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Not all white patches are vitiligo

18 August 2012

The skin, an important part of the body, is the first line of defence against various ailments. It serves many functions like thermoregulation, protection, metabolic function and sensation.

Human skin colour ranges from white to almost black. Colour is primarily due to the presence of melanin in skin.

There are number of diseases causing change in colour of skin, varying from loss of pigmentation as in vitiligo to increase in skin pigmentation as in many hyper-pigmentary skin conditions.

Although several theories have been proposed about the pathogenesis of vitiligo, the precise cause remains uncertain. The most widely accepted theory about de-pigmentation in vitiligo is autoimmune theory. According to this theory, the body’s immune system turns against the body itself, attacking the cells (melanocytes) that give colour to the skin. Vitiligo can run in families, but it is not yet clear how vitiligo is carried by genes.

Dr Bina Rabadia from DM Healthcare says, “There are various disorders which affect colour of the skin, vitiligo is one of them. Vitiligo is a pigmentary disorder of the skin and mucous membrane, and it is characterised by white patches caused by loss of pigmentation. These patches are more noticeable in dark skin individuals. This occurs due to progressive destruction of melanocytes, resulting in a loss of melanin in the skin. Since it is not caused by any virus or bacteria, it is not contagious.”

Dr Bina adds “It is important to differentiate vitiligo from other skin diseases with hypo-pigmented patches, as treatment differs for each.

Apart from medical treatment, patients of vitiligo need more emotional support as it can be both triggered and worsened by stress.

“Treatment options, depending upon many factors, include corticosteroids, PUVA, Narrow-band UVB phototherapy, topical tacrolimus, laser treatments, skin grafting, transplantation of cultured melanocytes, and de-pigmentation.”

Ultraviolet A (UVA) treatments are normally carried out in hospitals and clinics. PUVA (psoralen and UVA) treatment involves taking a drug which increases skin’s sensitivity to UV light. The skin is then exposed to specific doses of UVA light. This treatment requires 2-3 treatments per week for many months.

Narrow band UVB phototherapy has become the first choice of therapy for adults and children with generalised vitiligo, as it has many advantages over PUVA, including shorter treatment time, no drug costs, less side effects and no need for subsequent photo-protection.

As not all white patches are vitiligo, you should consult dermatologist when you notice any white patch on your body for correct diagnosis and treatment.


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