Introduction
Vitiligo is a chronic pigmentation disorder characterised by white patches caused by the gradual loss of melanocytes, the cells responsible for skin pigmentation. It can affect people of all ages and all ethnic backgrounds. Although it is neither contagious nor dangerous, its cosmetic and psychological impact can be significant.
Symptoms
- Well-defined white patches of varying size
- Common sites: face, hands, feet, around body openings (mouth, eyes, genitals)
- Gradual progression or flare-ups
- No pain, itching or inflammation
- Hair sometimes loses its colour on affected areas
- Increased sensitivity to the sun on depigmented areas
Causes
- Autoimmune mechanism leading to the destruction of melanocytes
- Genetic predisposition
- Possible triggers
- stress, skin injuries
- Possible association with other autoimmune diseases
Diagnosis
- Clinical skin examination
- Wood’s lamp examination, which highlights depigmented areas
- Assessment of the extent and activity of the disease
- Targeted further tests if an associated autoimmune disease is suspected
Treatments
- Topical corticosteroids
- Calcineurin inhibitors
- Targeted topical treatments depending on the site
- Medical narrowband UVB phototherapy
- Excimer laser for localised forms
- Medical LED as an add-on
- Medical camouflage techniques
Management
A personalised assessment of vitiligo activity
A choice of treatment tailored to each patient
Psychological support if needed
Rigorous sun protection of depigmented areas
Regular dermatological follow-up