Vitiligo (cont.)
What are the symptoms vitiligo?
People who develop vitiligo usually first notice white patches (depigmentation)
on their skin. These patches are more commonly found on sun-exposed areas of the
body, 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, genitals, and rectum.
Vitiligo generally appears in one of three patterns:
1. focal pattern -- the depigmentation is limited to one or only a few areas
2. segmental pattern -- depigmented patches develop on only one side of the body
3. generalized pattern -- the most common pattern. Depigmentation occurs
symmetrically on both sides of the body.
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.
Will the depigmented patches spread?
Focal pattern vitiligo and segmental vitiligo remain localized to one part of the body and do not spread. There is no way to predict if generalized 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.
How is vitiligo diagnosed?
The diagnosis of vitiligo is made based on a physical examination, medical
history, and laboratory tests.
A doctor will likely suspect vitiligo if you report (or the physical
examination reveals) white patches of skin on the body-particularly on
sun-exposed areas, including the hands, feet, arms, face, and lips. If vitiligo
is suspected, the doctor will ask about your medical history. Important factors
in the diagnosis include a family history of vitiligo; a rash, sunburn, or other
skin trauma at the site of vitiligo 2 to 3 months before depigmentation started;
stress or physical illness; and premature (before age 35) graying of the hair.
In addition, the doctor will ask whether you or anyone in your family has had
any autoimmune diseases, and whether you are very sensitive to the sun.
To help confirm the diagnosis, the doctor may take a small sample (biopsy) of
the affected skin to examine under a microscope. In vitiligo, the skin sample
will usually show a complete absence of pigment-producing melanocytes. On the
other hand, the presence of inflamed cells in the sample may suggest that
another condition is responsible for the loss of pigmentation.
Because vitiligo may be associated with pernicious anemia (a condition in
which an insufficient amount of vitamin B12 is absorbed from the
gastrointestinal tract) or hyperthyroidism (an overactive thyroid gland), the
doctor 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), which sometimes occurs with
vitiligo. 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.
Next: How can people cope with the emotional and psychological aspects of
vitiligo? »
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