Vitiligo

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VITILIGO

Vitiligo is a common condition in which the skin loses the pigment that determines its color. It happens  when melanocytes , the cells responsible for  colour of skin, hair  and eyes, die or are unable to function.

This leads to gradually enlarging white patches of irregular shapes to appear on the skin.

The white patches are more common where the skin is exposed to the sun, but other areas like mucous membrane, hair, genital organs are also affected.

CAUSES

The cause of vitiligo is unknown. But some research suggests the below said reasons

Autoimmune- Mainly in Hyper Thyroidsm.

Genetic-  Chance of getting if a close relative has vitiligo.

Other Reasons – Pernicious anemia, Adrenocortical insufficiency. oxidative stress, neural, or        viral causes, Alopecia Areata.

Vitiligo affects all races, but may be more noticeable in people with darker skin. It usually starts as small areas of hypopigmentation that spread with time. The scalp Hair, eye brows, eye lashes etc. also tend to become white.

Clinical presentation includes depigmented patches, which are often bilateral, symmetric, and periorificial. The skin samples show no or very few  melanocytes on microscopic examination

Vitiligo is not contagious, but it tends to run in family.

It  is not life threatening, but can act as life altering. It  plays an important role in self esteem and personality, often leading to emotional stigma and lack of confidence in public.

Classification 

Generalized Vitiligo: the most common pattern, wide and randomly distributed areas of depigmentation

Universal Vitiligo: affects  most of the body

Focal Vitiligo: one or a few scattered macules in one area, most common in children

Acrofacial Vitiligo: fingers and periorificial areas

Mucosal Vitiligo: only the mucous membranes

TIPS FOR MANAGING

Sun protection is inevitable as the affected area is easy vulnerable to sunburn. So always apply and Re-apply every 2-3 hrs sun protection lotion, and avoid sun bath and sun lamps.

TREATMENTS

There are many treatment options. The goal of most treatments is to restore lost skin color.

1)Medical Treatment

Topical agents like a potent cortico steroid, along with oral medicines

2)Non-Medical(Cosmetic) treatments.

Using Make-ups like self tanner, Skin Dye etc.

3)Light Treatments

Light Box for more areas and Laser for  small areas

4)PUVA Light Therapy

UVA Light and a medicine called Psoralen(topical or internal) are used for this therapy.

5)Surgery

-Autologus Skin Grafts- Mainly used for patients  affected with small areas  so that the un affected areas can be taken as donors.

-Melanocyte transplantation- Melanocytes are grown in a laboratory from a normal skin area from the patient,

6) Depigmentation

The unaffected area is depigmented as early as possible artificially to match the white skin. This is more useful in cases of wide spread situations

7)Stem Cell Treatment

Stem Cells are injected intra-venous in the body. They  help to  stabilize the spread of vitiligo, and boost the process of  gaining back the pigmentation  over a period of time.

The Melanocyte stem cells are activated in the epidermis with correct stimulation  and they mature to start  functioning, giving back the colour. The course, dosage  and result will vary for each individual.

Initially the some of the cells will start to mature and function, and continuous stimulation will help the melanoblasts in migrating to the epidermis where they become fully functioning, pigment producing melanocytes.

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