VITILIGO

A NON-CONTAGIOUS SKIN DISORDER

 INTRODUCTION
Vitiligo is a long-term skin condition characterized by patches of the skin losing their
pigment. The patches of skin affected become white and usually have sharp margins. The
hair from the skin may also become white.
The inside of the mouth and nose may also be involved . Typically both sides of the body
are affected. Often the patches begin on areas of skin that are exposed to the sun. It is
more noticeable in people with dark skin. Vitiligo may result in psychological stress and
those affected are sometimes stigmatized.
 SIGNS AND SYMPTOMS:
• The only sign of vitiligo is the presence of pale patchy areas of depigmented skin
which tend to occur on the extremities. Some people may experience itching
before a new patch occurs. The patches are initially small, but often grow and
change shape. When skin lesions occur, they are most prominent on the face,
hands and wrists.
• The loss of skin pigmentation is particularly noticeable around body orifices, such
as the mouth, eyes, nostrils, genitalia and umbilicus . Some lesions have increased
skin pigment around the edges . Those affected by vitiligo who are stigmatized for
their condition may experience depression and similar mood disorders.
 CAUSES
The exact cause of vitiligo is unknown . It is believed to be due to genetic
susceptibility that is triggered by an environmental factor such that an
autoimmune disease occurs . This results in the destruction of skin pigment cells.
Risk factors include a family history of the condition or other autoimmune
diseases, such as hyperthyroidism, alopecia areata, and pernicious anemia.
It is not contagious.
 TYPES OF VITILIGO
Vitiligo is classified into two main types:

Segmental and Non-segmental : Most cases are non-segmental, meaning they

affect both sides; and in these cases, the affected area of the skin typically
expands with time. About 10% of cases are segmental, meaning they mostly
involve one side of the body; and in these cases, the affected area of the skin
typically does not expand with time.
 DIAGNOSIS
An ultraviolet light can be used in the early phase of this disease for identification
and to determine the effectiveness of treatment . Using a Wood's light, skin will
change colour (fluoresce) when it is affected by certain bacteria, fungi, and
changes to pigmentation of the skin.
Skin biopsy .

Blood tests.
 TREATMENT
• There is no cure for vitiligo but several treatment options are available. The best evidence is for
applied steroids and the combination of ultraviolet light in combination with creams. Due to the
higher risks of skin cancer, the United Kingdom's National Health Service suggests phototherapy be
used only if primary treatments are ineffective. Lesions located on the hands, feet, and joints are the
most difficult to repigment; those on the face are easiest to return to the natural skin color as the
skin is thinner in nature.
• Immune mediators :
• Topical preparations of immune suppressing medications including glucocorticoids (such as 0.05%
clobetasol or 0.10% betamethasone) and calcineurin inhibitors (such as tacrolimus or pimecrolimus)
are considered to be first-line vitiligo treatments.
Phototherapy
 Phototherapy is considered a second-line treatment for
vitiligo.Exposing the skin to light from UVB lamps is the
most common treatment for vitiligo. The treatments can be
done at home with an UVB lamp or in a clinic. The exposure
time is managed so that the skin does not suffer
overexposure.
 Treatment can take a few weeks if the spots are on the neck
and face and if they existed not more than 3 years. If the
spots are on the hands and legs and have been there for
more than 3 years, it can take a few months. Phototherapy
sessions are done 2–3 times a week. Spots on a large area of
the body may require full body treatment in a clinic or
hospital. UVB broadband and narrowband lamps can be used
, but narrowband ultraviolet picked around 311 nm is the
choice
 It has been constitutively reported that a combination of
UVB phototherapy with other topical treatments improves
re-pigmentation. However, some people with vitiligo may
not see any changes to skin or re-pigmentation occurring. A
serious potential side effect involves the risk of developing
skin cancer, the same risk as an overexposure to natural
sunlight.
 SKIN CAMOUFLAGE: In mild cases, vitiligo patches can be hidden with makeup or other cosmetic
camouflage solutions. If the affected person is pale-skinned, the patches can be made less visible
by avoiding tanning of unaffected skin.
 DE-PIGMENTATION : In cases of extensive vitiligo the option to de-pigment the unaffected skin with
topical drugs like monobenzone, or hydroquinone may be considered to render the skin an even
color. The removal of all the skin pigment with monobenzone is permanent and vigorous. Sun-safety
must be adhered to for life to avoid severe sunburn and melanomas. Depigmentation takes about a
year to complete.