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Vitiligo

Overview

Vitiligo is a skin condition in which the skin begins to lose its color in the form of patches. It can occur anywhere on the body, but in most cases, it develops on hands, forearms, face, and feet. Vitiligo is not a painful or contagious condition. But this condition can affect your mental health because it can alter your appearance. Vitiligo is more prominent in people with dark skin than in those with light skin color. 

Causes

The exact cause of vitiligo is unknown. It has been noticed that it occurs due to the loss of melanocytes, the cells that produce melanin. Melanin gives our skin and hair its color. Loss or death of melanocytes in a particular skin area will lead to the formation of white spots or patches. Even the hair in that area will lose its color.

One theory is that vitiligo occurs as a result of an autoimmune process. In this case, the person’s immune cells destroy other cells of the body. This condition can be linked with genes as well. The exact cause of vitiligo is yet to be established. 

Types

Vitiligo can be divided into the following types based on its location:

  • Generalized: It can occur anywhere on the body. It is the most common type of vitiligo.
  • Segmental: This only affects one side of the body (face, arm, or leg). It is usually seen in children.
  • Focal: This only affects a particular skin area and does not follow a regular spread pattern.
  • Mucosal: In this type, white patches form on the mucosal lining inside the mouth and around the genitals.
  • Trichome: This presents with a small white patch in the center of a light-colored patch surrounded by normal skin.
  • Universal: In this case, more than 80% of the skin loses its natural pigmentation. This is a rare type of vitiligo. 

Risk Factors And Epidemiology

Since the exact causative mechanism of vitiligo has not been identified yet, it is difficult to determine who is at the highest risk. People with a family history of vitiligo have a greater chance of developing this condition at some point in their life.

Because it is considered a result of an autoimmune process, those with autoimmune diseases may also be at risk. Working or staying under harsh sunlight may also be responsible for the death of melanocytes in exposed skin regions.

Although it can occur at any age, it has seems vitiligo is more prominent among young females. Almost 1% of the global population is affected by this condition every year. 

Signs And Symptoms

The predominant sign of vitiligo is the development of white skin patches on your skin. It can occur in any area, but in most cases, it begins to develop on your face, hands, forearms, or feet. It progresses to other regions of the body within a few months. You may also notice a patchy color loss in your scalp hair, eyebrows, eyelashes, or facial hair. Small patches can also form on the mucous lining inside your mouth and around your genitals. The patches resemble normal skin texture in most cases, but they can have a burning sensation if you go under harsh sunlight.

Diagnosis

Vitiligo is typically diagnosed on the basis of its presentation. White patches spread around the body without any other apparent symptoms are a characteristic of vitiligo. Your doctor will ask about the onset and duration of your symptoms and family history. They will use a Wood’s lamp to differentiate vitiligo from other conditions. Other tests are only done if your doctor suspects an underlying autoimmune disease. 

Differential Diagnosis

Vitiligo needs to be differentiated from other conditions that cause loss of pigmentation in the skin. These diseases include albinism, chemical leukoderma, tinea versicolor, pityriasis alba, postinflammatory hypopigmentation, halo nevus, and tuberous sclerosis. 

Treatment

There is no actual cure for vitiligo yet. Treatment options that are available focus on improving skin pigmentation and limiting the spread of vitiligo. Your doctor will recommend the appropriate treatment based on your history and symptoms. It is done by camouflage therapy, repigmentation, phototherapy, or surgery. Your doctor may recommend a single treatment option or a combination method. Along with medical treatment, it is necessary to wear sunscreen 10 to 15 minutes before going out in the sun. Wear clothing that covers the majority of your skin and use hats or shades to protect the exposed skin of your face.

Medicines prescribed for vitiligo cannot halt the loss of melanocytes, but they can help gain your natural skin color back to some extent. Corticosteroids are prescribed in oral or topical forms. They can help to restore your skin shade and reduce inflammation if present.  Calcineurin inhibitor ointments are effective in those people who have small white patches in limited areas of skin. 

Prognosis

It is difficult to predict the prognosis of vitiligo. If you have a family history of this condition, the progression rate might be higher. Recovery is possible with treatment, but the process of vitiligo cannot be halted, and it can recur at any time. 

Prevention

There is no particular way to prevent vitiligo. Because its cause is unknown, it is difficult to take any precautions. However, if you have a family history or are prone to skin diseases, consult a dermatologist even if you develop mild symptoms. Practice protective measures against sunlight to prevent further damage to your skin. 

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