Vitiligo

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Vitiligo
SpecialtyDermatology Edit this on Wikidata

Vitiligo (IPA /ˌvɪtəˈlaɪgo/) or leukoderma is a chronic skin condition that causes loss of pigment, resulting in irregular pale patches of skin. The precise etiology of the disease is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic and environmental factors. The population incidence in the United States is between 1% and 2%.

Symptoms

Half of vitiligo patients develop signs of the disorder before the age of 20, with patches of de-pigmented skin appearing on extremities. The patches may grow or remain constant in size. Patches often occur symmetrically across both sides on the body (see photo above). Occasional small areas may repigment as they are recolonised by melanocytes. The location of vitiligo affected skin changes over time, with some patches re-pigmenting and others becoming affected.

In some cases, mild trauma to an area of skin seems to cause new patches - for example around the ankles (caused by friction with shoes or sneakers). Vitiligo may also be caused by stress that affects the immune system, leading the body to react and start eliminating skin pigment.

Vitiligo on the scalp may affect the color of the hair (though not always), leaving white patches or streaks. It will similarly affect whiskers and body hair.

Psychological effects

Vitiligo can have a significant effect on the psychological well being of the patient. This is especially true for darker skinned patients as the contrast between pigmented and depigmented skin can be quite drastic.

In some cultures there is a stigma attached to having vitiligo. Those affected with the condition are sometimes thought to be evil or diseased and are sometimes shunned by others in the community. People with vitiligo may feel depressed because of this stigma or because their appearance has changed dramatically.

Other people with vitiligo experience no negative psychological effects at all.

Treatment

File:Girlwithvitiligo.jpg
Sharni Kaur, right, and her mother, Roop Singh. Sharni has had vitiligo, which causes her skin to lighten, since she was nine years old.

There are a number of ways to alter the appearance of vitiligo without addressing its underlying cause. In mild cases, vitiligo patches can be hidden with makeup or other cosmetic solutions. If the affected person is pale-skinned, the patches can be made less visible by avoiding sunlight and the sun tanning of unaffected skin. However, exposure to sunlight is preferable in the long run, because it helps the melanocytes regenerate to allow the pigmentation to come back to its original color.

Repigmentation therapies to remove the white patches include corticosteroids, calcineurin inhibitors, ultraviolet light and surgery, but they are not very effective. Current treatments include exposure to Narrow Band UV-B light, which seems to blur the edges of patches, and lightly freckling the affected areas. Immunomodulator creams are believed to cause repigmentation in some cases, but there is no scientific study yet to back this claim. If repigmentation fails, the patient can opt for chemical depigmentation, which uses 20% monobenzylether of hydroquinone. This process is irreversible and generally ends up with complete or mostly complete depigmentation.

In late October of 2004, doctors successfully transplanted melanocytes to vitiligo affected areas, effectively repigmenting the region. The procedure involved taking a thin layer of normally pigmented skin from the patient's gluteal region. Melanocytes were then separated out and used to make a cellular suspension. The area to be treated was then ablated with a laser, and the melanocyte graft applied. Three weeks later, the area was exposed to UV light repeatedly for two months. Between 73 and 84 percent of patients experienced nearly complete repigmentation of their skin. The longevity of the repigmentation differed from patient to patient.

Alternative treatments

Alternative medicine such as homeopathy has gained popularity in the treatment of vitiligo.[citation needed] Homeopathy attempts to both control the underlying process of melanin destruction as well increasing melanin production. Early and segmental vitiligo is reported as responding better to homeopathy, while cases with extensive spread and especially where affecting the muco-cutaneous junctions such as lips, finger-tips, and genitals do not respond to homeopathic treatment, as documented by Dr Rajesh Shah, M.D., who has treated over 1000 cases of vitiligo.[citation needed]

Support Organizations

Support groups and organizations are available to help people learn more about the disorder, understand treatment options, and find support from other patients.

The largest vitiligo organization in the world is Vitiligo Support International, a nonprofit organzation that provides online message boards, chat rooms, information, articles. The group advocates on behalf of patients, conducts patient conferences and has local support groups. Their website is at www.VitiligoSupport.org.

The American Vitiligo Research Foundation Inc. (AVRF) is a non-profit, tax-exempt charity that aims to increase public awareness about vitiligo and to help those afflicted by the disease, focusing specifically on children and their families. It supports finding a cure through alternatives to animal testing.

Famous patients

  • Michael Jackson, famous singer/songwriter, was diagnosed with vitiligo in 1984
  • Graham Norton, famous TV presenter/comedian, developed vilitigo in 1988 after being stabbed whilst at Drama School in London. He has tell-tale white patches in his hair as a result.
  • Joe Rogan, actor/comedian and host of Fear Factor, is known to have the disease
  • Rigo Tovar, famous Mexican musician/singer, was diagnosed with it late in his life
  • John Henson, semifamous host of Talk Soup on E Entertainment Network earned his nickname "skunk boy" at least in part because of a stripe of white hair vitiligo created in his scalp above the right temple.

See also

  • Alphos, the skin leprosy originally called vitiligo.
  • Albinism, a genetic condition resulting in a lack of pigmentation in the eyes, skin and hair.

References

  • Grimes PE (2005). "New insights and new therapies in vitiligo". JAMA. 293 (6): 730–5. PMID 15701915.
  • Handa S, Kaur I (1999). "Vitiligo: clinical findings in 1436 patients". J Dermatol. 26 (10): 653–7. PMID 10554431.
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