Question 7. I have vitiligo: which blood tests ...?

Key points

  • After a full body skin examination, specific forms of vitiligo may require blood examination or other medical tests.
  • Vitiligo can be generally divided into three classification types: localized, generalized and universal (involving more than 80% of the skin): according to this, different blood tests or specific examinations are necessary.
  • Thyroid disorders and autoimmune diseases should be investigated in generalized and universal forms.
  • Ophthalmologic and auditory investigations can be useful in generalized and universal forms.
  • Localized vitiligo usually does not require blood tests or further medical examinations.
  • In conclusion, generalized and universal vitiligo per se, require the investigation of thyroid disorders and other autoimmune diseases, as well as ophthalmologic and auditory investigations.

After the diagnosis of vitiligo, a full body skin examination is necessary in order to evaluate the specific form of the disease. Thyrotropin (thyroid- stimulating hormone) levels, antinuclear antibody titer, and a complete blood count should be considered for all generalized forms of vitiligo, especially when prompted by signs or symptoms. Antithyroidperoxidase antibodies and/or antithyroglobulin antibody tests may also be worthwhile. They are mandatory, if any signs of thyroid disease are present.

The evaluation of possible associated disorders is mandatory in all generalized forms of vitiligo. In these cases all autoimmune diseases should be screened, as well as atopic dermatitis, psoriasis, pernicious anemia and diabetes. Ophthalmologic and auditory investigations can be useful, because melanocytes are present both in the eye and in the inner ear.

Author: Prof. Torello Lotti, MD

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