Vitiligo

Vitiligo

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Vitiligo is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Leukoderma

Disorder Subdivisions

  • None

General Discussion

Vitiligo is a dermatological condition characterized by the appearance of white patches of skin on different parts of the body as a result of the destruction of the cells that make pigment (melanocytes). This may vary from one or two white spots on the skin to large areas of depigmentation. Vitiligo is not contagious. It seems to occur more often among people who have certain autoimmune diseases. For some people, although not for everyone, the depigmentation is progressive.

Symptoms

Vitiligo is characterized by spots on the skin with decreased pigmentation. These lesions are usually sharply demarcated with increased coloring (hyperpigmentation) on the borders, and are often symmetrical in shape. These areas most often appear on the face, neck, hands, abdomen, and thighs although they can occur on all parts of the skin. The hair in vitiliginous areas is usually white and the skin lesions appear white under a Wood's light. The lesions are prone to sunburn and should be protected from sunlight.



People with vitiligo may have premature graying of the scalp hair, eyelashes, eyebrows, and beard.



For some people, the depigmentation begins with a few patches and then spreads to other parts of the body. Some people notice additional depigmentation during periods of physical or emotional stress. However, in some cases, the disorder does not appear to be progressive, and the depigmentation does not spread from the areas first noticed.

Causes

The exact cause of vitiligo is not known, although there are several theories. Research on this is continuing.



There appears to be a hereditary component in some cases. Although it often appears with no family history, the probability of developing vitiligo is somewhat higher for children in families where it has been known to occur. However, people who have vitiligo often have children who are not affected by it, and many people with vitiligo do not have a family history of the disorder.



This disorder appears to be more common among people who have certain autoimmune diseases. These are diseases in which a person's immune system for some reason perceives the body's own tissues as foreign and reacts against them. Some of the diseases that are sometimes associated with vitiligo include hyperthyroidism, pernicious anemia, alopecia areata, and adrenocortical insufficiency. Research at the National Institutes of Health indicates that vitiligo is 10 to 15 times more common in people with other autoimmune diseases. The disorder may also follow unusual trauma, especially to the head.

Affected Populations

Worldwide, about one to two percent of the population has the disorder at any one time. Although vitiligo can affect people at any age, 95 percent of those affected develop the disorder before age 40.

Standard Therapies

Most standard therapy consists of sensitizing a depigmented area with a topical or oral medication (psoralens) after which the treated area is exposed to the sun or ultraviolet light. Small lesions of Vitiligo may be camouflaged with cosmetic creams. Para-aminobenzoic acid solution or gel gives protection against sunburn.



The National Vitiligo Foundation, see below, maintains a formulary of safe cosmetics designed particularly for persons with vitiligo.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.



For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



The National Vitiligo Foundation provides brief summaries of current and recent research on its Web site. (See the Resources section of this report for information on how to contact the foundation.) Studies listed on that site include:

References

TEXTBOOKS

Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:835-36.



Fauci AS, et al., eds. Harrison's Principles of Internal Medicine, 14th Ed. New York, NY: McGraw-Hill, Inc; 1998:316-17.



Berkow R, ed. The Merck Manual-Home Edition. Whitehouse Station, NJ: Merck Research Laboratories; 1997:988-89.



Champion RH, et al., eds. Textbook of Dermatology. 5th ed. Cambridge, MA: Blackwell Scientific Publications; 1992:1608-10.



REVIEW ARTICLES

Silvan M. The psychological aspects of vitiligo. Cutis. 2004;73:163-67.



Matsumura Y, Ananthaswamy HN. Toxic effects of ultraviolet radiation on the skin. Toxicol Appl Pharmacol. 2004;195:298-308.



Hartmann A, Brocker CB, Becker JC. Hypopigmentary skin disorders: current treatment options and future directions. Drugs. 2004;64:89-107.



Orion E, Matz H, Wolf D, et al. Cafe au lait has a hue of its own. Dermatol Online J. 2003;9:8.

Arroyo MP, Tift L. Vitiligo therapy: where are we now? J Drugs Dermatol. 2003;2:404-08.



Roelandts R. Photo(chemo) therapy for vitiligo. Photodermatol Photo-immunol Photomed. 2003;19:1-4.



Yu HS. Melanocyte destruction and repigmentation in vitiligo: a model for nerve cell damage and regrowth. J Biomed Sci. 2002;9(6 Pt 2):564-73.



Taneja A. Treatment of vitiligo. J Dermatolog Treat. 2002;13:19-25.



van den Wijngaard R, Wankowicz-Kalinska A, Pals S, et al. Autoimmune melanocyte destruction in vitiligo. Lab Invest. 2001;81:1061-67.



van Geel N, Ongenae K, Naeyaert JM. Surgical techniques for vitiligo: a review. Dermatology. 2001;201:162-66.



FROM THE INTERNET

McKusick VA, ed. Online Mendelian Inheritance in Man (OMIM). Baltimore. MD: The Johns Hopkins University; Vitiligo. Entry No: 193200; Last Update: 5/29/03.



Vitiligo: The Pigment Problem. Kids Connection. American Academy of Dermatology. 2003. 1p.

www.aad.org/Kids/vitiligo.html



Questions and Answers about Vitiligo. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). nd. 9pp.

www.niams.nih.gov/hi/topics/vitiligo/vitiligo.htm



Vitiligo. American Academy of Dermatology. Revised 1999. 3pp.

www.aad.or/pamphlets/Vitiligo.html

Resources

American Autoimmune Related Diseases Association, Inc.

22100 Gratiot Ave.

Eastpointe, MI 48021

Tel: (586)776-3900

Fax: (586)776-3903

Tel: (800)598-4668

Email: aarda@aarda.org

Internet: http://www.aarda.org/



National Vitiligo Foundation

10945 Reed Hartman Highway

Suite 216

Cincinnati, OH 45242

USA

Tel: (513)541-3903

Fax: (513)558-0198

Email: info@nvfi.org

Internet: http://www.nvfi.org



NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

Information Clearinghouse

One AMS Circle

Bethesda, MD 20892-3675

USA

Tel: (301)495-4484

Fax: (301)718-6366

Tel: (877)226-4267

TDD: (301)565-2966

Email: NIAMSinfo@mail.nih.gov

Internet: http://www.niams.nih.gov/



American Vitiligo Research Foundation, Inc.

PO Box 7540

Clearwater, FL 33758

USA

Tel: (727)461-3899

Fax: (727)461-4796

Email: vitiligo@avrf.org

Internet: http://www.avrf.org



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



Autoimmune Information Network, Inc.

PO Box 4121

Brick, NJ 08723

Fax: (732)543-7285

Email: autoimmunehelp@aol.com



European Society for Immunodeficiencies

1-3 rue de Chantepoulet

Geneva, CH 1211

Switzerland

Tel: 410229080484

Fax: 41229069140

Email: esid@kenes.com

Internet: http://www.esid.org



AutoImmunity Community

Email: moderator@autoimmunitycommunity.org

Internet: http://www.autoimmunitycommunity.org



Vitiligo Support International

P.O. Box 3565

Lynchburg, VA 24503

Tel: (434)326-5380

Fax: (540)301-1551

Email: info@vitiligosupport.org

Internet: http://www.vitiligosupport.org



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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