Definition Vitiligo is a skin disorder characterised by the development of completely white patches of skin.
What is going on in the body? While the cause of vitiligo is unknown, there is some thought that it is an autoimmune disorder, or one in which the person's body attacks its own cells for unknown reasons. In a person with vitiligo, it is thought that the body attacks its own melanocytes, or pigment-producing cells. The white patches of skin found in people with vitiligo have completely lost these melanocytes.
What are the signs and symptoms of the disease? Signs and symptoms of vitiligo include:
chalk white areas without any skin pigment
no pain or itching
lesions more prominent over bony areas, around skin folds, the eyes, and mouth or at sites of injury to the skin
patches that are usually uniform in shape
What are the causes and risks of the disease? Vitiligo occurs in all age ranges and all races. There is a some evidence of a genetic link, since 30% of people have a close blood relative with vitiligo. This skin disorder is associated with thyroid disease in about 30% of cases. It is also associated with:
stress, such as surgery, injury, loss of a job, or chemical spills
What can be done to prevent the disease? Prevention of vitiligo depends on its underlying cause. With careful management of such conditions as diabetes or thyroid disease, the risk of vitiligo may be reduced. In many cases, vitiligo cannot be prevented.
How is the disease diagnosed? The first step in the diagnosis of vitiligo is a past medical history, family history, and physical examination. A doctor will want to know when symptoms started and what may have occurred before symptoms started. A special examination with a Wood's light may reveal areas of skin without pigmentation. Blood tests, such as thyroid function tests or blood glucose tests, may help in finding underlying causes to this condition.
What are the long-term effects of the disease? The pigment loss of vitiligo may continue, and can be disfiguring. However, many people will go for years with stable pigment loss. Pigment can return by itself and with the help of treatment.
What are the risks to others? Vitiligo is not contagious. Other family members are at higher risk of developing vitiligo because of shared genetic factors.
What are the treatments for the disease? Treatment for vitiligo may include:
topical corticosteroid creams and exposure to UVA rays or sunlight
the use of light sources in combination with medications that sensitise the skin to that light (photochemotherapy)
mini grafting, a surgical procedure to transfer tiny areas of pigmented skin into areas with pigment loss
removing skin colour from normal skin in order to unify the overall colour of skin
What are the side effects of the treatments? Side effects to treatment will depend on the treatment used. Side effects to photochemotherapy may produce skin burns. Oral medication can cause stomach upset. Removing pigment is permanent and not to be done as a minor temporary measure. It may cause severe sun sensitivity. Mini grafting can cause scarring and less than complete repigmentation.
What happens after treatment for the disease? Recurrence or new sites of pigment loss are common. Follow-up with a doctor and monitoring white spots on the skin may continue throughout life.
How is the disease monitored? Any new or worsening symptoms should be reported to the doctor.
Author: Lynn West, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 21/03/2005 Contributors Potential conflict of interest information for reviewers available on request
