Photo:Vesnaandjic / Getty Images
Vesnaandjic / Getty Images
Vitiligo isa chronic disorder, often due to genetics or a change in the immune system, that causes patches of skin to lose its pigmentation, giving these areas a milky white appearance. These discolored areas typically grow larger over time and can appear on any part of the body. Treatments can impact the appearance or slow the spread of vitiligo, however, there is no cure. This disease affects all races and sexes equally and can develop at any age, although patches typically develop in about half of people with the conditionbefore the age of 20. Vitiligo occurs in between.5 and 1% of the global populationand it is not contagious or life-threatening.
The first appearance of a description of a disease that is believed to be vitiligo appears in the Hebrew version of the book ofLeviticus from the Old Testament, which is dated to around 1280 B.C. However, a subsequent Greek translation of the text changed the word to leprosy as the diseases were often grouped together at the time. Vitiligo also appears in an ancient Egyptian medical text called theEbers Papyrusfrom around 1550 B.C.
Vitiligo is a chronic disease that causes patches of depigmented skin to appear on the body, often due to genetics or a change in the immune system.
Vitiligo Symptoms
The onlysymptom of vitiligois the appearance of patches of depigmented skin, called macules. These appear most often on the extremities, although they can occur anywhere. Macules are small to begin with, but typically will grow and change shape over time. The edges of the patch can appear smooth or irregular. Some people experience itching before a new patch appears. If you have vitiligo on a part of the body that has hair on it, the hair may turn white or silver as well.
Types of Vitiligo
Non-Segmental Vitiligo
Non-segmental vitiligois the most common type of vitiligo, affecting about9 in 10 peoplewith the condition. With non-segmental vitiligo, there is usually a symmetry in the location of the depigmented patches. New patches appear over time and can either cover large portions of the body or be contained to particular areas. People can develop non-segmental vitiligo at any age.
There are different classes of non-segmental vitiligo:
Segmental Vitiligo
Causes of Vitiligo
Vitiligo is also sometimesassociated with autoimmune and inflammatory diseases, such as Hashimoto’s thyroiditis, scleroderma, rheumatoid arthritis, type 1 diabetes mellitus, psoriasis, Addison’s disease, pernicious anemia, alopecia areata, systemic lupus erythematosus, and celiac disease.
Westend61/Getty Images
Complications from Vitiligo
Sensitive Skin
Due to the lack of melanocytes in the skin, these depigmented patches can become more sensitive to sunlight exposure which can lead to sunburns or even skin cancer.
Eye Abnormalities
Hearing Loss
Those diagnosed with vitiligo can experience partial hearing loss due to the loss of cochlear melanocytes.
Predisposition to Autoimmune Conditions
Those with vitiligo can also be more likely to get an autoimmune condition, such as hypothyroidism, diabetes, and anemia.
Mental Health Struggles
People with vitiligo can become embarrassed or self-conscious over their appearance, leading to anxiety and depression which can become exasperated as they continue to socially isolate themselves due to the disease.
Diagnosis
Reproduced with permission from © DermNet New Zealand and © Dr. Lawrence Meyerson www.dermnetnz.org 2023.
Treatment
Applying topical steroids has proven to be moderately beneficial and is typically the primary recommended form of treatment. Immune suppressing medications such asglucocorticoidsandcalcineurin inhibitorsare most often prescribed, and in July 2022 the creamruxolitinibwas approved in the United States for the treatment of vitiligo. It is the first FDA-approved pharmacologic treatment to address repigmentation in vitiligo patients.
Phototherapyis the second most-recommended treatment involving exposing the affected skin to UVB lamps or medical-grade lasers. Sessions are done two to three times a week and can take anywhere from a few weeks to a few months to show signs of improvement. Phototherapy comes with the potentially deadly side effect of developing skin cancer due to the increased exposure to UVB light.Epidermal graftinghas also become a popular procedure to reduce the appearance of macules, especially amongst those who have proven resistant to non-surgical treatments. Using this procedure, the damaged melanocytes causing the vitiligo are replaced using either tissue grafting or cellular grafting techniques. The first type of graft involves transferring the skin tissue as a whole to the depigmented area, while the second requires further breaking down the skin graft into its cellular components and then applying that to the affected spot.In mild cases, vitiligo can be covered with makeup and other full-coverage cosmetics.Vitiligo is typically permanent; however, around10 to 20% of people with vitiligo fully regain their skin pigmentation.This occurs most often amongst those who receive a diagnosis before the age of 20, have symptoms primarily in the area of their face, and who experience the peak of the condition spreading within six months or less. This is less likely to occur in those over the age of 20 or with macules on their lips, limbs, or hands.
source: people.com
