pigmentary disorders in children are somewhat different from those in the adults in terms of etiology ( pigmentary alterations due to genetic disorders are more commonly encountered in the children ) and heightened parental concerns . this study was undertaken to find out the pattern of hypopigmentary disorders in children in our population . this study was a descriptive study spanning over a period of 23 months , from august 2007 to june 2009 . all children ( up to 14 years of age ) attending the dermatology out patient department ( opd ) at our institution were screened for any cutaneous hypopigmentary lesions and those with any such lesion were included in the study after taking informed consent from the parents / guardians . a detailed clinical history was elicited with regard to patient 's age , gender , age of onset , site , familial involvement , associated skin and systemic conditions . detailed examination of the hypopigmentary lesion / lesions was done and findings were noted in terms of site , size , morphology of lesions , etc . general physical examination was done to see any associated cutaneous or systemic involvement and the relevant findings were recorded . a total of 113 children ( 61 boys and 52 girls ) were included in this study . the frequency of hypopigmentary disorders among children attending the dermatology opd was 3.28 per 1000 children . most common age group was 610 years contributing to 34 out of 113 ( 30.0% ) children , followed by 1114 years contributing to 32 out of ( 28.1% ) . most common hypopigmentary disorders in our study was pityriasis alba seen in 28 children ( 24.7% ) , followed by vitiligo in 23 ( 20.4% ) children , leprosy in 13 ( 11.5% ) , nevus depigmentosus in 11 ( 10.18% ) , and tinea versicolor in 7 ( 6.2% ) children [ table 1 ] . face was the most common affected site in 55 ( 28.6% ) children , followed by upper limb ( 23 children , 11.8% ) , lower limb ( 22 children , 11.3% ) , chest ( 20 children , 10.3% ) , back ( 18 children , 9.2% ) and abdomen . frequency of hypopigmentary disorders in different age groups sites of involvement of hypopigmentary lesions parental consanguinity was present in 41 ( 36.2% ) out of 113 children with hypopigmentary disorders . second degree consanguinity was present in 29 ( 25.6% ) children , and third degree consanguinity in 12 ( 10.6% ) children . family history was noted in four cases  one case of vitiligo had affected mother and sister , another case of vitiligo had affected grandfather , and two cases of bt leprosy had father having lepromatous leprosy . according to pinto and bolognia , the most common disorders of hypopigmentation in children are pityriasis alba , vitiligo , nevus depigmentosus , and tinea versicolor . in our study also , the most common hypopigmentary disorders were pityriasis alba , vitiligo , leprosy , nevus depigmentosus and tinea versicolor . leprosy in children is common in leprosy endemic countries like india ; thus , it has figured in the five most common disorders in children . sujatha et al . , in their study of 200 cases of pityriasis alba , found majority ( 69% ) of their cases below 15 years of age . itching was noted in 17 patients . personal history of atopy was noted in 34 ( 17% ) patients . in our study , pityriasis alba lesions occurred in the age range of 5 months14 years ( mean of 6.3 years ) . reported an incidence of 0.72% ( vitiligo was recorded in 90 children out of 346 cases of vitiligo ) . vitiligo vulgaris was the commonest type followed by segmental , focal , acrofacial and mucosal vitiligo . they noticed family history of vitiligo in 3 ( 3.3% ) children . in our study , vitiligo was seen in 23 children . vitiligo vulgaris was seen in 11 ( 47.8% ) cases , segmental vitiligo was seen in 8 children ( 34.7% ) , localized vitiligo in 2 girls , and lip - tip and lip vitiligo in one girl each . leprosy in children can be an indicator of disease prevalence in the general population and its detection helps in determining the disease transmissibility . kumar et al . , in their study , recorded the frequency of leprosy in children at 4.5% ( 61 out of 1360 new cases of leprosy )  most common type was borderline tuberculoid leprosy ( 78.7% ) followed by borderline lepromatous leprosy ( 8.2% ) , indeterminate leprosy ( 6.6% ) , lepromatous leprosy ( 4.9% ) and pure neuritic leprosy ( 1.6% ) . in our study , borderline tuberculoid leprosy was the commonest type followed by tuberculoid ( tt ) leprosy , and indeterminate leprosy . history of contact with lepromatous leprosy patients ( father ) was present in two children with bt leprosy ( paucibacillary ) , which is consistent with the finding of swain et al . , who noted that 57% cases of leprosy in children occurred from household contact with their father having lepromatous leprosy . in jena et al 's study of pityriasis versicolor in 271 children , majority of children were aged 812 years ( 31.7% ) , but 10 infants were also affected . face was the most affected site ( 39% ) and extensive involvement was seen in 45 ( 16.6% ) children with lesions on the back and shoulder . in our study , five children had lesions on the face , and the remaining two children had lesions on the chest , back and upper limb . medial canthi of both eyes were involved in two infants , which was a unique finding in our study . we noted lichen sclerosus et atrophicus in three boys who presented to us with depigmentation of foreskin of penis and phimosis . pityriasis lichenoides chronica ( plc ) may subside leaving behind hypopigmentation like we noted in three children in our study . lesions of plc were seen on the face , trunk , upper limb , thighs , and buttock . pigmentary mosaicism is characterized by hypo- or hyperpigmented lesions along the lines of blaschko . in our study , the lesion was well - defined , bizarre , roughly linear hypopigmentation with irregular margins unilaterally distributed over the right side of lower abdomen , inguinal region and over the lower limb . griscelli syndrome was seen in an 8-year- old girl who had generalized hypopigmentation of skin since birth .
background : hypopigmentary disorders are common group of dermatoses in pediatric age group.aim:to study the frequency and patterns of hypopigmentary disorders in children.materials and methods : this study was a descriptive clinical study spanning over a period of 23 months . a total of 113 children ( 61 boys and 52 girls ) were included in this study.results:the frequency of hypopigmentary disorders among children was 3.28 per 1000 children attending the dermatology out patient department . 
 the mean age of the children was 7.2 years . 
 the mean of age of onset was 7.36 years . 
 most common hypopigmentary disorder in our study was pityriasis alba ( 24.7% ) , followed by vitiligo ( 20.4% ) , leprosy ( 11.5% ) , nevus depigmentosus ( 10.18% ) , and tinea versicolor ( 6.2% ) . 
 others were hypomelanosis of ito ( 5 ) , post - inflammatory hypopigmentation ( 5 ) , pityriasis rosea ( 4 ) , steroid - induced hypopigmentation ( 4 ) , lichen sclerosus et atrophicus ( 3 ) , pityriasis lichenoides chronica ( 3 ) , lichen striatus ( 2 ) , oculocutaneous albinism ( 2 ) , tuberous sclerosis complex ( 2 ) , pigmentary mosaicism ( 1 ) , and griscelli syndrome ( 1).conclusion : pityriasis alba , vitiligo , leprosy , nevus depigmentosus and tinea versicolor are the five most common hypopigmentary disorders in children .