Vitiligo

                  

          Vitiligo

Vitiligo (vit-ill-eye-go) is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin, the tissues that line the inside of the mouth and nose and genital and rectal areas (mucous membranes), and the retina of the eyes 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 may turn white.

The cause of vitiligo is not known, but doctors and researchers have several different theories. One theory is that people develop antibodies that destroy the melanocytes in their own bodies. Another theory is that melanocytes destroy themselves. Finally, some people have reported that a single event such as sunburn or emotional distress triggered vitiligo; however, these events have not been scientifically proven to cause vitiligo.

Vitiligo seems to be more common in people with certain autoimmune diseases (diseases in which a person's immune system reacts against the body's own organs or tissues). These autoimmune diseases include hyperthyroidism (an overactive thyroid gland), adrenocortical insufficiency (the adrenal gland does not produce enough of the hormone called corticosteroid), alopecia areata (patches of baldness), and pernicious anemia (a low level of red blood cells caused by failure of the body to absorb vitamin B12). Scientists do not know the reason for the association between vitiligo and these autoimmune diseases. However, most people with vitiligo have no other autoimmune disease.

Vitiligo may also be hereditary, that is, it can run in families. Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder.

 Types of Vitiligo

There are three main types of vitiligo:

• Generalized Pattern Vitiligo
• Segmental Pattern Vitiligo
• Focal Pattern Vitiligo

Generalized Pattern Vitiligo

The skin disorder, Vitiligo is an autoimmune disease that can happen to anyone, regardless of age, gender, and ethnicity. In this pigmentation disorder, the melanocytes (cells that make pigment) in the skin are destroyed, causing white patches to appear on the skin. These patches can appear anywhere on the body, especially on areas that are more exposed to the sun, such as hands, arms, feet, face and neck. There are mainly three patterns of Vitilgo, and the most common one is Generalized Pattern Vitiligo. Generalized Pattern Vitiligo is listed as a type, and is proportional on both sides of the body.

Segmental Pattern Vitiligo

Vitiligo is a skin condition which is caused by the malfunctioning or loss of cells, called melanocytes, which give color to the skin. The loss of melanocytes results in smooth, white patches in the middle of normally pigmented skin. Vitiligo, or leucoderma, is a common skin disorder, which is usually inherited, and can affect anyone anywhere. There are two main types of vitiligo patterns: segmental and non-segmental (generalized). The non-segmental pattern of vitiligo is very common among people and causes depigmentation to occur symmetrically on both sides of the body, whereas in Segmental Pattern Vitiligo, depigmented patches develop on only one side of the body.

Focal Pattern Vitiligo

Focal Pattern Vitiligo is the most rare pattern form of the skin disorder called Vitiligo, or leucoderma. This skin disorder causes smooth white patches to appear on the skin due to the malfunctioning or the loss of melanocytes (cells that make pigment). In Focal Pattern Vitiligo, the depigmentation of skin is limited to one or only a few areas. The Focal Pattern Vitiligo and segmental vitiligo do not spread and remain localized to one part of the body, whereas generalized vitiligo is likely to spread over different parts of the body. There is no such cure for Vitiligo, however, herbal treatments have proved to be fruitful over the years.

Vitiligo patches often occur symmetrically across both sides on the body. Occasionally small areas of the body may repigment as they are recolonised by melanocytes. Vitiligo may also be caused by stress that affects the immune system. The disturbed immune system may lead the body to react and start losing skin pigment. Vitiligo on the scalp may affect the color of the hair, leaving white patches or streaks and so affect facial and body hair.

Most people with vitiligo are in good general health. But, it may occur with other autoimmune diseases such as thyroid disease. The duration and severity of pigment loss differ with each person. Light-skinned people usually notice the contrast between vitiligo affected areas and suntanned skin in the summer. There is no way to predict how much pigment an individual will lose; however, those with severe cases can lose pigment all over the body.

Treatment

• Topical steroid therapy
• Topical psoralen photochemotherapy
• Oral psoralen photochemotherapy
• Depigmentation
• Autologous skin grafts
• Skin grafts using blisters
• Micropigmentation (tattooing)
• Autologous melanocyte transplants
• Sunscreens
• Cosmetics
• Counseling and support

Self Care

Here are some points that Vitiligo patients can put to good use:

• Exposing the affected areas to early morning sunlight just after sunrise is known to stimulate pigment forming cells. However, patients must avoid strong sunlight especially between 10 am to 4 pm. If necessary to move out during such hours, patients must opt for a sunscreen with SPF (Sun Protection Factor) of more than 15.
• Regular use of sun screen also guards against sunburn and long term damage
• Use mild soap for bathing and avoid rubbing skin vigorously after a bath (fiction can trigger new patches)
• Wear clothing that adequately covers the skin (e.g. full sleeved shirt) - this protects the skin from any kind of external trauma
• Avoid direct contact with deodorants, perfumes - spray on clothes rather than directly on skin
• Avoid mental stress - take effective steps to identify and tackle with stress, if it exists
• Diet rich in copper is suggested for Vitiligo patients since scientific studies have shown low serum copper levels in patients suffering from Vitiligo. Green leafy vegetables and sesame are good sources of copper.
• Supplementation with vitamin B12, folic acid and pantothenic acid has been seen to have beneficial effects in Vitiligo patients (it has been credited with the formation of new melanin). Patients should include adequate lentils, eggs and yogurt in their daily diet for the same.