Vitiligo
National Organization for Rare Disorders, Inc.
General Discussion
Vitiligo is a dermatological condition characterized by the appearance of white patches of skin on different parts of the body as a result of the destruction of the cells that make pigment (melanocytes). This may vary from one or two white spots on the skin to large areas of depigmentation. Vitiligo is not contagious. It seems to occur more often among people who have certain autoimmune diseases. For some people, although not for everyone, the depigmentation is progressive.
Symptoms
Vitiligo is characterized by spots on the skin with decreased pigmentation. These lesions are usually sharply demarcated with increased coloring (hyperpigmentation) on the borders, and are often symmetrical in shape. These areas most often appear on the face, neck, hands, abdomen, and thighs although they can occur on all parts of the skin. The hair in vitiliginous areas is usually white and the skin lesions appear white under a Wood's light. The lesions are prone to sunburn and should be protected from sunlight.
People with vitiligo may have premature graying of the scalp hair, eyelashes, eyebrows, and beard.
For some people, the depigmentation begins with a few patches and then spreads to other parts of the body. Some people notice additional depigmentation during periods of physical or emotional stress. However, in some cases, the disorder does not appear to be progressive, and the depigmentation does not spread from the areas first noticed.
Causes
The exact cause of vitiligo is not known, although there are several theories. Research on this is continuing.
There appears to be a hereditary component in some cases. Although it often appears with no family history, the probability of developing vitiligo is somewhat higher for children in families where it has been known to occur. However, people who have vitiligo often have children who are not affected by it, and many people with vitiligo do not have a family history of the disorder.
This disorder appears to be more common among people who have certain autoimmune diseases. These are diseases in which a person's immune system for some reason perceives the body's own tissues as foreign and reacts against them. Some of the diseases that are sometimes associated with vitiligo include hyperthyroidism, pernicious anemia, alopecia areata, and adrenocortical insufficiency. Research at the National Institutes of Health indicates that vitiligo is 10 to 15 times more common in people with other autoimmune diseases. The disorder may also follow unusual trauma, especially to the head.
Affected Populations
Worldwide, about one to two percent of the population has the disorder at any one time. Although vitiligo can affect people at any age, 95 percent of those affected develop the disorder before age 40.
Standard Therapies
Most standard therapy consists of sensitizing a depigmented area with a topical or oral medication (psoralens) after which the treated area is exposed to the sun or ultraviolet light. Small lesions of Vitiligo may be camouflaged with cosmetic creams. Para-aminobenzoic acid solution or gel gives protection against sunburn.
The National Vitiligo Foundation, see below, maintains a formulary of safe cosmetics designed particularly for persons with vitiligo.
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Investigational Therapies
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.
For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov
For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com
The National Vitiligo Foundation provides brief summaries of current and recent research on its Web site. (See the Resources section of this report for information on how to contact the foundation.) Studies listed on that site include:
References
McKusick VA, ed. Online Mendelian Inheritance in Man (OMIM). Baltimore. MD: The Johns Hopkins University; Vitiligo. Entry No: 193200; Last Update: 5/29/03.
TEXTBOOKS
Fauci AS, et al., eds. Harrison's Principles of Internal Medicine, 14th Ed. New York, NY: McGraw-Hill, Inc; 1998:316-17.
Berkow R, ed. The Merck Manual-Home Edition. Whitehouse Station, NJ: Merck Research Laboratories; 1997:988-89.
Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:835-36.
Champion RH, et al., eds. Textbook of Dermatology. 5th ed. Cambridge, MA: Blackwell Scientific Publications; 1992:1608-10.
REVIEW ARTICLES
Silvan M. The psychological aspects of vitiligo. Cutis. 2004;73:163-67.
Matsumura Y, Ananthaswamy HN. Toxic effects of ultraviolet radiation on the skin. Toxicol Appl Pharmacol. 2004;195:298-308.
Orion E, Matz H, Wolf D, et al. Café au lait has a hue of its own. Dermatol Online J. 2003;9:8.
Hartmann A, Brocker CB, Becker JC. Hypopigmentary skin disorders: current treatment options and future directions. Drugs. 2004;64:89-107.
Arroyo MP, Tift L. Vitiligo therapy: where are we now? J Drugs Dermatol. 2003;2:404-08.
Roelandts R. Photo(chemo) therapy for vitiligo. Photodermatol Photo-immunol Photomed. 2003;19:1-4.
Yu HS. Melanocyte destruction and repigmentation in vitiligo: a model for nerve cell damage and regrowth. J Biomed Sci. 2002;9(6 Pt 2):564-73.
Taneja A. Treatment of vitiligo. J Dermatolog Treat. 2002;13:19-25.
van den Wijngaard R, Wankowicz-Kalinska A, Pals S, et al. Autoimmune melanocyte destruction in vitiligo. Lab Invest. 2001;81:1061-67.
van Geel N, Ongenae K, Naeyaert JM. Surgical techniques for vitiligo: a review. Dermatology. 2001;201:162-66.
FROM THE INTERNET
Questions and Answers about Vitiligo. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). nd. 9pp.
www.niams.nih.gov/hi/topics/vitiligo/vitiligo.htm
Vitiligo. American Academy of Dermatology. Revised 1999. 3pp.
www.aad.or/pamphlets/Vitiligo.html
Vitiligo: The Pigment Problem. Kids Connection. American Academy of Dermatology. 2003. 1p.
www.aad.org/Kids/vitiligo.html
Resources
American Autoimmune Related Diseases Association, Inc.
22100 Gratiot Avenue
Eastpointe, MI 48021
Tel: (586)776-3900
Fax: (586)776-3903
Tel: (800)598-4668
Email: aarda@aarda.org
Internet: http://www.aarda.org/
National Vitiligo Foundation
700 Olympic Plaza Circle
Suite 404
Tyler, TX 75701
USA
Tel: (903)595-3713
Fax: (903)593-1545
Email: info@nvfi.org
Internet: http://www.nvfi.org
NIH/National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse
1 AMS Circle
Bethesda, MD 20892-3675
USA
Tel: (301)495-4484
Fax: (301)718-6366
Tel: (877)226-4267
TDD: (301)565-2966
Email: NIAMSinfo@mail.nih.gov
Internet: http://www.niams.nih.gov/Health_Info
MUMS (Mothers United for Moral Support, Inc) National Parent-to-Parent Network
150 Custer Court
Green Bay, WI 54301-1243
USA
Tel: (920)336-5333
Fax: (920)339-0995
Tel: (877)336-5333
Email: mums@netnet.net
Internet: http://www.netnet.net/mums/
American Vitiligo Research Foundation, Inc.
PO Box 7540
Clearwater, FL 33758
USA
Tel: (727)461-3899
Fax: (727)461-4796
Email: vitiligo@avrf.org
Internet: www.avrf.org
Genetic and Rare Diseases (GARD) Information Center
PO Box 8126
Gaithersburg, MD 20898-8126
Tel: (301)519-3194
Fax: (240)632-9164
Tel: (888)205-2311
TDD: (888)205-3223
Email: gardinfo@nih.gov
Internet: http://www.genome.gov/10000409
Autoimmune Information Network, Inc
PO Box 4121
Brick, NJ 08723
Tel: (732)664-9259
Email: autoimmunehelp@aol.com
Internet: http://www.aininc.org
European Society for Immunodeficiencies (ESID)
c/o Dr. Esther de Vries
Jeroen Bosch Hospital
Dept. Paediatrics
P.O. Box 90153
Hertogenbosch, 5200 ME's
Netherlands
Tel: +31 73-6992965
Fax: +31 73-6992948
Email: info@esid.org
Internet: http://www.esid.org
AutoImmunity Community
Tel: (919) 552-9057
Email: bandrews@autoimmunitycommunity.org
Internet: http://autoimmunitycommunity.org
Vitiligo Support International, Inc.
P.O. Box 4008
Valley Village, CA 91617-0008
Tel: (818)752-9002
Fax: (818)337-7268
Email: info@vitiligosupport.org
Internet: http://www.vitiligosupport.org
For a Complete Report
For a Complete Report
This is an abstract of a report from the National Organization for Rare Disorders, Inc. ® (NORD). A copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html