Last reviewed 01/2018
Vitiligo is a common skin disorder characterized by the development of depigmented macules and patches.
- these patches and macules correspond histologically to decreased or absent cutaneous melanocyte in the skin.
- main mechanism of melanocyte destruction in vitiligo is theorized to be an autoimmune lymphocytic attack on melanocyte (1)
The prevalence of the disease is around 1% in the world population (2)
- both men and women equally affected (3)
- rate of occurrence do not differ according to skin type or race, though the lesions are most noticeable in pigmented individuals (3).
- the onset of illness occurs before 20 years of age in 50% of patients - therefore it can also be a significant paediatric problem
Vitiligo can be divided according to its extent and distribution into:
- nonsegmental (or generalized) vitiligo–
- seen in around 85-90% of the cases
- the disease is progressive with episodes of flare ups (3)
- often presents as symmetrical (vulgaris) type although it can be localized type with small focal lesions (2)
- frequently seen in sites where there is pressure and friction causing trauma to the skin.
- segmental vitiligo –
- due to the earlier onset of the disease, around 30% occur in childhood (3)
- the disease begins rapidly and later stabilizes
- it is confined to one unilateral segment and in most patients is limited to one unique segment only, although rarely two or more segments on the same side or opposite side may be involved (1)
- depigmentation may follow a dermatomal distribution or Blaschko’s lines (1)
There can be a significant effect on quality of life in patients with vitiligo. Patients may present with low self esteem, social anxiety, depression and rejection by those around them (1).
In vitiligo patients there is an increased prevalence of developing autoimmune thyroid disease or other autoimmune diseases (1)
Earlier onset of childhood vitiligo is linked to a family history of vitiligo (1).
- (1) Gawkrodger D.J. et al. Guideline for the diagnosis and management of vitiligo. BJD 2008;159:1051-1076
- (2) The Vitiligo Society 2007. Vitiligo: Information for medical professionals
- (3) Taïeb A, Picardo M. Vitiligo. NEJM 2009;360:160-169
- (4) Kovacs S. Vitiligo. J Am Acad Dermatol 1998;38: 647-666.
- (5) Silverberg NB et al. Tacrolimus ointment promotes repigmentation of vitiligo in children: a review of 57 cases. J Am Acad Dermatol. 2004 Nov;51(5):760-6
- (6) Pajvunu U et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol. 2006 Aug;55(2):238-44