Ted Rosen, MD: Seborrheic Dermatitis, Tinea Versicolor, Other Conditions Resembling Vitiligo

In his HCPLive interview on his SDPA 20th Annual Fall Dermatology Conference presentation, Ted Rosen, MD, spoke about common conditions that can resemble vitiligo, as well as what areas of research he believes should be further explored.

Rosen serves as Professor and Vice-Chair of Dermatology at Baylor College of Medicine. His presentation was entitled ‘It's not always Vitiligo.’

The presentation given by Rosen at SDPA featured a description of mundane and rare diseases and disorders with white spot presentation, helping participants to build a broad differential diagnosis for white skin spots and finding out more about the right diagnostic maneuvers or interventions for these cases.

“Let’s consider, in the 3 major groups, the things that can often be mistaken for vitiligo,” Rosen said. “Some of the common things might be seborrheic dermatitis in dark skin. It often presents with loss of pigment, which can be minimal or it can be quite extensive. The clinical clue is that it’s in the seborrheic area, like down the nasolabial folds, on the supraorbital ridges, and it might scale and it might itch. And neither scale nor itching are common in vitiligo.”

Rosen also referred to the fungal infection known as tinea versicolor, which he describes as a condition that may result in white spots for patients. In addition to his discussion about more common things mistaken for vitiligo, Rosen described a few of the less common conditions.

“Then we have a couple of really important, less common disease states which can look very very much like vitiligo,” he said. “And the 2 that I mentioned most prominently included hypopigmented sarcoidosis and hypopigmented cutaneous T-cell lymphoma, or hypopigmented mycosis fungoides, equivalent terminology.”

Rosen described the way in which sarcoidosis can look and feel exactly like vitiligo, most common among women in their 20s to their 40s at onset, although only a biopsy will establish accuracy.

He also highlighted certain skin conditions considered to be less common that may present in a similar way to vitiligo, although he questions how rare the conditions actually are.

“We should think about extremely rare things, but are they rare or are they going to be rare?” Rosen said. “Items that fall in this category could consist of things like pinta, which is an infection due to Treponema that’s endemic in Mexico, Central, and the northern part of South America.”

View the full interview segment above for more on Rosen’s SDPA 2022 Conference presentation.