Vitiligo is a chronic (long-lasting) depigmenting autoimmune disorder that causes patches of skin to lose pigment or color. This happens when the melanocytes – skin cells that make pigment – are attacked and destroyed, that leads to the disruption of the membrane bound vesicles known as Melanosomes. The production of melanin takes place in Melanosomes from L tyrosinase. This destruction results in hypopigmentation, a skin condition known as Vitiligo causing the skin to turn a milky-white color.

Types of Vitiligo

Vitiligo is generally classified into two main categories: Non-Segmental Vitiligo (NSV) and Segmental Vitiligo (SV). Each type has its characteristics and subtypes.

 

  1. Non-Segmental Vitiligo (NSV)

This is the most common form of vitiligo and is characterized by bilateral and symmetrical patches of depigmentation.

  1. Generalized Vitiligo: This type involves widespread depigmentation across various parts of the body. The patches are usually symmetrical and can develop on any area, including the face, trunk, and limbs.
  2. Vulgaris: Often considered a subtype of generalized vitiligo, vulgaris presents with multiple depigmented patches, often appearing on both sides of the body. It typically begins in childhood or early adulthood.
  • Acrofacial Vitiligo: This type specifically affects the extremities (hands, feet) and facial areas. It often starts as small patches around the eyes, mouth, and on the fingers.
  1. Universal Vitiligo: In this rare form, nearly all of the body’s skin loses its pigment, leading to a very light appearance overall. This can also include depigmentation of hair and mucous membranes.

 

  1. Segmental Vitiligo (SV)
  2. Segmental vitiligo tends to be localized and affects one side of the body or a specific area.
  3. Localized Vitiligo: This type usually appears as one or a few isolated patches in a specific region, often not progressing significantly over time.
  • Focal Vitiligo: Characterized by one or more small spots of depigmentation in one area, this type is often stable and does not spread.

 

Other Considerations

  • Associated Conditions: Vitiligo can be associated with other autoimmune disorders such as thyroid diseases, alopecia areata, and type 1 diabetes.
  • Diagnosis: Diagnosis is primarily based on clinical examination. Dermatologists may use a Wood’s lamp (a special UV light) to enhance the visibility of depigmented areas and to rule out other skin conditions.
  • Treatment Options: Treatments aim to restore skin color or reduce contrast. Options include:
  • Topical corticosteroids: To reduce inflammation and promote repigmentation.
  • Phototherapy: Controlled exposure to ultraviolet light to stimulate melanocyte activity.
  • Depigmentation therapy: For patients with extensive vitiligo who wish to have an even skin tone.
  • Cosmetic camouflage: Using makeup or self-tanners to cover white patches.

 

Psychological Impact

Vitiligo can have significant emotional and psychological effects on individuals, often leading to feelings of embarrassment, anxiety, or low self-esteem. Support groups and counselling can help individuals cope with the condition.

 

Conclusion

Vitiligo is a complex skin condition with various types and manifestations. Understanding the different forms can aid in diagnosis and management, improving the quality of life for those affected.