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Vitiligo is a dermatological condition characterized by the appearance of white patches of skin on different parts of the body as a result of the destruction of the cells that make pigment (melanocytes). This may vary from one or two white spots on the skin to large areas of depigmentation. Vitiligo is not contagious. It seems to occur more often among people who have certain autoimmune diseases. For some people, although not for everyone, the depigmentation is progressive.
Vitiligo is characterized by spots on the skin with decreased pigmentation. These lesions are usually sharply demarcated with increased coloring (hyperpigmentation) on the borders, and are often symmetrical in shape. These areas most often appear on the face, neck, hands, abdomen, and thighs although they can occur on all parts of the skin. The hair in vitiliginous areas is usually white and the skin lesions appear white under a Wood's light. The lesions are prone to sunburn and should be protected from sunlight.
People with vitiligo may have premature graying of the scalp hair, eyelashes, eyebrows, and beard.
For some people, the depigmentation begins with a few patches and then spreads to other parts of the body. Some people notice additional depigmentation during periods of physical or emotional stress. However, in some cases, the disorder does not appear to be progressive, and the depigmentation does not spread from the areas first noticed.
The exact cause of vitiligo is not known, although there are several theories. Research on this is continuing.
There appears to be a hereditary component in some cases. Although it often appears with no family history, the probability of developing vitiligo is somewhat higher for children in families where it has been known to occur. However, people who have vitiligo often have children who are not affected by it, and many people with vitiligo do not have a family history of the disorder.
This disorder appears to be more common among people who have certain autoimmune diseases. These are diseases in which a person's immune system for some reason perceives the body's own tissues as foreign and reacts against them. Some of the diseases that are sometimes associated with vitiligo include hyperthyroidism, pernicious anemia, alopecia areata, and adrenocortical insufficiency. Research at the National Institutes of Health indicates that vitiligo is 10 to 15 times more common in people with other autoimmune diseases. The disorder may also follow unusual trauma, especially to the head.
Worldwide, about one to two percent of the population has the disorder at any one time. Although vitiligo can affect people at any age, 95 percent of those affected develop the disorder before age 40.
Most standard therapy consists of sensitizing a depigmented area with a topical or oral medication (psoralens) after which the treated area is exposed to the sun or ultraviolet light. Small lesions of Vitiligo may be camouflaged with cosmetic creams. Para-aminobenzoic acid solution or gel gives protection against sunburn.
The National Vitiligo Foundation, see below, maintains a formulary of safe cosmetics designed particularly for persons with vitiligo.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.
For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
For information about clinical trials sponsored by private sources, contact:
The National Vitiligo Foundation provides brief summaries of current and recent research on its Web site. (See the Resources section of this report for information on how to contact the foundation.) Studies listed on that site include:
22100 Gratiot Ave.
Eastpointe, MI 48021
Phone #: 586-776-3900
800 #: 800-598-4668
Home page: http://www.aarda.org/
PO Box 7540
Clearwater, FL 33758 USA
Phone #: 727-461-3899
800 #: N/A
Home page: http://www.avrf.org
PO Box 4121
Brick, NJ 08723
Phone #: N/A
800 #: N/A
Home page: N/A
Phone #: N/A
800 #: N/A
Home page: http://www.autoimmunitycommunity.org
1-3 rue de Chantepoulet
Geneva, CH 1211 Switzerland
Phone #: 410-229-080484
800 #: N/A
Home page: http://www.esid.org
PO Box 8126
Gaithersburg, MD 20898-8126
Phone #: 301-251-4925
800 #: 888-205-2311
Home page: http://rarediseases.info.nih.gov/GARD/
11250 Cornell Park Drive
Cincinnati, OH 45242 USA
Phone #: 513-793-6834
800 #: --
Home page: http://www.nvfi.org
One AMS Circle
Bethesda, MD 20892-3675 USA
Phone #: 301-495-4484
800 #: 877-226-4267
Home page: http://www.niams.nih.gov/
P.O. Box 3565
Lynchburg, VA 24503
Phone #: 434-326-5380
800 #: N/A
Home page: http://www.vitiligosupport.org
Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:835-36.
Fauci AS, et al., eds. Harrison's Principles of Internal Medicine, 14th Ed. New York, NY: McGraw-Hill, Inc; 1998:316-17.
Berkow R, ed. The Merck Manual-Home Edition. Whitehouse Station, NJ: Merck Research Laboratories; 1997:988-89.
Champion RH, et al., eds. Textbook of Dermatology. 5th ed. Cambridge, MA: Blackwell Scientific Publications; 1992:1608-10.
Silvan M. The psychological aspects of vitiligo. Cutis. 2004;73:163-67.
Matsumura Y, Ananthaswamy HN. Toxic effects of ultraviolet radiation on the skin. Toxicol Appl Pharmacol. 2004;195:298-308.
Hartmann A, Brocker CB, Becker JC. Hypopigmentary skin disorders: current treatment options and future directions. Drugs. 2004;64:89-107.
Orion E, Matz H, Wolf D, et al. Cafe au lait has a hue of its own. Dermatol Online J. 2003;9:8.
Arroyo MP, Tift L. Vitiligo therapy: where are we now? J Drugs Dermatol. 2003;2:404-08.
Roelandts R. Photo(chemo) therapy for vitiligo. Photodermatol Photo-immunol Photomed. 2003;19:1-4.
Yu HS. Melanocyte destruction and repigmentation in vitiligo: a model for nerve cell damage and regrowth. J Biomed Sci. 2002;9(6 Pt 2):564-73.
Taneja A. Treatment of vitiligo. J Dermatolog Treat. 2002;13:19-25.
van den Wijngaard R, Wankowicz-Kalinska A, Pals S, et al. Autoimmune melanocyte destruction in vitiligo. Lab Invest. 2001;81:1061-67.
van Geel N, Ongenae K, Naeyaert JM. Surgical techniques for vitiligo: a review. Dermatology. 2001;201:162-66.
FROM THE INTERNET
McKusick VA, ed. Online Mendelian Inheritance in Man (OMIM). Baltimore. MD: The Johns Hopkins University; Vitiligo. Entry No: 193200; Last Update: 5/29/03.
Vitiligo: The Pigment Problem. Kids Connection. American Academy of Dermatology. 2003. 1p.
Questions and Answers about Vitiligo. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). nd. 9pp.
Vitiligo. American Academy of Dermatology. Revised 1999. 3pp.
Report last updated: 2007/03/09 00:00:00 GMT+0