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- Vitiligo is a skin problem in which some areas of skin appear lighter than others. It affects about 1% of the population.
- There is a genetic component, with 30% of patients having a family history.
- It can be seen in all ages; 50% begin between ages 10-30.
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- The affected areas appear as
"white" or "pale" patches of skin.
- Usually it does not cause any
symptoms.
- It mostly affects the person's
appearance cosmetically.
- However, these areas are more sensitive to sunlight and burn easily, which may eventually lead to skin cancer.
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- Childhood vitiligo can be more commonly associated with other conditions, in which the immune system destroys normal tissue, causing hair loss, low thyroid hormone, diabetes, anemia, or low adrenal hormones.
- Vitiligo is due to a problem with melanocytes, the cells in the skin that carry color. In the regions where the skin is lighter, there is a lack of these special cells.
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- Examination -- the doctor may easily recognize the typical "white patches" of discolored skin.
- If needed, a special light may be used to examine the suspected area, or the doctor may choose to examine a scraping of the skin under a microscope. If the diagnosis is still not known, a biopsy may be in order.
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- Treatment for vitiligo is difficult. Treatment is primarily to help with the cosmetic appearance.
- Cosmetic makeup such as Covermark or Dermablend may be used to cover the "white" areas.
- If less than 20% of the skin surface is involved, a
medicated cream with Methoxsalen may be applied and the area
is then exposed to ultraviolet light. The medicine is then
washed off. People treated with this medicine must use a SPF
15 sunscreen when outdoors.
- If more than 20% is involved,
Methoxsalen is given by mouth, followed by treatment with
ultraviolet light. Patients must be careful
outdoors, as severe sunburn may result from Methoxsalen
use. This treatment is best for the face and
chest. Fingertips and genital areas do not respond well.
- Years of therapy may be needed.
- Some patients have been treated
with large doses of steroids to good effect.
- Newer, more promising surgical treatments are being studied.
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- Steroids can cause skin thinning and facial acne.
- Psoralen (a phototoxic drug) can cause mild to severe rashes after UVA exposure and also have liver toxicity and is not recommended for children.
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- Vitiligo has been seen more often in people with Hypothyroidism,
hyperthyroidism, diabetes, pernicious anemia, and
Addison's disease.
- Skin cancers are
more likely to develop with vitiligo, so regular check ups
with the doctor are advised.
- Areas of light skin are more sensitive to sunlight and
should be protected with SPF 15 (or greater) sunscreen when
exposed to the sun.
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