Definition:

Vitiligo is a disfiguring medical disease whose cause is unknown. The disease causes destruction or loss of function of melanocytes in the skin, mucous membranes, eyes, inner ear, and occasionally in hair bulbs. Melanocytes produce the pigment that gives skin its color. The loss of melanocytes alters both the structure and function of these organs and results in the absence of pigment.

Scope:

This disease affects an estimated 1% of the world's population. It affects individuals of all ethnic origins and both sexes. Loss of pigment most commonly is noted first on the hands, feet, arms, face or lips. Frequently this disease is progressive.

Therapy:

The primary goal of therapy is to restore the skin's color by restoring melanocytes in the skin. Repigmentation of the skin with melanocytes allows the skin to regain its normal immune/inflammatory functions and improves the appearance of those suffering from this disease.

Medical:

Several methods of treatment with varying success rates are currently in use. Some doctors prescribe topical medications and/or ointments with or without corticosteriods. A treatment frequently used is the application or ingestion of a drug (psoralens) followed by exposure to ultra-violet light (sun light). This combined treatment is known as PUVA or PUVB. It is reported that these treatments result in limited success (only 61% of patients achieve more than 25% repigmentation). Even in patients who have a good response to medical treatment methods, the hands, fingers, feet, and ankles and penis frequently do not repigment.

Surgical:

You should consider the surgical treatment of vitiligo only if:

• Your vitiligo has not changed in the last year.
• You are not responding to PUVA or PUVB treatment.
• Your skin has never permanently lost its color (pigment) when you have suffered a small cut or scrape.
• You do not have Hepatitis C or AIDS.

Surgical treatment is ideal for those that have Segmental Vitiligo (this form involves an area only on one side of the body and tends not to repigment with other forms of treatment).

Questions? Send your questions to Dr. Kahn.