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.
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
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
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
American Academy of Dermatology 202/842-3555 http://www.aad.org
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Vitiligo Foundation 903/595-3713 http://www.vitiligofoundation.org
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
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TOPIC: SKIN DISORDERS
Ringold S, Glass TJ, Glass RM. Vitiligo. JAMA. 2005;293(6):762. doi:10.1001/jama.293.6.762