Question 6. How can I be sure that I am ...?

Key points

  • Uniformly white patches surrounded by normal skin, not painful and usually not itchy: this is the most usual presentation of vitiligo.
  • Vitiligo is usually discovered during spring and summer months in sun-exposed areas of skin. The resulting white patches do not pigment after sun exposure and will have a tendency to sunburn easily.
  • The dermatologist should always make a full body examination for vitiligo.
  • A hand device (Wood’s lamp) emitting ultraviolet light is usually used to increase the visibility of white patches: this can be enough for a correct clinical diagnosis.
  • A biopsy of the skin is usually not required.
  • After the examination, appropriate blood tests can be taken and then the appropriate treatment be selected according to blood test results.
  • Rare types of vitiligo are possible and, thus, an assessment by an expert dermatologist is advisable.

Discrete, uniformly white patches with convex borders surrounded by normal skin, not painful and very rarely itching are the usual symptoms of vitiligo. White hair can be associated or not with these white patches. Any kind of trauma of the skin may induce white patches of vitiligo in any part of the skin surface; this is called Koebner Phenomenon, and is quite common.

The diagnosis of vitiligo is usually made clinically and with the use of a Wood’s lamp, a hand device emitting ultraviolet rays (at 365 nm) which makes the color of white patches even whiter. Vitiligo is usually discovered during the spring and summer moths in sun - exposed areas: normal skin becomes tanned while vitiligo skin remains white, with tendency to sunburn. When presentation of vitiligo is atypical, a biopsy can be taken from the skin, in order to show the complete absence of melanocytes in the white patch. A full body examination is necessary to detect all skin areas affected, including mouth mucosal and genital depigmentation.

Author: Prof. Torello Lotti, MD

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