What is Vitiligo?

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What is Vitiligo?

Vitiligo is a pigmentation disorder in which melanocytes in the skin - tissues that line the inside of the mouth, nose, the genital areas, the rectal areas (mucous membranes) and the retina of the eyes - are destroyed as a result of which white patches of skin appear on different parts of the body. 

The term Vitiligo is probably derived from the latin word Vitilus - meaning calf and was first used by roman physician Celsus of 1st century AD,The characteristics white patches of disease resembled the white patches of a spotted calf in India. Leukoderma is a generic name for relatively or absolutely lightened in colour.

Noble Vitiligo clinic was established in 1997 in Bangalore-India and was the first clinic in South India to start treating Vitiligo patients with melanocyte transplantation. Over a period of 10 years, over 4500 patients have taken advantage of this new technique to gain excellent cosmetic results, with a success rate of 80%. 


Key Words



Protective protiens produced by the body's immune system to fight infectious agents (bacteria or viruses) or other foreign substances. Autoantibodies are abnormal antibodies that attack a part of the body and cause autoimmune disease


Colouring matter in the cells and tissues of the body


Colouring of the Skin, Hair, Mucous membrane


Loss of colour in the skin


Yellow, Brown or Black pigment that determines skin colour


Special cells that produce melanin

The term Vitiligo is probably derived from the latin word Vitilus - meaning calf and was first used by roman physician Celsus of 1st century AD,The characteristics white patches of disease resembled the white patches of a spotted calf in India. Leukoderma is a generic name for relatively or absolutely lightened in colour.

Incidence of Vitiligo 
About 1-3% of the India's population is affected by Vitiligo.Vitiligo is most common in the first and second decade of life and 95% of people develop it before their 40th birthday. 

Emotional & Psychological Aspects of Vitiligo 
The appearance of a white patch can affect a persons emotional & Psychological well-being. Patients can experience emotional stress especially if Vitiligo develops on visible areas of the body like face, hands, feet or genitals & though it is not a contagious disease people with Vitiligo feel embarrassed, ashamed, depressed or worried about how others will react.Patients need to let their doctors know about their mental status so that appropriate medical treatment can be given. 

Causes of Vitiligo 
Various causes are attributed to the disease. some of the common ones are: 

Vitiligo can run in families. Children whose parents have the disorder are more likely to develop Vitiligo. However most children will not get vitiligo even if a parent has it and most people with vitiligo do not have a family history of the disorder. 

This accounts for majority of the cases where-in the patients own body produces antibodies that destroy melanocytes. There are certain auto-immune diseases which are associated with Vitiligo like:

» Hyper Thyroidism (Overactive Thyroid Gland).
» Adrenocortical Insufficiency (Decrease in level of Hormone called corticosteriod).
» Alopecia Aerate (Patches of Baldness).
» Pernicious Anaemia (a low level of Haemoglobin caused by the failure of the body to absorb Vitamin B12). 
» Diabetes Mellitus, Psoriasis.

Segmental Vitiligo 
Here the lesion spreads along the course of a particular nerve. It is thought that the nerve releases certain toxic substances which may destroy the melanocytes. 

Chemical / Contact leukoderma 
This occurs at the site of contact of certain chemicals like rubber gloves containing monobenzylether of hydroguinone, rubber condoms, bindis, brassiere, watch strap, surgeons gloves, rubber chappal straps. 

Symptoms of Vitiligo 
The disease is characterised by the appearance of depigmented patches(milky white) on the skin, common in sun exposed areas like hands, feet, arms, face and lips. Other common areas include armpits, groin, around the mouth, eyes, nostrils, navel and genitals. Rarely the patches show slight erythema, but as a rule they show only depigmentation and sensivity to light, the hair may be white or black but in a particular lesion, when hairy areas are involved the hair may turn white. 
Vitiligo generally appears in one of the three patterns:

Focal Pattern : Depigmentation is limited to one or only few areas. 
Segmental Pattern : Depigmentation develops on only one side of the body. 
Generalised Pattern : Depigmentation develops on different parts of the body. 

Diagnosis of Vitiligo 
Clinical Examination 
Depigmented patch is usually the diagnostic features of Vitiligo. There may be a predisposing history of a rash/sunburn or trauma at the site of patch 2-3 months prior to the onset or History of auto-immune disease in the family. A biopsy of affected skin confirms Vitiligo. 

The primary goal is to restore the function of the skin & improve the patient's appearance. The choice of therapy depends upon the number of patches, the size of patch & on patient's preference for the treatment. 
» Topical steriod therapy. 
» Topical psoralen photochemotherapy. 
» Oral psoralen photochemotherapy. 
» Oral steroid therapy. 
» Depigmentation. 

Surgical Therapy 
» Autologous skin Grafts.
» Punch Grafts.
» Autologous Melanocyte transplantation. 

Medical Treatment 
Several methods of treatments are available with varying success rate. The most commonly used is called PUVA therapy where in patient is given oral/topical psoralens followed by exposure to ultra-violet light. The success rate is limited (Only 60% achieve more than 30% repigmentation) & difficult areas like hands, fingers, feet, ankles and lips do not pigment. 

Surgical treatment 
This should be considered for patients in whom: 
» Vitiligo has not changed over a period of one year.
» Failed medical line of treatment.
» No New hypopigmented patches should develop in this one year period.
» All wound should heal with normal pigmentation.