Vitiligo (White Patches) – Introduction
Dr Vivekananda Bhat
Lavelle road, Bengaluru Feb 14, 2017
All of us are born with Melanocyte, the job of which is to manufacture melanin pigment in the skin, there are two types of cells in the epidermis the Melanocytes and the keratinocytes, the Melanocyte manufacture the pigment melanin which is then stored in the keratinocytes the storage cells in the skin.
So how is it that skin color varies from person to person and also in our own bodies some areas have different skin color like the lips, nipples, is because the Melanocytes in different areas are destined to lay down a particular level of melanin, this is what causes the skin color to vary.
The Melanocytes can also be stimulated with UV light like in sun light which causes more melanin to be produced, and this is what causes temporary skin tanning to occur, once the stimulation stops the cells do not manufacture melanin and the skin color tones down to your original level.
Vitiligo occurs when the Melanocytes are destroyed and hence the skin in that area stops manufacturing skin color and without Melanocytes all of us would be white in color, an exciting prospect for people who spend lot of money trying to become fair, but these same people become distressed when they see vitiligo on the skin.
Symptoms of Vitiligo
The only sign of vitiligo is the appearance of pale to white patches on the body, in some cases this can be preceded by itching on skin, after a new patch appears, it can
- Increase in size for varying periods of time.
- New patches can appear in other areas of the body.
- Injuries suffered during this period can turn white in color.
This is called the unstable phase of vitiligo a period of time when the disease is very much active inside the body, and can last for months to years.
The only treatment for spreading patches is medical, no surgical option is possible during this period.
Patches can appear on any part of the body may be single,or multiple, may be restricted to one half of the body ,or appear symmetrically on both sides of the body depending upon the pattern of vitiligo.
At times the loss of skin color can happen around all body openings like ears, eyes, nostrils, mouth, umbilicus, anus and penis.
Like I said before Vitiligo can produce either a single patch, few patches or multiple patches on the body, accordingly we can classify it on a simpler level which a common person can understand into
CHANCES OF CURING THESE PATCHES ARE EXCELLENT
1. Focal vitiligo : One or few patches appear on the body, in focal vitiligo if medical treatment fails to deliver results then Melanocyte transplant offers an excellent cure for it, once the patches have stopped spreading.
2.Segmental Vitiligo : Here like the name suggest a segment of skin is affected by white patches, segmental vitiligo affects only one half of the body never crosses the midline, does not respond well to medical treatment most of the times and responds very well to Melanocyte transplant surgery.
3.Generalised Vitiligo : Here the patches are symmetrical and appear on both sides of the body, hence one can have patches from top to bottom and on both sides of the body, most common areas affected could be the eyes, bony prominences like elbows, wrist, fingers, knees and foot, and to top it up patches can also appear on the chest ,abdomen, lips, nipples & genitals and legs.
These patches can respond well to medical and surgical options, medical works in all the areas of the body that have black hairs and the rest that does not respond well to medical treatment can be finished with Melanocyte transplant surgery.
4.Acro Facial Vitiligo : A Vitiligo pattern all doctors would love to hate.Here patches develop on fingers, lips, and feet including the toes, and the chances of curing this with medicine is very poor and with Melanocyte transplant it remains a challenge till date, for some reasons i have seen a all or none phenomenon with this pattern which means some do very well and some do not get any color at all.
5.Lips : A whole lot of patients come with patches on the lips alone, either upper, lower or both, and the response to Melanocyte transplant surgery has been good, chances of curing this with medicine alone is poor most of the times.