What is it?
Melanocytes are present in the skin and are responsible for making pigment, giving you your skin color. Vitiligo is a condition where there is destruction of melanocytes. Anything that contains pigment can essentially be affected. This includes skin, hair, and the retina. As a result white patches can appear on the skin, the hair and the retina of the eye. This condition affects around 2% of people all around the world.
The exact cause of the condition is not yet known, but some links have been identified. The most popular explanation is that it is an autoimmune disease, in which the body destroys its own melanocytes, hence pigment can no longer be made. As such it has been described that people with pre-existing autoimmune diseases are more at risk of developing this condition. Another popular theory is that people who have a particular set of genes make them more likely to suffer depigmentation.
There are three main types of patterns that arise with vitiligo. The focal pattern is when the depigmentation is only limited to one or several areas. A segmental pattern refers to when these white patches develop on one side of the body only. A generalised pattern is where patches occur on both sides of the body. It is the most common type of pattern
The diagnosis of the condition is generally suspected on physical examination. There are few things that can mimic the condition, but the doctor will ask for an extensive history to find more evidence. You may be asked about other signs like premature graying, a family history of the condition, a personal and family history of other autoimmune diseases, a recent physical illness, and about your sensitivity to the sun.
The test to confirm the condition basically involves taking a sample of the affected area. Under a microscope no pigment will be seen in a person who has this condition. However, certain inflammatory processes could also have killed off the melanocytes in the area, so this would have to be ruled out. Vitiligo is also associated with complications like pernicious anemia and hyperthyroidism. Blood tests may then be sent off to exclude the presence of these conditions. A good doctor will also do a test to make sure that you don’t have any other autoimmune diseases. For this you will be tested for an antinuclear antibody.
There are a number of medical treatments that can be used to reduce the appearance of depigmented patches. The most widely used type is a topical corticosteroid. Corticosteroids dampen down the immune response, and therefore will slow down the destruction of melanocytes. Unfortunately, results can only truly be seen from the third or fourth month of treatment. Corticosteroids do have side effects so it is important to use them under the advice of a doctor.
There is also a surgical option where skin can be taken from elsewhere in the body and transplanted to cover the affected area. Some people who have extensive white patches may choose to depigment the rest of their body for a uniform appearance.