Skinrepublic

Dear Dr. Jen,

There are multiple white spots on my back.  My doctor said it is “ap-ap” and gave me some creams.  It has been a month already and it hasn’t gone away.  My neighbor, who is a nurse, seems to think it is vitiligo.  How exactly can you differentiate between the two?

Greg

Dear Greg,

Tinea Versicolor, locally labeled as “ap-ap” can present as whitish or brownish flat spots, with or without scales on the face, chest or back.  Vitiligo on the other hand is totally devoid of color and can even come off as paper-white.  Vitiligo can appear on any part of the body.

The best way to differentiate is of course to do a skin biopsy. However, this is costly and scarring.  The next best thing is to get some skin scrapings to check under a microscope.  Finding hyphae and spores will tell you what fungal infection it is. 

Take heart, your PDS dermas are all trained to look for the little clues that are giveaways to differentiating between vitiligo and tineaversicolor(“ap-ap”).  Clues such as the degree of whiteness, the absence or presence of scales, the borders and  the location of the lesions are all obvious to the trained eye. 

If you’ve been applying the anti-fungal creams for a month, the active fungal infection may be gone and it is just the color that takes more time to go back to normal.  Go back to your dermatologist for a follow up just to see if there are any remnants of an active infection.

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Dear Dr. Jen,

My baby keeps on getting rashes underneath her diaper. I’ve been applying petroleum jelly and sometimes it helps. Is there a way to avoid this?

Dina

Dear Dina,

Prolonged use of diapers on infants gives rise to diaper rash or diaper dermatitis when occlusion with a non-breathable material causes sweat and urine to irritate the skin.  It can also lead to further complications by causing a yeast infection such as candidiasis. 

Changing the diaper frequently can help decrease the time that urine or poop touches the skin. Washing the area with clean water and soap after every bowel movement also helps prevent any bacterial or yeast infection.  Lastly, application of diaper creams containing zinc oxide after every diaper change provides a barrier between the skin and the sweat or urine.  This helps protect the delicate skin of infants.

Once infection has set in, it is best to go see your dermatologist so the appropriate anti-fungal or anti-bacterial creams can be given.

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