Vitiligo is an acquired, idiopathic progressive whitening of skin and hair, caused by the destruction of pigment-producing cells called melanocytes.
- It Affects 1-2 % of population irrespective of age, sex and race.
- 50% begin before age 20·
- There is no definite mode of inheritance but genetic and environmental factors contribute to vitiligo.
- People from families increased the prevalence of Thyroid diseases, Diabetes and other autoimmune diseases are at risk for vitiligo.
- Many patients attribute vitiligo to precipitating factors such as physical trauma, illness, emotional stress etc.
- The typical vitiligo macule is chalky white in color often showing depigmented hair distribution.
Frequently it occurs on the exposed areas dorsal surface of hand, elbows, feet, legs, knees, neck and face or on the chest wall, lower back and areola.
- Pre-tibial region, plantar and palmar region is most commonly affected in India.
- The distribution is most or less symmetrical.
- Vitiligo Vulgaris is the common type of vitiligo.
- Bilateral, symmetrical; macules predominantly on the hands, feet, generally fingers, toes and face, is a subtype called Acro-facial vitiligo.
Vitiligo again is of 3 Types:
- Generalized vitiligo
- Focal vitiligo
- Segmental vitiligo
Generalized is widespread of macules in a symmetrical array.
Focal vitiligo is one or more macules on a single site or sometimes early evolutionary stage of other forms of the disease.
Segmental vitiligo is uncommon is characterized by several macules on one side of the body.
The change in appearance caused by vitiligo can affect the emotional and psychological well being.
It can be emotional stress if vitiligo develops on visible areas, faces, hands, arms or feet.
There is a rapid advancement in the field of treatment for vitiligo.
Treatment depends on:
- Age of the patient
- The extent of the body involved
- Pattern of vitiligo
- Cosmetic disability
- Psoralens and UVA therapy (somewhat older method of treatment)
- Narrowband UVB therapy (safe and effective method)
- Excimer laser
- Topical corticosteroids and oral steroids
- Placental extract preparations
- Surgical methods.