luck!

Dear Dr. Jen,

I was recently diagnosed of chicken pox.  I was properly immunized when I was young.  Can you actually get chicken pox twice?  I've always remembered that you can only get it once and that's it.

Jason

Dear Jason,

Chicken pox or varicella, is caused by a varicella zoster virus (VZV).  When you get immunized, the first shot is given at one year old and the next shot is between four to six years old. Complete immunization "almost always" protects you from ever getting chicken pox.

Unfortunately, some people still get chicken pox in spite of the immunization.  They do have a better course though since the rashes are fewer, the fever is usually absent, and the patient recovers faster.  Uncomplicated chicken pox does not necessitate any treatment aside from relief of the itch and fever.  Acyclovir creams are ineffective in treating chicken pox.

Some doctors label shingles or zoster as a "second time chickenpox." Shingles is caused by the same VZV.  The VZV remains inactive in the nerve and comes out when a person's immune system is weakened.  Shingles has a different presentation from chickenpox because it only stays on one side and one part of the body. Chicken pox, on the other hand, has a generalized distribution over the body.

Shingles or zoster may need treatment depending on the part of the body involved (eyes or face) and the presence of other symptoms (pain).  If diagnosed too late, shingles may cause permanent damage as well. A prompt visit to your doctor may ease your anxieties about your condition.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0932 857 7070; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan.