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VITILIGO

VITILIGO

15-10-2019

Vitiligo is commonly known as Leucoderma. It causes immune system cells to destroy melanocyte cells which give our skin its color. Loss of color generating cells results in whitening at such areas of our skin.

Vitiligo is commonly known as Leucoderma. It causes immune system cells to destroy melanocyte cells which give our skin its color. Loss of color generating cells results in whitening at such areas of our skin.

Vitiligo is classified as an autoimmune (unknown cause) disease. Autoimmune diseases cause immune system cells to damage certain target tissues for reasons that are not fully understood. Vitiligo targets melanocytes which are cells that give our skin its color. For this reason, it frequently occurs alongside other autoimmune diseases.  It is usually advised to test for other rheumatic (autoimmune) diseases in patients diagnosed with vitiligo.

White areas on the skin are different in each individual. Vitiligo cases are usually classified as segmental and non-segmental vitiligo based on their manner of spreading. This classification helps in estimating its point of origin and spread in addition to its age in certain cases. Segmental vitiligo is used to describe types of vitiligo frequently seen in child age group which are usually limited to one side and one area, while non-segmental is a term used for multiple white areas dispersed throughout the body.

Extent and intensity of vitiligo vary greatly from patient to patient. The disease starts and ends with a single white area in some cases, while it spreads quickly to cover almost the whole body in others. In some cases, it may start and spread for a certain period before stopping and act up from time to time.  It is usually difficult to predict the course of this disease.

Despite the fact that the disease affects 1-2% of the population, it can be difficult to notice from the outside if the contrast between vitiligo lesions and normal skin color is low on individuals with white skin. Awareness of the population regarding this disease can be low, as vitiligo patients hide affected areas on their bodies with clothing. The disease affects females and males at an equal ratio.

                Vitiligo is diagnosed by using wood light on patients who seek medical advice for white spots seen on their bodies under sunlight. Under wood light, vitiligo lesions distinguish themselves with a whiter (lime white) color compared to normal skin. Examination under wood light is a reliable diagnosis method, as white spots on the body can be confused with fungus disease or certain skin diseases such as pityriasis alba. Skin biopsy can be used to make sure when diagnosis is not clear.

                The first goal of vitiligo treatment is to turn skin into its original color. For this purpose, cream treatment involving cortisone and tacrolimus are used to regulate the immune system while treatments such as excimer laser and phototherapy are used to stimulate melanocytes. The treatment process is affected by stress factor of the patient, accompanying diseases, and initial age of vitiligo. In addition, the newer vitiligo lesion is, the better patient responds to treatment.  Patients’ response to treatment is weaker if the treatment process starts later.

Antioxidants may be suggested to support treatments that regulate immune system. Psychotherapy can also help in regulating damage on immune system caused due to stress.

                Permanent concealers or tattoos can be used to reduce visibility of vitiligo lesions. In addition, normal skin areas of patients with wide-spread vitiligo can be whitened (depigmentation).

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