Vitiligo Flashcards
Define vitiligo.
Vitiligo is an acquired loss of melanocytes in circumscribed areas of the epidermis, resulting in complete depigmentation of affected skin. The extent of the disease ranges from limited, focal disease to almost complete (universal) pigment loss.
What is the aetiology of vitiligo?
Vitiligo is caused by the T-cell-mediated destruction of melanocytes. Intrinsic abnormalities present in melanocytes probably initiate inflammation through the activation of innate immunity.
This inflammation leads to the recruitment of T cells, including cytotoxic T-cells that are melanocyte-specific, recognising antigens produced specifically by melanocytes.
What are risk factors for vitiligo?
Age <30 years
FHx of vitiligo
Auto-immune disease
Chemical contact e.g. hair dyes
Summarise the epidemiology of vitiligo.
Vitiligo is a common disorder affecting all races and geographic areas with a prevalence of 0.5% to 2% worldwide.
What are the signs and symptoms of vitiligo?
Presence of risk factors
Acral and periorificial depigmentation
Perianal and genital depigmentation
Recent cutaneous trauma
Localised sunburn pain
Enhancement and fluorescence with UV-A exposure
Halo naevus
What are some investigations for vitiligo?
CLINICAL DIAGNOSIS
(skin biopsy)
What is the management for vitiligo?
Topical corticosteroid
Phototherapy
What are complications associated with vitiligo?
Koebner’s phenomenon - depigmentation in response to trauma
Photosensitivity
Treatment-induced permanent photosensitivity
Corticosteroid-induced atrophy and hypertrichosis
Dermatoheliosis
Skin cancer
Psychological dysfunction
Retinal and choroid depigmentation, uveitis
Audiological compromise
What is the prognosis of vitiligo?
Vitiligo is a progressive disease that may arrest after an initial phase of variable duration. Prognosis depends on type.
