Vitiligo is the appearance of white patches surrounded by normal skin. It is a result of the loss of functional melanocytes that can no longer produce pigment. The risk factors, exact cause, and clinical course of vitiligo remains unknown.
The exact cause of vitiligo is unknown. It is likely due to a combination of genetic predisposition and environmental factors, including emotional distress and oxidative stress. While the exact trigger remains unknown, vitiligo has been shown to be caused by increased inflammatory cells that prevent melanocytes from producing pigment.
Vitiligo is characterized by the appearance of a patch of milky white skin on any part of the body. Lesions can grow in a peripheral manner at varying degrees. While vitiligo usually does not have other findings, it can be occasionally itchy.
The risk factors of vitiligo remain unknown.
Vitiligo is a clinical diagnosis, characterized by depigmented patches on the body. It appears as a milky white patch upon Wood’s lamp illumination.
Patients with vitiligo are often treated first with high potency topical steroids to reduce the inflammatory cells responsible for causing the depigmented patches. They can also be treated with calcineurin inhibitors such as pimecrolimus or tacrolimus, especially in sun-exposed areas such as the face. Ruxolitinib is a topical JAK inhibitor cream that also has been shown to repigment patches of vitiligo. Patients who have patches on hair-bearing areas such as the face have a better chance of repigmentation with treatment than on areas with non hair-bearing areas such as the hands and feet.
Natural sunlight has anti-inflammatory properties on the skin and 20-30 minutes of sun exposure can also help repigment the skin. Narrow band UVB (NBUVB) and excimer laser utilizes a safe wavelength that does not cause skin cancer. These treatments can be done two to three times a week to help repigment the skin and are not performed at New Bloom Dermatology.
Other treatment options for vitligo include oral JAK inhibitors, which are not prescribed at New Bloom Dermatology.
There are no preventative steps or measures to avoid vitiligo. However, earlier treatment of affected lesions may increase the chances of repigmentation of the affected skin.
The clinical course of vitiligo is difficult to determine if left untreated. Repigmentation of long-standing vitiligo patches can be more difficult to achieve than newer lesions.
Patients with vitiligo can occasionally have other autoimmune conditions, including Hashimoto’s thyroiditis. Other less common associated conditions include pernicious anemia and lupus. Patients diagnosed with vitiligo are advised to have their primary care doctor check their thyroid function panel, Vitamin B12, D, and folate levels. Furthermore, vitiligo can be associated with loss of pigment in the eye.
Individuals are recommended to see a board-certified dermatologist for immediate diagnosis and treatment.
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