Vitiligo

Excerpt

Vitiligo is an acquired pigmentary skin disorder caused by the absence of pigmentary cells from the epidermis that results in white macules and patches on the body. The condition is usually associated with a few autoimmune disorders, with thyroid abnormalities being the most common one. The etiology of vitiligo is unknown but there are different theories to explain its pathogenesis. Vitiligo presents clinically with signs and symptoms of white spots on the body distributed symmetrically and more obvious in people with dark skin. The lesions are characterized by well-demarcated pearly white or depigmented macules and patches, oval, round, or linear-shaped, and the borders are convex, ranging from the size of a few millimeters to centimeters, and enlarged centrifugally. There are different clinical variants of vitiligo, which are trichrome, marginal inflammatory, and quadrichrome vitiligo. Koebner phenomenon (Development of vitiligo at specific trauma prone sites, like cut, burn, or abrasion)is also a common clinical manifestation. Initial lesions occur most frequently on the hands, forearms, feet, and face, favoring a periocular or perioral distribution.

On the basis of the distribution, pattern Vitiligo is classified into three types: generalized, segmental, and localized. The severity of the disease is scored by the body surface area affected. The course of the disease is often unpredictable and varies in response to the treatment. Depigmentation is often the cause of psychological distress, social stigmatization, and low self-esteem.