Vitiligo (vit-ill-EYE-go) is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin, the mucous membranes (tissues that line the inside of the mouth and nose and genital and rectal areas), and the retina (inner layer of the eyeball) are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo usually turns white.
Vitiligo shows no racial preference, but the distinctive patches are most prominent in blacks. Vitiligo doesn't favor one sex; however, women tend to seek treatment more often than men. Repigmentation therapy, which is widely used in treating vitiligo, may necessitate several summers of exposure to sunlight; the effects of this treatment may not be permanent.
Vitiligo is now believed to be an autoimmune disorder. An autoantibody to tyrosinase, the enzyme responsible for melanin synthesis, has been found in most patients.
Some link exists between vitiligo and other autoimmune disorders that it often accompanies - autoimmune thyroiditis, pernicious anemia, Addison's disease, and alopecia areata.
Signs and symptoms
Vitiligo produces depigmented or stark white patches on the skin; on fairskinned Whites, these are almost imperceptible. Lesions are usually bilaterally symmetric with sharp borders, which occasionally are hyperpigmented.
These unique patches generally appear over bony prominences, around orifices (such as the eyes and mouth), within body folds, and at sites of trauma. The hair within these lesions may also turn white. Because hair follicles and certain parts of the eyes also contain pigment cells, vitiligo may be associated with premature gray hair and ocular pigmentary changes.
Diagnosing vitiligo requires accurate history of onset and of associated illnesses, family history, and observation of characteristic lesions. Other skin disorders, such as tinea versicolor, must be ruled out.
In fair-skinned patients, Wood's light examination in a darkened room detects vitiliginous patches; depigmented skin reflects the light, and pigmented skin absorbs it. If autoimmune or endocrine disturbances are suspected, laboratory studies (thyroid indexes, for example) are appropriate.
The change in appearance caused by vitiligo can affect your emotional and psychological well-being. You may experience emotional stress, particularly if vitiligo develops on visible areas of you body, such as your face, hands, arms or feet. You may feel embarrassed, ashamed, depressed or worried about how others will react. Certain strategies may help you cope with vitiligo. Consider these tips:
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