Vitiligo By Dr. Shivani Verma (MD)

Vitiligo is a skin disease in which the skin loses its colour in patches due to depigmentation of body parts. Vitiligo can affect any body part which has pigment including skin, hair, inside mouth or in the eyes. Our body gets it colour from the pigment melanin and when the cells producing this die or stop functioning, Vitiligo develops. It is noncontagious and non-life threatening.

Signs and Symptoms of Vitiligo:

The only sign of Vitiligo is depigmented patches. The loss of colour depends on amount of pigment lost. The lesions may be chalky white or milky white or three colours may be seen in the same patch. They can occur anywhere on the body especially on pressure points.

Causes of Vitiligo

The exact cause of Vitiligo is still not known though the disease has autoimmune etiology with familial predisposition. Genetic factors are important because about 20-30% patients give positive family history.

Association Of Vitiligo With Other Diseases

Vitiligo may be associated with:

Cutaneous Disorders: 

alopecia areata, halo nevus, atopic dermatitis, malignant melanoma

Endocrine Disorders:

 Diabetes Mellitus, pernicious anemia, Addison's disease, Hypoparathyroidism, hypothyroidism, hyperthyroidism.

Patterns of Vitiligo

Vitiligo Vulgaris-

Most common type of Vitiligo, usually has positive family history

Segmental Vitiligo-

It is not associated with autoimmune disease. Depigmentation is restricted to one part of the body. Approximately 50%case involves skin in the distribution of trigeminal nerve.

Generalized Vitiligo- 

It has extensive lesions as described below:
acrofacial vitiligo-discolouration seen predominantly around orifices e.g. around eyes, lips and around palm and soles.

Lip-Tip Vitiligo-

lips, tip of penis, vulva and nipples are involved.

Vitiligo Universalis -

Almost whole of the body is involved. This type of vitiligo is usually associated with multiple endocrinopathies.

Diagnosis of vitiligo

The disease is self-diagnosed by the patches. A few features to be known are :
it is usually not present at birth
There are depigmented mules with scalloped borders.
predilection for site of trauma.

differential diagnosis of vitiligo

Leucoderma- 

It includes all depigmented lesions of the skin inclusive of vitiligo

Albinism- 

total absence of pigment in whole body since birth

Treatment- 

Reassurance and psychotherapy are most imp. Homeopathy has a remarkably good success rate in cases of leucoderma nevus achromicus - present at birth.
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