Vitiligo
Vitiligo is a depigmenting disorder likely caused by an autoimmune destruction of melanocytes affecting 0.5–1 % of the population worldwide. Over half of patients present before the age of 20. Depigmented areas are more apparent in patients with skin of c
- PDF / 945,608 Bytes
- 6 Pages / 595.28 x 790.87 pts Page_size
- 82 Downloads / 171 Views
Vitiligo Sharif Currimbhoy and Amit G. Pandya
Contents
1.1
1.1
Introduction ........................................................................
3
1.2
Clinical Features .................................................................
4
1.3
Diagnosis and Differential Diagnosis ................................
7
1.4
Histopathological Features ................................................
7
1.5
Natural History and Prognosis ..........................................
7
1.6
Treatment ............................................................................
7
References .....................................................................................
8
Introduction
Vitiligo is a chronic depigmenting skin disease that is caused by progressive autoimmune-mediated melanocyte destruction [1]. Although there is no predilection for skin type or race, lesions in patients with skin of color are more visible and thus cause a higher impact on quality of life [1–3]. The prevalence of vitiligo is estimated at 0.5–1 %, with half of patients presenting before the age of 20 and 95 % before the age of 40 [2]. The majority of cases of vitiligo are sporadic in nature with a positive family history of vitiligo found in 20–30 % of the patients [2]. Although men and women are affected by vitiligo at equal rates, there is a higher proportion of women who seek treatment [2]. The psychological impact of vitiligo can be severe, especially in patients with skin of color, and includes depression, low self-esteem, fear of rejection, and a decreased quality of life [2, 4]. Although no inciting factors for vitiligo have been confirmed, stress, skin trauma, severe sunburn, pregnancy, and emotional stress have been reported by patients as events which preceded the onset of vitiligo [2, 5]. Early diagnosis and treatment should be sought by patients and physicians to help maximize repigmentation [2].
S. Currimbhoy, BS Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, Dallas, TX 75235, USA e-mail: [email protected] A.G. Pandya, MD (*) Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA e-mail: [email protected] D. Jackson-Richards, A.G. Pandya (eds.), Dermatology Atlas for Skin of Color, DOI 10.1007/978-3-642-54446-0_1, © Springer-Verlag Berlin Heidelberg 2014
3
4
1.2
S. Currimbhoy and A.G. Pandya
Clinical Features
Vitiligo is separated into two main variants, each with a different presentation and clinical course. Non-segmental vitiligo (NSV), also called generalized vitiligo, is the most common form, seen in approximately 90 % of cases, and is generally more rapidly progressive in its course than segmental vitiligo [1]. Non-segmental vitiligo presents with depigmented macules and patches that occur in a bilateral distribution anywhere on the body but typically involves the face, axillary regions, dorsal hands, fingers, and feet (Fig. 1.1) [1–3]. Early les
Data Loading...
