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Background: Hypopigmentary and depigmentary lesions are frequently encountered in pediatric age group which can be alarming and distressing to parents. They may be insignificant or denote an underlying multisystem disorder. Hence, a thorough medical history, clinical, Wood’s lamp examination, and an interdisciplinary consultation may aid in the correct diagnosis of these dermatoses. Objectives: The objectives of the study were to study the various hypopigmentary and depigmentary dermatoses in children attending the outpatient department of a tertiary care center in South India. Materials and Methods: A descriptive study was conducted at the outpatient department of dermatology at the tertiary care center of South India, where 121 patients aged between 0 and 18 years presenting with hypopigmentary and depigmentary skin lesions from August 2018 to August 2019 were included in the study irrespective of gender. A detailed history, clinical examination, and basic investigations were done. Results: Out of 121 children included in our study, 67 (55.37%) were girls and 54 (44.62%) were boys. The mean age of the study group was 9.8 years. The most common dermatosis observed was pityriasis alba (28.9%), followed by primary disorders of hypopigmentation (vitiligo, lichen striatus, nevus depigmentosus, nevus anemicus, halo nevus, hypomelanosis of Ito, progressive macular hypomelanosis, and blaschkoid dermatitis), post-inflammatory hypopigmentation (19.8%), pityriasis versicolor (8.2%), Hansen’s disease (3.3%), and morphea (2.4%). Conclusion: The most common hypomelanotic dermatosis noted in the present study was pityriasis alba followed by primary disorders of hypopigmentation and depigmentation. Most of the dermatoses were either self-limiting or benign in nature and required only reassurance and managed with only medical line of management. These diseases may be the reason for undue concern and anxiety in parents; hence, a thorough evaluation and management of these dermatoses are necessary.

Lupus miliaris disseminatus faciei (LMDF), initially thought to be a tuberculid, is an uncommon independent clinicopathological entity characterized by asymptomatic erythematous papules over the face, usually encountered in young individuals and rarely in the extremes of age group. It was initially thought to be a tuberculid due to similar histopathological features between the two entities. LMDF has a spontaneously resolving course; however, due to its ability to cosmetically debilitate an individual, patients often seek a dermatologist's opinion. Various treatment options, such as oral tetracyclines, steroids, and retinoids, have been tried with varying results. Around 200 cases have been reported till date, and further studies are needed to understand the etiopathogenesis and management of this distinct dermatosis. We report a case of LMDF in a young lady who was started on oral minocycline and topical tacrolimus but was lost to follow-up. We hereby report this case for its rare occurrence. The present paper highlights the clinical importance of LMDF mimicking granulomatous facial dermatitis and the need for further laboratory investigations to rule out tuberculosis. This report reviews the available literature and presents a patient with LMDF. Biopsy done on one of the lesions over face showed epidermal atrophy, dermal perivascular and periadnexal inflammatory infiltrate, focal granulomatous inflammation with multinucleated giant cells, with the special stain for acid-fast bacilli being negative. These findings suggested LMDF. LMDF is a distinct granulomatous inflammatory dermatosis not associated with cutaneous tuberculosis.

Pachyonychia congenita (PC) is a rare autosomal dominant genodermatosis characterized by hyperkeratosis affecting the nails and palmoplantar areas, oral leucokeratosis, and cystic lesions. It is classically subdivided into two major variants, PC-1 (Jadassohn–Lewandowski syndrome) and PC-2 (Jackson-Lawler syndrome), according to the localization of the mutations in the KRT6A/KRT16 or KRT6B/KRT17 genes, respectively. We report a 9-year-old male patient with a history of thickened, discolored nails, raised spiny skin lesions all over the body since birth with focal plantar keratoderma and absence of natal teeth.