EUREKA DERMATOLOGY
What is vitiligo?
Vitiligo is an acquired depigmentation disease that causes white spots of various sizes and shapes to appear on the skin due to the destruction of melanocytes.
White spots of various sizes and shapes, round or oval, appear on the whole body or in localized areas, and although there are no symptoms such as contagiousness or itchiness, they can be a cosmetic problem.
1-2% of the total population
About a million people (based on South Korea)
Why would it be a problem if it's not contagious or causes any pain?
Problems with Vitiligo
Vitiligo is not contagious, and it does not cause serious physical pain.
However, many patients are teased by their friends in childhood just because they are different from others, cannot concentrate on their studies, and complain about their difficulties in social life in the future.
The area with vitiligo has lost melanin cells, so it lacks the ability to block ultraviolet rays, so it can easily get burned.
EUREKA DERMATOLOGY
Early symptoms of vitiligo
The early symptoms of vitiligo are not particularly painful or uncomfortable, so it is difficult to recognize the symptoms in the early stages.
Usually, two to as many as dozens of similar-shaped milky white spots appear on both the left and right sides of the body.
They mainly appear on the face, neck, elbows, fingers, the front of the calves, lips, and scalp, but white spots can appear anywhere on the body, and discoloration (albinism) can also appear in the eyebrows or hair.
Doctor's Comment
It is most important to treat vitiligo early so that melanocytes are not lost any more.
In particular, when vitiligo occurs on a child's face, it is often mistaken for pityriasis alba and left untreated, which can worsen vitiligo all over the face.
Areas where vitiligo occurs
Vitiligo occurs in various areas such as the face, neck, back, chest, arms, hands, waist, groin, thighs, genitals, knees, and feet, and occurs more often in areas with a lot of contact. In addition, when melanocytes are destroyed in the hair follicles of the skin where vitiligo occurs, white hair often accompanies it.
EUREKA DERMATOLOGY
Causes of Vitiligo
The cause of vitiligo has not yet been clearly identified.
Since vitiligo can be caused by a variety of situations, it is not easy to provide a clear treatment method that is right for the patient.
Among the various hypotheses, the most promising hypothesis is the autoimmune theory.
Autoimmune theory
It can occur when one's own white blood cells destroy melanocytes, and occurs frequently in patients with autoimmune diseases.
Vitiligo is often called an autoimmune disease.
Melanocyte self-destruction theory
Vitiligo is a condition in which melanocytes are destroyed by the melanin they produce.
Neurohumoral theory
Abnormal nerve cells can also cause vitiligo by secreting chemicals that destroy melanocytes.
mental stress
This is when excessive neurotransmitters are secreted due to stress, which causes vitiligo.
If vitiligo is caused by stress, it may improve when the stress disappears.
EUREKA DERMATOLOGY
Diagnosis of Vitiligo
Vitiligo can be easily diagnosed by visual observation.
If the initial diagnosis of vitiligo is unclear with a Wood's lamp, vitiligo can be diagnosed through a skin biopsy. Wood's lamp can clearly see the difference in skin color with blue light in the ultraviolet range. It can also distinguish darkened skin color, and especially when the skin color turns white, the difference from the surrounding skin is clearly visible.
In other words, when looking at an area where skin color has decreased with a Wood's lamp, vitiligo appears as bright blue or white fluorescence. If it is not vitiligo, it appears as gold or yellow-green.
Diagnosis of Vitiligo by Wood's Light Test
※ This is a case treated at Eureka Dermatology Clinic.
EUREKA DERMATOLOGY
Vitiligo-like disease
Tinea versicolor
Superficial skin fungi are diseases caused by fungal infections in the stratum corneum, the outermost layer of the skin, fingernails, toenails, and hair. Tinea versicolor is a superficial fungal infection caused by infection with a yeast called Malassezia, and can be diagnosed through a fungal test.
Depigmented nevus
It is a skin hypopigmentation that mainly occurs in young children, and since it is observed from birth, if it is a new lesion, the possibility of a depigmented nevus is low. The lesion does not grow or spread, but maintains its shape and grows in size in proportion to the growth of the body. The border with the surrounding skin is clear and has a light white or slightly light color.
Whitehead
This is a phenomenon in which facial pigmentation temporarily decreases due to unclear causes such as rapid temperature changes, strong UV rays, and fungal infections. It mainly appears in children and teenagers before puberty, and especially in the summer, when the skin is sunburned, it becomes more and more prominent. It is also called dry dermatitis or white ichthyosis. It will naturally improve if you apply skin softeners or moisturizers.
Idiopathic hypopigmentation
Small white plaques with clear boundaries, less than 1 cm in diameter, occur in multiple locations, mainly on the limbs exposed to sunlight. It is thought to be a phenomenon of aging due to sunlight exposure, and they gradually appear after the teens, and the number of lesions tends to increase with age. The lesions do not grow or merge like vitiligo, and the hair inside the lesions does not discolor.
Other diseases
Nevus annulus, partial albinism, drug-induced albinism, progressive macular hypodensity, chemical leukemia, mycosis fungoides, melanoma
EUREKA DERMATOLOGY
Vitiligo Types
This is the most representative classification type when treating vitiligo, and more detailed classifications may be used depending on the hospital and doctor treating the patient.
LOCALIZED
(Localized/Segmented Image)
Local type
It starts with one or two white spots on the face, torso, or neck, and is likely to spread to the entire body.
Segmental
White spots appear only on one side of the body, either left or right, and do not cross the midline of the skin when viewed from the face or torso.
In this case, they do not spread to the entire body.
GENERALIZED
(Face, Resin Terminal/General/Full Body Image)
Face, resin terminal type
This is a form of vitiligo that mainly occurs on the face and extremities.
It can also progress to general or systemic form.
General type
This is the most common form of vitiligo, and it occurs symmetrically all over the skin.
It can appear at any age and may stop and then start again.
Full body type
The most severe form of vitiligo causes widespread vitiligo to occur over the entire body.
