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JAMA Patient Page
February 9, 2005

Vitiligo

JAMA. 2005;293(6):762. doi:10.1001/jama.293.6.762

Vitiligo is a disorder that results in damage to and loss of melanocytes (cells within the skin that produce melanin, the skin's natural color or pigment). This damage results in patches of depigmented skin. The process primarily affects the skin, but may also affect pigmentation of other sites, including the eyes and hair. Vitiligo may be focal (occurring in only a few patches), segmental (in which the patches occur on one side of the body only), and generalized (patches throughout the body). The course of vitiligo varies and some patients may develop only a few patches while others may experience almost total depigmentation. Vitiligo may affect persons of all ages; however, its onset most commonly occurs during young adulthood. The cause of vitiligo is not completely understood; however, it is thought to be an autoimmune process (a process by which the body produces an immune response against some of its own cells, in this case melanocytes, resulting in their destruction). The February 9, 2005, issue of JAMA includes an article that describes the disorder and discusses available treatments.

DIAGNOSIS

In addition to obtaining a complete medical history and performing a physical examination, including a detailed skin examination, your doctor may order blood tests and refer you to a dermatologist (a doctor with specialized training in skin disorders). A skin biopsy (removal of a small area of the affected skin for testing) may be done to confirm the diagnosis. Because there is evidence that people with vitiligo are at an increased risk for other autoimmune disorders, in particular disorders of the thyroid gland (the gland in the neck that produces a hormone that controls many important processes within the body), your doctor may choose to evaluate you periodically for these disorders.

POSSIBLE TREATMENTS

Treatment may not be necessary in limited cases or when the patches are not a concern for the patient.

  • Topical treatments are creams or ointments that are applied to affected areas of the skin and block the immune system within these areas, decreasing melanocyte damage.

  • Phototherapy (the use of ultraviolet light or laser therapies) targets the affected areas with specific wavelengths of light.

  • Surgical therapies, involving the transplantation of a patch of normal skin or melanocytes grown in culture into an area of depigmentation, may be appropriate for certain kinds of focal vitiligo.

  • In many cases, optimal treatment may require a combination of these therapies.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

TOPIC: SKIN DISORDERS

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