Vitiligo

Introduction

Vitiligo is an acquired skin disorder characterized by white and depigmented patches enlarging and becoming more numerous with time. It is due to a disappearance of functioning melanocytes and loss of melanin in the epidermis. The condition can be cosmetically disfiguring and the lesional skin is thus more sensitive to sunburns. It affects 0.1-2% of the world’s population, irrespective of gender and race. Etiology is unknown and the several pathogenetic hypotheses do not account for the entire spectrum of the disease. Although no full therapeutic solution for vitiligo is available, many options may lead to acceptable results in most patients. Management includes sun protection, as well as medical and surgical repigmentation therapy. Medical treatments consist of narrowband ultraviolet B (UVB), broadband UVB, psoralen plus UVA, corticosteroids and other novel approaches. Surgical treatment, consisting of autologous transplantation methods, is generally recommended for stable/focal vitiligo, after medical therapy has failed. Finally, for patients with extensive areas of vitiligo, depigmentation of the residual melanin should be taken into account.

Types of Vitiligo

1. Generalized – when many lesions occur all over the body
2. Focal – when a few lesions occur at distinct areas of the body
3. Unilateral (segmental) – when a few lesions occur on one side of the body with the mirror side unaffected
4. Acrofacial – when lesions occur on the extremities and face only
5. Total – when lesions cover more than 90% of the body surface
6. Inflammatory – when lesions have a red, slightly raised border around them
7. Contact/Occupational – when lesions occur after exposure to specific chemicals