Vitiligo


Vitiligo is a common disorder of depigmentation which probably has an autoimmune etiology. It presents in childhood or early adult life with well-demarcated macules of complete pigment loss. Patients are very susceptible to sunburn. Lesions are often symmetrical and frequently involve the face, hands and genitalia. The hair can also depigment. Trauma may induce new lesions. Spontaneous repigmentation can occur and often starts around hair follicles, giving a speckled appearance. However, repigmentation is rare if a lesion has persisted for more than 1 year or if the hair is depigmented. The psychological consequences of vitiligo can be devastating.

Management

  • Proper sun protection
  • Topical glucocorticoids
  • Topical calcineurin inhibitors like tacrolimus, pimecrolimus
  • Systemic glucorticoids
  • Phototherapy (PUVA or NB-UVB)
  • Surgery

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