Vitiligo

Vitiligo is a skin condition in which the skin loses its color. On a person’s skin, smooth white spots (called macules if less than 5mm or patches if 5mm or more) develop. If you have vitiligo in a hairy area of your body, your hair may become white as well.

The disease develops when the body’s immune system destroys melanocytes (skin cells that generate melanin, the chemical that gives skin its color or pigmentation).

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Vitiligo
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Vitiligo

Everything you should know about Vitiligo


Vitiligo is a skin color loss-related illness. In general, the discolored patches get larger over time. Any component of the body may have an impact on the skin. The hair and inside of your mouth may also be affected.

Usually, melanin determines the color of the hair and skin. Vitiligo takes place when melanin-producing cells die or cease working. Vitiligo affects people of all skin types however, it is more noticeable in people with darker skin. The condition doesn’t endanger or spread to life. It might be stressful, or it can make you feel awful.

Vitiligo therapy may restore the skin’s color. But the loss of skin color or recurrence does not continue.

Vitiligo has yet to be identified as a particular cause. Vitiligo is a condition that is caused by autoimmune disease, often in those who have vitiligo personal or family history. It has been shown to run in families, implying that genetics may be involved.

Vitiligo is commonly thought to be an autoimmune disease. When the immune system targets the body’s tissues and organs, autoimmune diseases develop. The immune system appears to target the pigment cells (melanocytes) in the skin of patients with vitiligo. An extra 15-25% of vitiligo patients are affected by at least one other autoimmune illness. This includes autoimmune thyroid disease, rheumatoid arthritis, type 1 diabetes, psoriasis, pernicotal anemia, Addison disease, or systemic lupus erythematosus.

Vitiligo can occur and spread slowly over many years in certain people. Spreading happens rapidly for others. After physical or mental stress, some people have reported seeing additional white spots.

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The illness is misunderstood to spread by touch. Vitiligo, however, is non-contaminated and does not spread by touch.

Vitiligo takes place when melanin-producing cells die or cease working. Vitiligo affects people of all types of skin, however, it may be more noticeable in people with a dark complexion. The condition doesn’t endanger or spread to life. It might be stressful or it can make you feel awful.

If you see parts of your skin, hair, or mucous membranes losing color, see your doctor. Vitiligo is incurable. Treatment, on the other hand, may be able to halt or delay the discoloration process and restore some color to your skin.

When cells that generate melanin die or cease working, vitiligo develops. Vitiligo affects people of all skin kinds, although it is more visible in those who have darker skin. It is not a life-threatening or infectious disorder. It might be stressful and make you feel self-conscious.

It is a common misunderstanding that the illness may be transmitted through touch. Vitiligo, on the other hand, is not infectious and does not spread through touch.

Use an SPF with a minimum of 30 wide-spectrum water-proof sunscreens. Apply sunscreen generously and apply each other every two hours — or more often if you swim or swim.

Shade and clothes that protect your skin from the sun might be additionally sought from you. Do not use sunlamps and tanning beds.

Protecting your skin from the sun helps prevent the darkened skin from sun-burning. Sunscreen also reduces tanning, emphasizing vitiligo spots. 

Vitiligo and Leucoderma are two prevalent skin diseases that cause white spots to appear all over the body. It’s frequently difficult to tell the difference between Vitiligo and Leucoderma because they have so many symptoms in common. The main difference between vitiligo and leucoderma is that vitiligo is caused by autoimmune conditions, hormonal changes, acute emotional trauma, recurrent episodes of jaundice or typhoid fever, prolonged antibiotic treatments, or corticosteroid treatment, whereas leucoderma is caused by physical trauma.

  • Clinical Characteristics

In terms of clinical appearance, both Vitiligo and Leucoderma are characterized by white patches that can only be distinguished by the etiology. However, even though it is difficult to distinguish, the elevated patches in certain people might represent Leucoderma without the use of a light source.

  • Cause

Autoimmune disorders, hormonal changes, severe emotional trauma or stress, recurring bouts of jaundice or Typhoid fever, extended antibiotic treatments, or corticosteroid therapy are the most common causes of vitiligo.

Following a physical trauma such as a cut, burn, or ulceration, leucoderma will develop. The scar that forms will eventually turn into a white patch that may occasionally grow in size over time.

  • Treatment and Diagnosis

Because there are two clinical diagnoses, a thorough history, and physical examination, particularly of skin abnormalities, are essential before deciding on a treatment strategy.

Most patients would benefit from concealing creams and phototherapy, but because of their life-long nature, they cannot be stopped from progressing.

Albinism and vitiligo are both medical diseases caused by a pigmentation deficiency in the body, however, there is a distinction between the two. Albinism is a congenital illness defined by the full or partial lack of melanin, which is the pigment present in the skin, hair, and eyes, whereas vitiligo is a skin condition characterized by the loss of pigment in a portion of the skin.

Albinism

Albinism is a congenital condition in which there is a total or partial lack of melanin. To be specific, albinism is an autosomal recessive disease caused by the inheritance of recessive gene alleles. X-linked inheritance is also present in some situations.

Depending on the underlying genetic abnormality, pigment deficit can range from total absence to mild deficiency.

Vitiligo

Vitiligo is a skin disorder in which a portion of the skin loses its pigmentation. Aside from cases of harmful chemical exposure, the etiology of vitiligo is mainly unclear. Some experts, however, believe that vitiligo might be caused by autoimmune, genetic, and oxidative stress, as well as viral infections.

Albinism and Vitiligo Characteristics

Cause

  • Albinism

Albinism is a hereditary condition.

  • Vitiligo

Vitiligo is, in most circumstances, an acquired condition.

Participation of the eyes

  • Albinism

Albinism is a condition that affects the eyes.

  • Vitiligo

Vitiligo does not damage the eyes.

The Size of the Problem

  • Albinism

Albinism is a condition that affects the entire body.

  • Vitiligo

Vitiligo is a skin condition that affects only one region of the body.

Diseases that are linked

  • Albinism

Albinism has nothing to do with autoimmune diseases.

  • Vitiligo

Vitiligo is a skin condition that is linked to autoimmune illness.

Your therapy will depend on your age, the quantity of skin damaged and its location, how quickly and how it affects your life.

To help restore skin color or level out skin tone, medications, and light-based treatments are available, however, outcomes vary and are unpredictable. Furthermore, some therapies have severe adverse effects. As a result, your doctor may advise that you initially attempt altering the look of your skin using self-tanning or cosmetics.

If you and your doctor decide to use a medication, surgery, or treatment to address your illness, the evaluation process might take months. And you might have to try a few different treatments or a mix of treatments before you find the one that works best for you.

Even if therapy is effective for a short time, the benefits may fade or new patches may emerge. To assist avoid recurrence, your doctor may prescribe a topical medicine to be applied to the skin as maintenance treatment.

Vitiligo generally starts as a few tiny white spots that progressively spread throughout the body over months. Vitiligo most commonly affects the hands, forearms, feet, and face, but it can also affect the mucous membranes (wet lining of the mouth, nose, genital, and rectal regions), the eyes, and the inner ears.

When pigment-producing cells (melanocytes) die or cease generating melanin, the pigment that gives your skin, hair, and eyes color, vitiligo develops. The affected skin areas lighten or turn white. It is not known what causes the pigment cells to fail or die. It might be linked to:

  • A problem with the immune system (an autoimmune condition)
  • History of the family (heredity)
  • Stress, severe sunburn, or skin damage, such as contact with a chemical, are examples of trigger events.

The bigger patches that begin to form can sometimes continue to grow and spread, although they generally stay put for years. As specific regions of skin lose and recover color, the position of smaller macules varies and changes throughout time. The quantity of skin damaged by vitiligo varies, with some individuals having only a few depigmented patches and others having a broad loss of color.

Vitiligo can be:

  • Generalized

Macules occur in numerous areas of the body in this kind, which is the most frequent.

  • Segmental

Refers to a condition that affects only one side of the body or a specific region, such as the hands or face.

  • Mucosal 

A condition that affects the mouth and/or genital mucous membranes.

  • Focal

An uncommon kind in which the macules are concentrated in a limited region and do not spread predictably throughout one to two years.

  • Trichome

Implies that there is a white or colorless core, followed by a lighter pigmented region, and finally a normal-colored area.

  • Universal 

A rare form of vitiligo in which more than 80% of the body’s skin is devoid of color.

Symptoms of vitiligo include:

  • Skin discoloration occurs in patches on the hands, face, and around bodily openings and the genitals.
  • Hair on your head, eyelashes, eyebrows, or beard that is prematurely whitening or greying
  • The tissues that line the interior of your mouth and nose have lost their color (mucous membranes)

Vitiligo can develop at any age, although it is more common before the age of 30.

Vitiligo can have a variety of effects depending on the type of vitiligo you have:

  • Almost all of the skin’s surfaces

The darkening affects almost all skin surfaces in this kind of vitiligo, known as universal vitiligo.

  • Several parts of your body

The discolored patches on adjacent body parts generally grow similarly in generalized vitiligo, the most common form (symmetrically).

  • Only one side or a portion of your body is affected

This kind of vitiligo, known as segmental vitiligo, appears at a younger age, progresses for a year or two, and then stops.

  • Only one or a few parts of your body are affected

This kind of vitiligo is known as confined (focal) vitiligo.

  • The hands and face

The afflicted skin on the face and hands, as well as surrounding bodily openings such as the eyes, nose, and ears, is known as acrofacial vitiligo.

It’s tough to forecast the course of your illness. Without therapy, the patches may stop developing. Pigment loss usually spreads and eventually affects the majority of your skin. On rare occasions, the skin regains its original hue.

Listed below are the therapies available for Vitiligo.

  • Light therapy

Active vitiligo can be treated with narrow-band ultraviolet B (UVB) phototherapy, which has been shown to stop or slow the disease’s progression. Phototherapy is also available. When used with corticosteroids or calcineurin inhibitors, it may be more effective. Two to three times a week, you’ll need treatment. It may take one to three months to see a difference, and it may take six months or longer to see the complete impact.

Redness, itching, and burning are all possible adverse effects of narrowband ultraviolet B treatment. After treatment, these adverse effects generally go away within a few hours.

  • Using psoralen in combination with light therapy

This treatment combines a plant-derived substance called psoralen with light therapy to restore color to the bright patches (photochemotherapy). You’re exposed to ultraviolet A (UVA) light after taking psoralen or applying it to the afflicted skin. While effective, this method is more difficult to implement, and narrow-band UVB treatment has largely supplanted it in many clinics.

  • Getting rid of the last bit of color (depigmentation)

If your vitiligo is severe and previous treatments have failed, this therapy may be a possibility. Unaffected regions of the skin are treated with a depigmenting chemical. This lightens the skin over time, blending it in with the discolored regions. For nine months or longer, the therapy is done once or twice a day.

Redness, swelling, itching, and very dry skin are all possible side effects. Depigmentation is a long-term process.

Surgical methods to Treat Vitiligo

The following treatments are designed to restore color and level out skin tone:

  • Skin grafting

Your doctor will do this operation by transferring extremely tiny pieces of healthy, pigmented skin to regions that have lost color. If you have tiny areas of vitiligo, this treatment may be utilized.

  • Blister grafting

In this operation, your doctor uses suction to generate blisters on your pigmented skin, then transplants the blisters’ tips to discolored skin.

  • Transplantation of cellular suspension

In this treatment, your doctor removes some pigmented skin tissue, dissolves the cells in a solution, and then transplants the cells to the afflicted region. Within four weeks, the benefits of this repigmentation process are visible.

Vitiligo does not spread through the touch and is not contagious.

Diagnosis of Vitiligo


Your doctor will inquire about your medical history and do a skin examination, which may include the use of a special light. A skin biopsy and blood testing may be part of your assessment.

Tests used to diagnose Vitiligo: The primary and most essential diagnostic technique for someone suspected of having vitiligo is a visual examination followed by a skin sample. Blood tests may be ordered by your doctor to rule out other diseases that might be producing vitiligo-like symptoms. Additional testing (for underlying autoimmune illnesses such as Thyroid, Anemia, or Diabetes) aids the expert in ruling out other skin disorders that resemble vitiligo, such as leprosy or leucoderma. ANA (Antinuclear Antibody), Thyroid peroxidase antibody (TPOAb), complete metabolic panel, a thyroid panel including Free T3, Free T4, and TSH, and lupus panel are all often suggested tests to establish the precise cause of vitiligo.

If the expert suspects that vitiligo is caused by nutritional insufficiency, the patient should have the following tests done:

  • Vitamin B12
  • Vitamin C
  • 25-Hydroxy-Vitamin D
  • Folic acid (also known as folate)
  • L-Phenylalanine
  • Zinc levels 
  • Copper concentrations

Identifying the vitiligo type is critical for prescribing the optimal treatment for the skin condition. The distribution of white spots in Nonsegmental Vitiligo (NSV) is unpredictable. The afflicted region of the skin in Segmental Vitiligo (SV) does not generally grow with time. A tissue biopsy can assist a specialist in determining the difference. Both NSV and SV can coexist in a few cases, which is referred to as Mixed Vitiligo in daily parlance.

 

Topical medications

Topical treatment in the skin, particularly when used immediately following the disease, can enhance repigmentation. The dermatologist recommends appropriate topical medicines that can be coupled with phototherapy or laser therapy. This is based on the size and pattern of the patch of vitiligo to increase the effectiveness of both treatments.

  • Topical Corticosteroids

Corticosteroid creams are anti-inflammatory medicines that can slow down or enable the reappearance of vitiligo. To cure vitiligo, a powerful formula of corticosteroids is needed and dermatologists thus monitor its use carefully when recommended. Skin thinning, stretch marks, and acne are all possible adverse effects.

In a few months, many people start to experience benefits. Topical corticosteroids are frequently given as part of a long-term treatment strategy that involves two to four annual visits to your dermatologist.

  • Topical Calcineurin Inhibitors

Calcineurin inhibitors are immune-suppressing medications that keep the body’s immune system from attacking pigment-producing melanocytes. Calcineurin inhibitors are usually used when topical corticosteroids are unsuccessful or when vitiligo affects delicate regions of the skin that can’t be treated with them. The eyelids, lips, and genitals are among them.

Topical calcineurin inhibitors come in the form of a tacrolimus ointment or a pimecrolimus cream. These medicines are applied to the afflicted regions of skin once or twice a day and can take many months to take action. They are generally part of a long-term therapy strategy if they are beneficial.

Oral medications

There is no cure for vitiligo, which is characterized by the loss of pigment cells (melanocytes). Several medications, however, can help restore skin tone whether taken alone, in combination, or in conjunction with light treatment.

  • Inflammation-controlling medications

A corticosteroid cream applied to the afflicted skin may help to restore color. When vitiligo is still in its early stages, this is the most effective treatment.

Although this type of cream is effective and simple to use, you may not see any changes in your skin’s color for several months. Skin thinning or the development of streaks or lines on your skin are possible adverse effects.

Children and individuals with significant patches of discolored skin may be administered milder versions of the medication.

For those whose health is quickly worsening, corticosteroid tablets or injections may be an option.

  • Immune-suppressing medications

Calcineurin inhibitor ointments, such as tacrolimus (Protopic) or pimecrolimus (Elidel), may benefit individuals who have small patches of depigmentation, particularly on the face and neck. The Food and Drug Administration (FDA) in the United States has issued a warning regarding a potential relationship between these medicines and lymphoma and skin cancer.

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