Vitiligo
(vit-uh-LIE-go) is an autoimmune skin
disorder, which leads to the loss of skin color (pigment). Your skin color
comes almost entirely from the pigment melanin, which is produced by your
pigment cells called melanocytes. The color from your blood and other pigments
like carotenoids from your diet, contribute only a little to the color of your
skin. Of note, patients with a skin condition called, oculocutaneous albinism
may completely lack the ability to produce melanin and have white skin
throughout.
Melanocytes can be thought of as a manufacturing machine
of melanin skin pigment. In vitiligo your immune cells “mistakenly”
attack the melanocytes. Normally your immune system circulates in your vascular
system, constantly sifting through, looking for foreign invaders. When your
immune system recognizes foreign invaders, such as viruses and bacteria, it
begins an attack. In vitiligo, the immune system mistakenly attacks the
melanocytes as if it were a “foreign invader” resulting in loss of skin color.
Having vitiligo does not imply a “weak” immune system, rather it is a specific
little “glitch” in one small set of immune cells. Thus, for the most part, having
vitiligo does not mean that there are necessarily other things wrong with you.
In fact, it usually occurs by itself in otherwise healthy people. However,
sometimes vitiligo may be found in individuals with other autoimmune conditions
like, autoimmune thyroid disease or alopecia areata. Those issues should be
discussed with your doctor.
Since
the color of your hair is also determined by melanin, often times the hair
overlying a patch of vitiligo will also be white. Vitiligo is not contagious
and is not associated with any symptoms. It can occur anywhere on the body,
including the face, trunk, arms, legs, and genitals. The most common pattern of
vitiligo is to occur in multiple areas, often in areas where there is frequent
use such as, the hands, elbows, and knees. A less common form occurs only on one side of
the body, called segmental vitiligo tends to me more resistant to treatment.
Since vitiligo is an autoimmune disorder, the treatments aim to reduce the activity of the immune cells in the skin. The mainstay of treatment is corticosteroid cream/ointments prescribed by the treating physician. Patients who have more extensive vitiligo may be candidates for light treatment like UVB or PUVA. Narrowband UVB is the most common form of phototherapy used to treat vitiligo. The UV rays actually have suppressive effects on the immune cells in the skin. This form of treatment is done under the careful supervision of a dermatologist. Dermablend is the #1 camouflage cream recommended by dermatologists.
Note the typical "symmetric"distribution of vitiligo
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