Vitiligo

Vitiligo is an autoimmune condition that is characterised by depigmentation of the skin due to loss of melanocytes.

It affects 1% of the population. The peak incidence is 20 – 30 years. It affects men and women almost equally.

• Risk factors
  • Presence of other autoimmune conditions
  • Genetic predisposition
  • Physical trauma (Koebner phenomenon), sunburn, and emotional stress. These can cause the disease or influence progression
  • History of atopy
  • Family history of atopy
  • Chemical exposure e.g., phenolic compounds
• Associated conditions
  • Type 1 diabetes mellitus
  • Addison’s disease
  • Autoimmune thyroid disorders
  • Pernicious anaemia
  • Alopecia areata
• Signs and symptoms
  • Well demacarted patches of depigmented skin
    • Tends to affect the peripheries
    • New lesions may be precipitated by trauma (Koebner phenomenon)
• Investigations
  • Wood’s lamp: no pigment
  • Biopsy: absence of melanocytes
• Treatment
  • Apply sunscreen to affected areas
  • Camouflage make-up
  • Topical corticosteroids (may reverse changes if applied early)
  • Topical tacrolimus
  • Phototherapy