What is Vitiligo?
Vitiligo is a long-term skin pigmentation disorder characterized by loss of melanin in which pale white patches develop on the skin in different body parts.
What Causes Vitiligo?
The particular cause of vitiligo remains unknown, but several researchers have hypothesized different theories linking to the development of the disease. Vitiligo is an autoimmune disease through which people’s bodies produce proteins known as cytokines that trigger autoimmune reactions to destroy the pigment-producing cells in the skin (melanocytes) causing depigmentation.
Evidence supports that vitiligo is a genetically inherited disease in which defective genes are passed from parents to children. Although it is not proven scientifically, reports show that events of emotional distress or exposure to skin allergens and irritants such as industrial chemicals and sunburn may trigger the onset of vitiligo.
Who is at Risk?
Vitiligo affects millions; that is, about 0.5 -1 % of people around the world. It affects both males and females of all races equally, but it is more noticeable among people with dark skin. Vitiligo may appear at any age; however, nearly half of the people get the disease in their mid-twenties.
The increased risks of developing vitiligo include people with family history of the disease. Other people are more likely to get the disorder vitiligo in association with certain autoimmune diseases such as hypothyroidism, alopecia areata (patches of baldness), adrenocortical deficiency, and pernicious anemia (low levels of red blood cells caused body dysfunction in absorbing vitamin B12).
Symptoms
The onset of vitiligo is commonly manifested by symptoms of patchy loss of skin color, discoloration or depigmentation. Typically, depigmentation appears as white patches that first show on sun-exposed areas of the skin including the face, lips, feet, hands, and arms. The white patches may also appear in other body parts such as eyes, nostril, around the mouth, armpits, groin, navel, genitals, and rectum.
The affected areas of the skin by vitiligo may sometimes cause graying or premature whitening of the hair on the scalp, beard, eyelashes or eyebrows. The discolored patches may be limited to one or few body areas (localized) or scattered in many body parts (generalized) in which they only affect one side of the body (segmental or unilateral) or systematically on both body sides (nonsegmental or bilateral) patterns.
Diagnosis
The dermatologists will base the diagnosis using the results of the physical exams related to the white patches of the skin (depigmentation), particularly on sun-exposed areas of the body. In case of a suspected case of vitiligo, the dermatologists may request for your medical history or ask you about your family’s history of vitiligo, auto immune diseases, whether exposed to industrial chemicals, sunburn, or other skin trauma before the onset of depigmentation. Skin biopsy on the affected areas helps to identify the presence of pigment-producing melanocytes to confirm the diagnosis of vitiligo. Blood tests may be performed to determine if you have another autoimmune disease that commonly concurs together with vitiligo.
Treatment and Prevention
The treatment options for vitiligo primarily aim to restore the skin color (re-pigmentation), improve appearance, and prevent the widespread of white patches to the unaffected body parts. Some of the current treatment options include topical medications using corticosteroid creams and ointments containing tacrolimus or pimecrolimus (calcineurin inhibitors). Light and psoralen photochemotherapy may also help re-pigment the discolored patches of the affected skin using ultraviolet A (UVA), UVB light or excimer light.
In the cases of a widespread vitiligo, removing the remaining skin color (depigmentation) therapy and surgeries such as micro-pigmentation, blister grafting, and skin grafting are effective when other treatment options do not work. Cosmetics and sunscreens are also vital skin care remedies to help minimize sun exposure and protection against both AVA and UVB light among vitiligo patients. Counseling and support groups help the affected people in coping with vitiligo through reducing emotional distress, adherence to the treatment regimens, and prevention measures against exposure to allergic products such as industrial chemicals or synthetic fabrics.
References
American Academy of Dermatology. (May 2010). Vitiligo. Retrieved 8th, September 2017. https://www.aad.org/public/diseases/color-problems/vitiligo
Mayo Clinic Staff. Vitiligo. May 2017. Retrieved 8th, September 2017. http://www.mayoclinic.org/diseases-conditions/vitiligo/home/ovc-20319041
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (October 2016). Vitiligo. Retrieved 8th, September 2017 from https://www.niams.nih.gov/health_info/Vitiligo/default.asp
