What is it?
Disease of unknown cause, vitiligo is characterized by the presence of depigmented spots on the skin. The lesions are formed due to the decrease or absence of melanocytes (cells responsible for formation of melanin, pigment that gives color to the skin) in the affected sites.
The cause of this is unclear but autoimmune phenomena seem to be associated with vitiligo. Furthermore, it is common to correlate the disease with emotional trauma which could act as triggering factor or promote the aggravation of the condition.
Characteristics and symptoms
The typical vitiligo spots are white, with total absence of pigment, which have well defined borders and may have a thin rim of darker skin around them. The lesions don't present any symptoms.
Vitiligo affects mainly the face, limbs, genitals, knees and elbows, but it may spread all over the skin. When it reaches hairy areas, the hairs also become white. Another characteristic is that injuries to the skin may lead to the formation of new lesions.
Vitiligo has a chronic course and there is no way to predict its progression. It may remain stable for years, re-develop or regress spontaneously. In the same patient it may occur simultaneously the regression of some lesions while others develop.
Although vitiligo does not cause any damage to physical health, aesthetic changes often cause psychological disorders that can impair social life. The degree of emotional impairment may affect negatively the evolution of the disease.
Vitiligo presents itself in form and intensity varied in each patient, so the recommended treatment should be individualized according to each case.
Drugs that exert great results in some patients may have no effect in others. Often, the results seem to be more related to patients treated than to the treatment itself. When necessary, the counseling of patients on treatment may be crucial to achieve a good result.
The medications are intended to correct the immune alterations responsible for the depigmentation process or stimulate the melanocytes present in the lesions to produce melanin.
The repigmentation of the lesions occurs from the hair follicles, forming small pigmented spots inside the lesions. These points increase gradually coalescing to repigment the lesion (photo below).
In cases of stable vitiligo, when new lesions are no longer formed and existing ones do not increase in size, some surgical techniques promote the transfer of melanocytes obtained from areas of healthy skin to the affected area. Once embedded into the skin they begin to produce melanin, repigmenting the spot.
Treatments with Excimer laser and Narrow Band UVB has also shown good results in some patients.
Vitiligo is a treatable disease, but its treatment is time consuming and requires patience. For children, it is important that parents try to control themselves to avoid transmiting their anxiety to them, making them think they suffer from a serious illness, which can only bring difficulties to achieve good results. It is important to remember that vitiligo brings no risks to health, despite of the great aesthetic disturbance.
- Guttate hypomelanosis