Vitiligo

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What is vitiligo?

Vitiligo is a commonly seen condition in which areas of skin lose their pigmentation, resulting in white patches. Vitiligo is a non-contagious condition and can occur at any age and primarily affects the skin of the face, hands, feet, and genitals. White patches disease can affect any race or ethnicity, it tends to be more noticeable in people with darker skin.

Alternate name

  • White patches disease

Is vitiligo a medical emergency?

White patches disease is not a medical emergency.

Types of vitiligo

White patches disease may be of the following types:

  • Segmental vitiligo: In most of the cases it presents as one single patch affecting one side of the body. Very few patients have a second segment. The commonly affected sites are head and neck region, the trunk and extremities. The affected site will enlarge rapidly to the maximum size and seldom progress further. Segmental Vitiligo is seldom associated with autoimmune disorders.
  • Non-segmental vitiligo: White patches disease can affect different proportions and areas of the body (focal, generalized, or universal) often following asymmetrical and bilateral in distribution.

Causes of vitiligo

The most common causes of white patches disease may be related to:

  • Autoimmune disorder: The immune system attacks and destroys the melanocytes in the skin resulting in loss of pigmentation
  • Family history (heredity)
  • Other causes: Physical trauma or stress to the skin like a sunburn or exposure to industrial chemicals seems to trigger vitiligo or at least precedes it

Risk factors for vitiligo

White patches disease can affect almost anyone from infants and children to the elderly, and it can occur in both males and females. The risk of vitiligo is higher in individuals:

  • Family history
  • People with thyroid disease
  • Type 1 diabetes mellitus
  • Autoimmune disorders like Hashimoto thyroiditis or alopecia aerate
  • An individual with frequent and prolonged exposure to the sun 

Signs & symptoms of vitiligo

The progress of white patches disease varies from person to person. The following may be seen in White patches disease:

  • Light or depigmented spots appearing on the skin. The spots can show up anywhere on the body, though they usually first appear in areas that are exposed to sun exposure, such as on the face, arms, and hands.
  • Spots can also appear in the groin area, in the armpits, and around the belly

Other signs of vitiligo, may include:

  • Hair turning gray or white prematurely
  • Eyelashes or eyebrows losing color and turning white
  • Change of color in the retina of the eye
  • Color loss in the nose and mouth

Investigations

The following are done as part of investigations for White patches disease and include a thorough physical examination and medical history including a detailed family to rule out hereditary causes and other diseases like Psoriasis and dermatitis.

Laboratory tests: May include blood tests to evaluate other underlying medical conditions like diabetes and anemia.

Skin biopsy: A biopsy of the hypopigmented skin is done.

Diagnosis of vitiligo

A diagnosis of vitiligo is established based on medical history, clinical evaluation, and results of the investigations done.

Vitiligo treatment options

Treatment of vitiligo is aimed at making the color of the skin look even and depends on the number of white patches and how widespread the patches are:

A. Medical treatment

  • Topical Medicines (topical steroids): That are applied to the skin
  • Oral Medicines such as steroids
  • A treatment that uses medicine plus ultraviolet A (UVA) light (PUVA)

B. Surgical treatment

Interventional management of vitiligo may include the following:

  • Skin grafts from a person's tissues
  • Tattooing small areas of skin

Other treatments

  • Sunscreens
  • Cosmetics, such as makeup or dye, to cover the white patches

C. Role of diet/physiotherapy/lifestyle/prevention

Counseling and support may be required for some individuals with vitiligo to help them cope with the condition.

Complications of vitiligo

White patches disease affects the physical appearance of individuals which in turn can impact a person’s quality of life by creating extreme emotional stress, depression, and suicidal thoughts.

Prognosis

Although there is no cure for the disease, the available treatments may stall the progression of the disease and induce varying degrees of repigmentation with acceptable cosmetic results in many cases.

When to contact the doctor/how to identify the complications?

Medical consultation is always recommended after noticing symptoms of vitiligo.

Indications for hospitalization if required

Hospitalization is not required for the management of white patches disease.

Suggested clinical specialists/department to consult for this condition

  • Dermatology
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