Vitiligo: A pigmentation disorder

The word literally means white skin. There is gradual loss of the pigment melanin from the skin layers which results in white patches. The condition does not cause any organic harm. This disease is caused neither by any germs, nor is it due to bad blood, so it is neither infectious nor contagious.

Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. As a result, white patches appear on the skin in different parts of the body. Similar patches also appear on both the mucous membranes tissues that line the inside of the mouth and nose, and the retina. The hair that grows on areas affected by vitiligo sometimes turns white.

The cause of vitiligo is not known, but doctors and researchers have several different theories. There is strong evidence that people with vitiligo inherit a group of three genes that make them susceptible to de-pigmentation. The most widely-accepted view is that depigmentation occurs because vitiligo is an autoimmune disease — a disease that affects a person’s immune system by reacting against the body’s own organs or tissues. It is also believed that vitiligo occurs after triggering factors such as emotional distress, major illness, chemicals, skin trauma, sun burn etc.

About 0.5 to 1 per cent of the world’s population, or as many as 65 million people, have vitiligo. Half the percentage develop it before age 20; most develop it before their 40th birthday. The disorder affects both sexes and all races equally. However, it is more noticeable in those with dark skin.

Vitiligo may also be hereditary. It can run in the family gene pool. In fact, 30 per cent have a family member with the disease. However, only 5 to 7 per cent of children can get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder.

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:

*Focal pattern: Depigmentation is limited to one or only a few areas;
*Segmental pattern: Depigmented patches develop on only one side of the body
*8Generalised pattern: The most common pattern. Depigmentation occurs symmetrically on both sides of the body.

Focal pattern vitiligo and segmental vitiligo remain localised to one part of the body and do not spread. In some cases,  the disorder is usually progressive, however, and over time the white patches will spread to other areas of the body.
Some patients have reported additional depigmentation following periods of physical or emotional stress.

“Homoeopathic remedies are helpful in achieving this. Rightly indicated constitutional remedy is capable of re-pigmentation in the white patches and also to prevent depigmentation in the future.

Commonly indicated medicines for vitiligo are arsenicum album, ars.sulph.flavum, bacillinum, graphites, merc sol, natrum muriaticum, nitric acid, nux vomica, phosphorus, sepia, silicea, sulphur, thuja. But the remedy should be taken in appropriate dosage under medical supervision for good results. The diagnosis of vitiligo is made based on a physical examination, medical history, and laboratory tests. A doctor will likely suspect vitiligo if the patient reports (or the physical examination reveals) white patches of skin on the body — particularly on sun-exposed areas.

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 graying of the hair.  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.

Vitiligo is usually supposed to be incurable or left to the fate. Exposure to UV radiation may temporarily darken the skin but the condition may aggravate later.  So treatment should be aimed at removing the root cause of the disease and finding a permanent solution to the problem.

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