Question 1. What is vitiligo?

Key points

  • Vitiligo is a pigmentary disorder resulting in typically asymptomatic white macules that can appear at any time during human life and can be psychologically devastating.
  • It occurs in all skin types and at all ages, with equal frequencies between men and women.
  • Vitiligo is considered to be an autoimmune disease with an underlying genetic predisposition in the majority of cases.
  • Vitiligo is not caused by poor medical care.
  • Personal behavior or state of mind may play an important role in the disease management.
  • Vitiligo is never a contagious disease, but infective agents may apparently play an indirect role in some cases.
  • Vitiligo is not related to bad diet, but correct diet may help.
  • Vitiligo seems not to be directly related to pollution, but the environment plays a major role in vitiligo development.
  • Vitiligo is not clearly genetically transmitted.
  • Progression of the disease can be halted in about 90% of cases, if treatment is sought.
  • A cure is not yet known for each and every case, but adequate medical and /or surgical therapies may treat satisfactorily over 75% of the affected subjects.
  • Be optimistic! It is not true that there is nothing that can be done for vitiligo. In fact, just the opposite is true and research is happening all over the world to find the cure for vitiligo.

Vitiligo is an acquired sudden loss of the inherited skin color. Despite its long recognition, the cause of this disorder is still unknown. The loss of skin color yields white patches of various sizes, which can be localized anywhere on the body. The disease affects people of all races, men and women, and all age groups. It may appear at any age; cases have been reported as early as 6 weeks after birth and after 80 years of age.

Vitiligo is not a contagious disease, however is is a difficult condition to tolerate, being more often a psychologically devastating disease, especially in darker skinned individuals, in whom it is more easily noticeable. The actual cause of vitiligo is under debate and has been attributed to autoimmune causes, oxidative stress, and/or a neurogenic disturbance. These terms will be explained later on.

In other terms, vitiligo is a skin and/or mucosal disorder characterized by white patches, often, but not always, symmetrical, which usually increase in size with time, corresponding to a substantial loss of functioning epidermal and sometimes hair follicle melanocytes. It may occur in a unilateral distribution or may be generalized.

Vitiligo lesions may rarely itch and have a high propensity to sunburn. Vitiligo is a chronic persistent and often progressive disorder; spontaneous repigmentation is uncommon and usually occurs around the hairs in a perifollicular pattern. Many patients are poorly educated about their illness. In one study, 51.3% of patients believed that their vitiligo was caused by poor medical care, 30% thought personal behavior played a major role, 25% - wrong diet, 21.3% - altered state of mind, and 20% blamed only pollution or environmental alterations. All the beliefs mentioned above are considered by the scientific community to be “per se” unfounded and misleading, even if all of them may offer some true indications for understanding the disease and for finding the cure.

Vitiligo is a disease that presently cannot be cured, but still can be treated successfully with many different approaches. Its progression can be halted in almost 90% of cases with appropriate therapy, most frequently by combining different treatments. More than 75% of subjects affected by vitiligo respond satisfactorily to active treatments (medical or surgical).

Thus, it is not true that there is nothing that can be done for vitiligo. In fact, just the opposite is true.

Author: Prof. Torello Lotti, MD

Please be advised that all information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician or health practitioner. Users are warned against changing any aspects of their treatment, diet or lifestyle based on this information without first consulting a registered medical practitioner. While every precaution is taken to ensure accuracy, VR Foundation makes no warranty as to the reliability, accuracy, timeliness, usefulness or completeness of the content which reflect personal opinion of the authors.

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