VITILIGO | WHAT CAUSES VITILIGO | VITILIGO IN SKIN

Vitiligo

Vitiligo is a condition in which white patches develop on the skin. Any location on the body can be affected, and most people with vitiligo have white patches on many areas. more topics here

Vitiligo is a loss of melanocytes that causes patches of skin to turn white.

• Patches of whitened skin are present on various parts of the body.

• Doctors usually base the diagnosis on the appearance of the skin.

• Corticosteroid creams, other drugs, or phototherapy plus light-sensitizing drugs may help repigment the skin, or, if needed, skin grafts may be used.

Vitiligo Causes and Risk Factors

The skin doesn't have its characteristic color because it has lost its melanin. For some reason, the pigment-forming cells known as melanocytes have been destroyed.

We don't know why this happens. It might be an autoimmune condition, where your body's defenses turn on your own cells instead of attacking invading germs.

Although vitiligo affects all races equally, it's more noticeable in dark-skinned people.

Vitiligo affects up to 2% of people all over the world

The cause of vitiligo is unknown, but it is a disorder of skin pigmentation that may involve an attack by the immune system on the cells that produce the skin pigment melanin (melanocytes). Vitiligo tends to run in families, or people may spontaneously develop it. Vitiligo may occur with certain other diseases. Vitiligo is associated with autoimmune disorders (when the body attacks its own tissues), and thyroid disease is the most common one. It is most strongly associated with an overactive thyroid ( hyperthyroidism, particularly when caused by Graves disease) and an underactive thyroid ( hypothyroidism, particularly when caused by Hashimoto thyroiditis). People with diabetes, Addison disease, and pernicious anemia also are somewhat more likely to develop vitiligo. However, the relationship between these disorders and vitiligo is unclear.

Vitiligo Types

Vitiligo is an autoimmune condition in which the pigment forming cells known as melanocytes are injured, resulting in white patches. The condition tends to progress and may even become universal. Vitiligo appears to affect all races equally but is more noticeable on those with darker skin.

 

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There are five types of vitiligo. Which type you have depends on where you have it.

Generalized is the most common type. This is when discolored patches show up all over your body.

Segmental is when your vitiligo is confined to one area of your body, like your face or your hands.

Focal happens when the discoloration stays in one spot and doesn't spread.

Trichrome is when there is an area of heavy discoloration, followed by an area of lighter discoloration, followed by regular-color skin.

Universal is a rare type. If you have this, at least 80% of your skin is discolored.

 

 

Melanocyte

Specialized cells called melanocytes produce the pigment melanin. Melanocytes originate from cells in the deepest layer of the epidermis called the basal layer.

Occasionally, vitiligo occurs after physical injury to the skin, for example, as a response to a chemical burn or sunburn. People may also notice vitiligo is triggered by an episode of emotional stress.

Vitiligo may cause considerable psychologic distress, especially in dark-skinned people.topics for health

 

 

Symptoms of Vitiligo

In some people, one or two well-defined patches of vitiligo appear. In other people, patches appear over a large part of the body. Rarely, vitiligo occurs over most of the skin surface. The changes are most striking in people with darker skin. Commonly affected areas are the face, fingers and toes, wrists, elbows, knees, hands, shins, ankles, armpits, anus and genital area, navel, and nipples. The affected skin is extremely prone to sunburn. The areas of skin affected by vitiligo also produce white hair because melanocytes are lost from the hair follicles.

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Vitiligo

The white spots on the ankle are vitiligo, which is caused by loss of skin pigment–producing cells (melanocytes).

Diagnosis of Vitiligo

• A doctor's evaluation

Vitiligo is recognized by its typical appearance. A Wood light examination is often done to help distinguish vitiligo from other causes of lightened skin. Other tests, including skin biopsies, are rarely necessary.

 

Treatment of Vitiligo

• Sun protection
• Cream containing a corticosteroid and calcipotriene or sometimes other substances applied to the skin (topical therapy)
• Phototherapy and psoralens
• Surgery
• Bleaching unaffected skin

No cure is known for vitiligo, and the disorder can be challenging to manage. However, skin color may return spontaneously. Treatment may be helpful. All affected areas of skin are at risk of severe sunburn and should be protected from the sun with clothing and sunscreen.

Topical therapy

Small patches sometimes darken (repigment) when treated with strong corticosteroid creams. Drugs may be applied to patches on the face or groin, where strong corticosteroid creams may cause side effects. Calcipotriene (also called calcipotriol), which is a form of vitamin D, blended with betamethasone (a corticosteroid cream), can be effective and is more effective than either cream used alone. Some people simply use bronzers, skin stains, or makeup to darken the area.

Phototherapy and psoralens

Because many people still have a few melanocytes in the patches of vitiligo, exposure to ultraviolet (UV) light in a doctor’s office (phototherapy) restimulates pigment production in more than half of them ( see Phototherapy). In particular, psoralens (drugs that make the skin more sensitive to light) combined with UVA light (PUVA) or narrowband UVB light treatment without psoralens can be given. However, phototherapy takes months to years to be effective and may need to be continued indefinitely. It can also lead to skin cancer. Doctors also use lasers on some people who have small patches that do not respond to corticosteroid creams.

A new class of drugs called Janus kinase inhibitors (or JAK inhibitors) are emerging as possible treatment options for vitiligo. However, depigmentation can recur after use of these drugs is stopped.

Surgery

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Areas that do not respond to phototherapy may be treated with various skin-grafting techniques and even transplantation of melanocytes grown from unaffected areas of the person’s skin. Tattooing is especially useful for areas where it is difficult to restimulate pigment production (such as the nipples, lips, and fingertips).

Bleaching

Some people who have very large areas of vitiligo sometimes prefer to bleach the pigment out of the unaffected skin to achieve an even color. Bleaching is done with repeated applications of a strong hydroquinone cream to the skin for weeks to 1 year or more. The cream can be extremely irritating. The effects of bleaching (such as permanent loss of pigment) are irreversible.

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