VITILIGO

What’s it?

It’s a disease in which a loss of skin pigmentation occurs (discoloration with white patches) affecting 1 to 2% of the world population, irrespective of racial, sexual or regional differences. Hair depigmentation may occur as well.

How is it acquired?

The cause is unknown, and there seems to be a family predisposition for this condition, in association with other autoimmune diseases, such as those of the thyroid and diabetes. It may also be triggered by psychological factors. The hereditary pattern of the disease hasn’t been defined yet.

What does one experience?

Patients describe a skin area in which the pigment has disappeared, in general with well outlined borders and without symptoms. The lesions may be symmetrical (trunk and limbs), generalized, or with a segmental pattern. The areas usually affected are around the mouth, eyes, genitals, elbows, knees, arm pits, groins, hands and forearms.

The incidence peak takes place in the third decade of life; 50% of cases occur prior to age 20 though.

How does the doctor diagnose it?

The diagnosis usually is clinical: by the lesions, their location and evolution.

Seldom is a biopsy (skin exam) necessary for differential diagnosis.

How to treat it?

Firstly, it’s very important that a clinical investigation be undertaken into the patient by means of laboratory tests in search of associated diseases or vitiligo-triggering diseases.

Conventional treatments are more efficient and are carried out in alternate regimens. These treatments take a longer time and require protection against sunlight and use of an adequate sunscreen on the discolored skin so as to prevent sunburns and the long-term damage caused by the sun.

Currently, there exist other therapeutic alternatives that still need further studies.

Complete repigmentation of the skin is rare, as there are some areas that remain untreated or present greater difficulty in repigmentation, namely: lips, eyelids, genitals, hands and feet. The association of treatment efficiency with safety of the treated areas is highly important.

How to prevent it?

There isn’t any measure available for preventing this condition or its evolution.

Periodical rounds of tests are recommended for detection of associated diseases.

In the event of a suspect lesion, we’d advise looking for medical care, and, in some cases, psychological counseling, since the emotional aspect may be the triggering factor for the disease and lead to esthetic and social problems, mainly in people with darker skin.

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