Vitiligo is an acquired skin disorder characterized by white spots. It is the total absence of pigment-producing cells in the skin called melanocytes.
Who Gets Vitiligo?
Vitiligo appears to affect at least 1% to 2% of the population, irrespective of sex, race, or age. The more dark skinned a person is, the more their vitiligo stands out, because of the contrast between affected and unaffected areas of skin. Hence, there is a higher prevalence of vitiligo in countries with darker-skinned populations.
In half of all vitiligo cases, onset occurs between the ages of 10 and 30. There are a few reported cases of vitiligo present at birth. Vitiligo in old age also rarely happens.
Both genetic and environmental factors contribute to vitiligo. Many patients attribute the onset of their vitiligo to physical trauma, illness, or emotional stress. Often mentioned is the emergence following the death of a relative or after severe bodily injury. Even sunburn reaction may precipitate vitiligo.
White Vitiligo Spots
The typical vitiligo macule is chalk white and has convex margins. It is usually 5mm or more in diameter. It is round, oval, or elongated in shape.
The disease progresses by gradual enlargement of each macule and the development of new white spots on various parts of the body.
Where Does Vitiligo Appear On The Body?
Generalized vitiligo is the most common type of vitiligo. In this type, there is a widespread distribution of white macules, often in a symmetrical array.
Focal vitiligo appears as one or more macules on a single site. In some cases, this may be an early evolutionary stage of one of the other forms of the disease. Typical macules occur in the elbows, fingers, lower back, genital area, and knees.
The segmental type, which is uncommon, features one of several macules on one hand or one side of the body.
Not All White Spots Are Vitiligo
Few conditions are as patterned and symmetrical as vitiligo. Sometimes, the spots match on both extremities in a mirror-image.
Woods light examination detects all the spots, especially in fair-skinned persons. In certain severe cases, a skin biopsy may confirm the diagnosis. A defining feature is that pigment cells in the skin are absent in vitiligo.
Vitiligo is sometimes a result of general diseases, such as thyroid disease among others. Associated cutaneous conditions include white hair and grey hair, alopecia areata, and halo nevi. There is no increased risk of malignancy. Skin cancers appear to be unusual.
An eye examination may reveal evidence of healed chorioretinitis or iritis. Vitiligo does not affect vision, and there are no critical hearing changes. Laboratory studies for detection of general diseases associated with vitiligo include:
Thyroid profile: especially TSH (radioimmunoassay)
Fasting blood sugar (to rule out diabetes)
Complete blood count with indices (to rule out pernicious anemia)
Why Does Vitiligo Develop?
Vitiligo results from many factors. The mechanism involves the progressive destruction of selected melanocytes by cytotoxic T-cell lymphocytes
How Much Vitiligo Will You Develop?
Vitiligo is a chronic disease process. Its course is variable and unpredictable. Rapid onset followed by a period of stability or low progression is most characteristic.
Some vitiligo patients report some spontaneous re-pigmentation, particularly in sun-exposed areas. Treatment of vitiligo-associated diseases doesn’t produce re-pigmentation in areas discolored by vitiligo.