Glossary of related terms |
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Antibodies: protective proteins produced by the body's immune system to fight infectious agents (such as bacteria or viruses) or other "foreign" substances. Occasionally abnormal antibodies develop that can attack a part of the body and cause an "autoimmune" disease. These abnormal antibodies are called autoantibodies. Pigment: a coloring matter in the cells and tissues of the body. Pigmentation: coloring of the skin, hair, mucous membranes, and retina of the eye. Depigmentation: loss of color in the skin, mucous membranes, hair, or retina of the eye. Melanin: a yellow, brown, or black pigment that determines skin color. Melanin also acts as a sunscreen and protects the skin from ultraviolet light. Melanocytes: special cells that produce melanin. Ultraviolet light A (UVA): one type of radiation that is part of sunlight and reaches the earth's surface. Exposure to UVA can cause the skin to tan. Ultraviolet light is also used in a treatment called phototherapy for certain skin conditions, including vitiligo. |
Vitiligo (vit-ill-eye-go) is a disorder that affects the pigment (color) of the skin. With vitiligo, the melanocytes (the cells that make pigment) in the skin, the mucous membranes that line the inside of the mouth, nose, genital and rectal areas, and the retina of the eyes are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo may turn white.
The cause of vitiligo is not known, but doctors and researchers have several different theories. One theory is that people develop antibodies that destroy the melanocytes in their own bodies. Another theory is that melanocytes destroy themselves. Finally, some people have reported that a single event such as sunburn or emotional distress triggered vitiligo. These events have not been scientifically proven to cause vitiligo.
About 1 to 2 percent of the world's population, or 40 to 50
million people, have vitiligo. In the United States, 2 to 5 million
people have the disorder. Ninety-five percent of people who have
vitiligo develop it before their 40th birthday. The disorder
affects all races and both sexes equally. Vitiligo seems to be more
common in people with certain
autoimmune diseases
(diseases
in which a person's immune system reacts against the body's own
organs or tissues). These autoimmune diseases include:
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. However, most children will not get vitiligo even if a parent has it. Most people with vitiligo do not have a family history of the disorder.
People who develop vitiligo usually first notice white patches (depigmentation) on their skin. These patches are more common in sun-exposed areas, 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, and genitals.
Vitiligo generally appears in one of three patterns. In one pattern (focal pattern), the depigmentation is limited to one or only a few areas. Some people develop depigmented patches on only one side of their bodies (segmental pattern). But for most people who have vitiligo, depigmentation occurs on different parts of the body (generalized pattern). 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.
There is no way to predict if 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.
If a doctor suspects that a person has vitiligo, he or she usually begins by asking the person about his or her medical history. Important factors in a person's medical history are:
In addition, the doctor will need to know whether the patient or anyone in the patient's family has had any autoimmune diseases and whether the patient is very sensitive to the sun. The doctor will then examine the patient to rule out other medical problems. The doctor may take a small sample (biopsy) of the affected skin. He or she may also take a blood sample to check the blood-cell count and thyroid function. For some patients, the doctor may recommend an eye examination to check for uveitis (inflammation of part of the eye). A blood test to look for the presence of antinuclear antibodies (a type of autoantibody) may also be done. This test helps determine if the patient has another autoimmune disease.
The change in appearance caused by vitiligo can affect a person's emotional and psychological well-being. In some cases it may even create difficulty in getting or keeping a job. People with this disorder can experience emotional stress, particularly if vitiligo develops on visible areas of the body, such as the face, hands, arms, feet, or on the genitals. Adolescents, who are often particularly concerned about their appearance, can be devastated by widespread vitiligo. Some people who have vitiligo feel embarrassed, ashamed, depressed, or worried about how others will react.
Several strategies can help a person cope with vitiligo. First, it is important to find a doctor who is knowledgeable about vitiligo and takes the disorder seriously. The doctor should also be a good listener and be able to provide emotional support. Patients need to let their doctor know if they are feeling depressed. Doctors and other mental health professionals can help people deal with depression. Patients should also learn as much as possible about the disorder and treatment choices so that they can participate in making important decisions about medical care.
Talking with other people who have vitiligo may also help a person cope. The National Vitiligo Foundation can provide information about vitiligo and refer people to local chapters that have support groups of patients, families, and physicians. Family and friends are another source of support.
Some people with vitiligo have found that cosmetics that cover the white patches improve their appearance and help them feel better about themselves. A person may need to experiment with several brands of concealing cosmetics before finding the product that works best.
The goal of treating vitiligo is to restore the function of the skin and to improve the patient's appearance. Therapy for vitiligo takes a long time-it usually must be continued for six to 18 months. The choice of therapy depends on the number of white patches and how widespread they are and on the patient's preference for treatment. Each patient responds differently to therapy, and a particular treatment may not work for everyone.
All surgical therapies must be viewed as experimental because their effectiveness and side effects remain to be fully defined.
Over the past 10 years, research on how melanocytes play a role in vitiligo has greatly increased. This includes research on autologous melanocyte transplants. Doctors and researchers continue to look for the causes of and new treatments for vitiligo.
Where can people get more information about vitiligo?
National Vitiligo Foundation
P.O. Box 6337
Tyler, TX 75711
903/534-2925
World Wide Web address:
http://www.nvfi.org/
This nonprofit organization stimulates,
coordinates, and sponsors scientific research on vitiligo. In
addition, the Foundation educates the public about vitiligo and
assists in making referrals for treatment. The Foundation holds
annual and regional meetings and sponsors symposia open to both
professionals and the public. It publishes a newsletter two times a
year and can provide free brochures on vitiligo.
American Academy of Dermatology
P.O. Box 4014
Schaumburg, IL 60168-4014
847/330-0230
World Wide Web address:
http://www.aad.org
This national organization for
dermatologists publishes a six-page brochure on vitiligo. A single
copy is free with a self-addressed stamped envelope. The Academy
also can provide referrals to dermatologists.
Source:
National Institutes of Health
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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