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Vitiligo: Treatment, symptoms, advice and help

About vitiligo

Vitiligo is an acquired condition in which circumscribed depigmented patches develop on the skin.

Vitiligo: Incidence, age and sex

It affects 1% of the population worldwide.

Signs and symptoms of vitiligo: Diagnosis

Segmental vitiligo is restricted to one part of the body, generalized vitiligo is often symmetrical and frequently involves the hands, wrists, knees and neck as well as the area around the body orifices. The hair of the scalp and beard may also depigment. Some spotty perifollicular pigment may be seen within the depigmented patches. Sensation in the depigmented patches is normal. The course is unpredictable but most patches remain static or enlarge; a few repigment spontaneously.

Causes and prevention of vitiligo

Vitiligo involves focal areas of melanocyte loss. There may be a positive family history of the disorder in those with generalized vitiligo and this type is associated with autoimmune diseases such as diabetes, thyroid and adrenal disorders, and pernicious anaemia. Trauma and sunburn may precipitate the appearance of vitiligo.

Vitiligo: Complications

Vitiligo itself does not cause complications. However, other 'auto-immune' disorders are slightly more common in people with vitiligo. For example, thyroid problems and a type of anaemia called pernicious anaemia. Many people with vitiligo are embarrassed about their condition. This can lead to low self-esteem and even depression.

Vitiligo: Treatment

Treatment methodologies are unsatisfactory. Protecting the patches from excessive sun exposure with clothing or sunscreen may be helpful in reducing episodes of burning and risk of skin cancer in the long term. Camouflage cosmetics may also be helpful. Potent topical corticosteroids can sometimes be helpful. Phototherapy with PUVA or more recently TL01 has been used.

The absence of whiteness of the hairs in the area of vitiligo is a good prognostic features. Finally, transplantation, using a range of techniques including split-skin grafts and blister roof grafts, is used on to dermabraded recipient skin.