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What does the appearance of small white spots on the back of the hand indicate?

Oct 17, 2023 Source: Cainiu Health
Dr. Liu Qingyun
Introduction
In general, the appearance of small white spots on the back of the hand may indicate that the patient could be suffering from miliaria, solar leukoderma, folliculitis, pityriasis alba, vitiligo, or other conditions. Patients are advised to follow medical guidance for symptomatic treatment. Additionally, such spots may also be associated with diseases such as pityriasis versicolor or psoriasis. If patients experience any discomfort or symptoms, it is recommended to seek timely medical evaluation at a hospital to avoid delaying diagnosis and treatment.

Under normal circumstances, the appearance of small white spots on the back of the hand may indicate that the patient could be suffering from miliaria (prickly heat), solar leukoderma, folliculitis, pityriasis alba, vitiligo, or other conditions. It is recommended that patients receive treatment according to medical advice based on their specific diagnosis. Detailed analysis is as follows:

1. Miliaria

Miliaria is a common superficial inflammatory skin condition occurring in summer or hot environments. If local hygiene is neglected, it may lead to the development of miliaria in localized areas, presenting as small white spots, pustules, and itching on the back of the hand. Patients may use calamine lotion or mometasone furoate cream under medical guidance for treatment.

2. Solar Leukoderma

Solar leukoderma results from repeated sun exposure, leading to clearly demarcated areas of pigment loss at exposed sites. It manifests as skin hypopigmentation, commonly affecting the face with indistinct borders, and may also present with the aforementioned symptoms. Patients may be treated under medical supervision with medications such as compound dexamethasone acetate cream or tacrolimus ointment.

3. Folliculitis

If a patient has folliculitis, papules typically appear; if not promptly treated, these may progress to pus formation and cause the symptoms described above. Under medical guidance, patients may use topical treatments such as mupirocin ointment or fusidic acid cream.

4. Pityriasis Alba

Pityriasis alba is often associated with Malassezia furfur, which can inhibit tyrosinase secretion in the body, leading to tyrosinase deficiency and consequently impairing melanin synthesis. This results in round or oval patches of pigment loss, potentially causing small white spots on the back of the hand. Some patients may also experience mild itching. Treatment under medical supervision may include medications such as levocetirizine hydrochloride granules or olapatadine hydrochloride tablets.

5. Vitiligo

Vitiligo is a common acquired depigmenting disorder affecting the skin and mucous membranes, possibly related to genetic and autoimmune factors. Patients may develop small white spots on the back of the hand. Under medical guidance, patients may use oral medications such as prednisone acetate tablets or levamisole hydrochloride tablets for treatment.

In addition, similar symptoms may also be associated with conditions such as pityriasis versicolor or psoriasis. If patients experience any discomfort, they are advised to seek timely medical evaluation at a hospital to avoid delays in diagnosis and treatment.

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