Vitiligo presents as symmetric milky, white patches, most commonly on the face, lips, hands, arms, legs and genitals. Half of those affected are under the age of 20, and 1 in 5 have affected family members.
Vitiligo is believed to be an autoimmune process. Autoimmune disease develops when self attacks self. In the setting of vitiligo, the body attacks its own pigment producing cells, the melanocytes. Most patients with vitiligo are otherwise healthy. Occasionally, vitiligo may occur with other autoimmune diseases like thyroid disease or alopecia areata.
The course and severity of pigment loss varies from patient to patient. There is no way to predict how much color an individual will lose. In general, because of the contrast in color, vitiligo appears more obvious in patients with skin of color.
Treatment of vitiligo begins with topical corticosteroids and calcineurin inhibitors, like pimecrolimus and tacrolimus. Other options include light and laser therapy. In extensive disease, where repigmentation is not practical, complete chemical depigmentation may be considered.