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What Is Vitiligo?
Vitiligo (vit-ill-EYE-go) is a pigmentation
disorder in which melanocytes (the cells that make pigment) in
the skin are destroyed. As a result, white patches appear on the
skin in different parts of the body. Similar patches also appear
on both the mucous membranes (tissues that line the inside of
the mouth and nose), and the retina (inner layer of the
eyeball). The hair that grows on areas affected by vitiligo
sometimes turns white.
The cause of vitiligo is not known,
but doctors and researchers have several different theories.
There is strong evidence that people with vitiligo inherit a
group of three genes that make them susceptible to
depigmentation. The most widely accepted view is that the
depigmentation occurs because vitiligo is an autoimmune
disease—a disease in which a person’s immune system reacts
against the body’s own organs or tissues. As such, people’s
bodies produce proteins called cytokines that alter their
pigment-producing cells and cause these cells to die. Another
theory is that melanocytes destroy themselves. Finally, some
people have reported that a single event such as sunburn or
emotional distress triggered vitiligo; however, these events
have not been scientifically proven as causes of vitiligo.
Who Is Affected by Vitiligo?
About 0.5 to 1 percent of the world’s
population, or as many as 65 million people, have vitiligo. In the United
States, 1 to 2 million people have the disorder. Half the people who have
vitiligo develop it before age 20; most develop it before their 40th
birthday. The disorder affects both sexes and all races equally; however, it
is more noticeable in people with dark skin.
Vitiligo seems to be
somewhat more common in people with certain autoimmune diseases. These
autoimmune diseases include hyperthyroidism (an overactive thyroid gland),
adrenocortical insufficiency (the adrenal gland does not produce enough of
the hormone called corticosteroid), alopecia areata (patches of baldness),
and pernicious anemia (a low level of red blood cells caused by the failure
of the body to absorb vitamin B12 ). Scientists do not know the reason for
the association between vitiligo and these autoimmune diseases. However,
most people with vitiligo have no other autoimmune disease.
Vitiligo may
also be hereditary; that is, it can run in families. Children whose parents
have the disorder are more likely to develop vitiligo. In fact, 30 percent
of people with vitiligo have a family member with the disease. However, only
5 to 7 percent of children will get vitiligo even if a parent has it, and
most people with vitiligo do not have a family history of the disorder.
What Are the Symptoms of Vitiligo?
People who develop vitiligo usually
first notice white patches (depigmentation) on their skin. These patches are
more commonly found on sun-exposed areas of the body, including the hands,
feet, arms, face, and lips. Other common areas for white patches to appear
are the armpits and groin, and around the mouth, eyes, nostrils, navel,
genitals, and rectal areas.
Vitiligo generally appears in one of three
patterns:
focal pattern—the depigmentation is limited to one or only a
few areas
segmental pattern—depigmented patches develop on only one side
of the body
generalized pattern—the most common pattern. Depigmentation
occurs symmetrically on both sides of the body.
In addition to white
patches on the skin, people with vitiligo may have premature graying of the
scalp hair, eyelashes, eyebrows, and beard. People with dark skin may notice
a loss of color inside their mouths.
Will the Depigmented Patches Spread?
Focal pattern vitiligo and segmental vitiligo remain localized to one part
of the body and do not spread. There is no way to predict if generalized
vitiligo will spread. For some people, the depigmented patches do not
spread. The disorder is usually progressive, however, and over time the
white patches will spread to other areas of the body. For some people,
vitiligo spreads slowly, over many years. For other people, spreading occurs
rapidly. Some people have reported additional depigmentation following
periods of physical or emotional stress.
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