Vitiligo

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Images of Vitiligo

Overview

Vitiligo is a benign (noncancerous) skin condition in which the immune system attacks the color-producing (pigment-producing) cells of the skin, causing white or light patches to gradually appear on the skin. The face and hands are commonly involved. If the skin involved is in a hair-bearing area, the hair may also turn white. There is no cure for vitiligo, but there are available treatments that help some people more than others. Some people with vitiligo use makeup to disguise the light patches, though if the patches grow large this can be difficult. In some people, vitiligo begins as one small patch and does not spread; in others, it can involve more than half the body. Vitiligo is not contagious. It is associated with other autoimmune disorders such as diabetes, thyroid disease, and alopecia areata.

Who's at risk?

Anyone can get vitiligo, though it is usually begins in early adulthood (but can be seen in young children as well). All races are affected by vitiligo, but in is more obvious in darker-skinned individuals.

Signs and Symptoms

Vitiligo most commonly affects areas of injury (trauma), particularly on the face, upper chest, hands, axillae, and groin. It may be widespread, affecting both sides of the body (generalized); it may affect only one side of the body (segmental); or it may affect only one localized area (focal).

Sharply defined white patches are seen. If the affected area contains hair, the hair may turn white.

Sometimes "halo" nevi (moles) may be seen, in which a mole is surrounded by a circular white patch, resembling a halo.

Self-Care Guidelines

To protect your skin from sunburning, particularly in the affected areas:

  • Avoid exposure to midday sun (10 AM to 3 PM).
  • Apply SPF 45 sunscreen.
  • Wear protective clothing and hats.
  • Apply Dermablend™ or Covermark® cosmetic cover-up makeup to hide white (depigmented) patches.

When to Seek Medical Care

It is not necessary for treat vitiligo, but seek medical evaluation if it becomes bothersome.

Treatments Your Physician May Prescribe

Your doctor may try any of the following:

  • Topical steroid creams or ointments to help restore skin color. These should be used with caution because of the risk of tissue damage (atrophy) with prolonged use, particularly on the face and skin fold areas.
  • Topical non-steroid medications, such as tacrolimus and pimecrolimus, which deactivate immune cells, may be of benefit. These medications, however, can increase your risk of developing cancer (malignancy).
  • Ultraviolet (UV) light therapy for lesions that do not affect the joints.
  • For very extensive lesions in darker-skinned individuals, topical chemicals remove color (depigment) the normal skin.
  • Superficial skin grafts, especially in hard-to-treat (recalcitrant) locations, such as over joints.

References

Bolognia, Jean L., ed. Dermatology, pp.947-955. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.839-847. New York: McGraw-Hill, 2003.