What Is Vitiligo?

Vitiligo is a chronic skin conditions affecting 0.5%-1% of the world population. The condition affects both sexes, all races and all ages, with no difference in prevalence between men and women, however it commonly appears around the age of 20. The condition causes parts of the skin to lose their color and become lighter. The scope of symptoms changes from one person to another. In some, the lighter patch appears on a small area of the body, while in others, light patches appear in several locations and cover a larger skin area. Vitiligo isn’t painful, nor does it itch or have any other symptom other than the change in the color of the affected skin.

Vitiligo Prevalence in Israel:

It is estimated that there are 50-170 thousand people in Israel suffering from vitiligo. Since this condition affects visible areas of the skin, it may appear to be more common than it actually is.

What Causes Vitiligo?

The exact cause is unknown, however it appears to be a combination of genetic factors, an immune system disorder, environmental factors, and other external factors which, when combined, cause the disease.

Vitiligo is an autoimmune condition (meaning that the patient’s immune system attacks their own body), where the immune response is aimed at melanocytes (the cells responsible for producing melanin, which gives the skin its dark shade). The destruction of melanocytes impedes the production of melanin, which in turn leads to lighter, or even white, skin patches. Although a great number of patients attribute the appearance of vitiligo to emotional stress, there currently aren’t any studies which prove a causal link between stress and vitiligo.

How Is Vitiligo Diagnosed?

The appearance of light-colored patches on the skin is not an uncommon complaint among those coming to consult a dermatologist. A variety of skin conditions may cause this symptom, and therefore it is important to consult a dermatologist who may diagnose this condition appropriately. Correct diagnosis is critical for tailoring the right treatment. In most cases, vitiligo is diagnosed clinically based on the appearance of the depigmented patches. In some cases, a designated lamp (woods lamp) may be used. The lamp projects light with a wavelength of 365 nanometer and highlights areas with no melanocytes. If the diagnosis still isn’t conclusive, a skin biopsy may be done, with specific stains for melanocytes and melanin. In addition, a number of lab tests are recommended for vitiligo patients, since this condition may be related to other autoimmune conditions.

What Types of Vitiligo Are There?

Segmental Vitiligo:

Vitiligo which appears on one side of the body in a specific pattern. Onset of symptoms often occurs early in life. This type is stable in nature, meaning it doesn’t spread and remains unchanged over many years, or even throughout the entire lifetime of the patient.

Non-segmental Vitiligo:

Generalized – extensive spots which appear symmetrically on both sides of the body.

Acrofacial – spots on the face and limbs (fingertips and lips).

Universal – involves nearly the entire body, leaving only a few spots with pigment.

Focal – few light patches on a specific area with no specific pattern.

Mucosal – involving only mucous tissue (in the oral cavity and genetalia).

Which Groups Are at Risk for Developing Vitiligo?

Most patients are healthy individuals with no background illnesses. Patients with an impaired immune function, such as a thyroid disorder or lupus, are at an increased risk of being affected by vitiligo.

Each patient must be questioned specifically by an expert about symptoms which may indicate additional autoimmune conditions (and, accordingly, be sent for lab tests in order to rule out these additional conditions).