Vitiligo is a common, slowly progressive, skin disease which results in depigmentation of the skin due to loss of the melanocytes, the color producing cells in the skin. It was present in 1 in 100 to 1 in 250 individuals in various studies. Vitligo affects all races and affects both sexes equally.
What is the Cause of Vitiligo?
The exact cause of vitiligo is not known. Three theories have been postulated for the destruction of the pigment bearing cells (melanocytes) in vitiligo.
- The Autoimmune Theory. These hypothesize that white blood cells which are responsible for the immune defense of the body mistakenly get activated against the melanocytes. They attack and destroy them in patches. Presence of vitiligo in association with some autoimmune diseases like Hashimoto’s thyroiditis, pernicious anemia, lupus erythematosus, alopecia areata and diabetes mellitus gives credence to this theory.
- The Neurogenic Hypothesis. Some neurological stimulus destroys the melanocytes. Psychoneuroimmunological effects of stress may be acting through this pathway to cause vitiligo.
- According to the Self Destruct Theory, melanocytes are destroyed by toxic by-products of melanin synthesis in the skin.
In most cases, vitiligo appears following a skin trauma, stressful period or other systemic illnesses. Genetically determined cytobiological changes are also proposed as a factor in the causation of vitiligo.
Is Vitiligo Inherited?
It is now becoming increasingly clear that certain genes passed on to successive generations are responsible for the vitiligo inducing tendency. Approximately 30% of patients give family history of vitiligo.
Is Vitiligo and Leucoderma (Leukoderma) One and the Same Disease?
Though vitiligo and leucoderma are used synonymously most of the time, they are not same. One can say that vitiligo is a type of leucoderma. There are many other diseases causing loss of skin color and leucoderma simply means ‘white skin’. Vitiligo secondary to chemical allergies and secondary to burns are called leukoderma.
What are the Common Sites of Involvement in Vitiligo?
Vitiligo patches appear most commonly at the elbows, knees, armpits, groin, forearms, around eyes and mouth, and in the anogenital area. Tips of fingers and toes, lips and the oral mucosa are also involved in most cases. In severe, advancing cases vitligo turns hairs also white.
What are the Skin Changes in Vitiligo?
Surprisingly, the texture and surface of skin is normal in vitiligo except for the ivory or chalky white color. In inflammatory vitiligo, the margins may be red and the skin itchy. Usually, though, there are no symptoms in vitiligo except the color change. Early skin lesions show an off-white color. A variant is the trichrome vitiligo where white color in the center has a light brown halo followed by dark brown margins.
What are the Types of Vitiligo?
There are many different types of vitiligo depending upon the extent, type and areas of involvement. The following are the types of vitiligo:
- Focal vitiligo, also known as Vitiligo Areata: A few, isolated white patches in various body areas.
- Acral or acrofacial Vitiligo: Loss of skin color on tips of fingers and toes, anogenital area and on face (lips, around eyes etc)
- Generalized Vitiligo: Usually symmetrical distribution generalized all over the body
- Segmental Vitiligo: Vitiligo patches limited to a segment of the body, usually in a dermatomal pattern (skin area supplied by a single nerve branch).
- Mucosal Vitiligo: Sometimes mucous membranes of the oral cavity and genitals are involved in vitiligo
Did Vitiligo Turn Michael Jackson White?
Yes, Michael Jackson was afflicted with vitiligo from his adolescent age. This became generalized and patchy so that he had to depigment his facial and other exposed skin so that the skin color was uniform.
Is Vitiligo Curable?
Vitiligo is not curable, but it is treatable. Vitiligo can be controlled with regular, systematic treatment. In a good number of patients it is possible to achieve good repigmentation. The repigmentation occurs through the stimulation of melanocytes in the nearby skin and the black hairs within the lesions.
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