Vitiligo is a common acquired disorder of skin and mucous membranes (labial, oral, and genital mucosa) characterized by depigmented macules that result from decreased number and function of melanocytes. The other features observed in lesions include leukotrichia, trichrome morphology, and koebnerization. It affects 1–2% of world’s population without any racial predilection. Its prevalence varies between 3% and 4% in India, although an incidence as high as 8.8% has been reported. There is a preponderance of females in most studies based on outpatient attendance, but the frequency across populations is probably the same in both sexes. Its exact etiology remains obscure and is perhaps multifactorial. A positive family history in 30–40% of patients suggests a genetic predisposition. Various factors which may incite vitiligo include emotional stress, sunburn, a major illness or surgical procedure, pregnancy, parturition, physical trauma, and certain chemicals and drugs. The lower extremities are most commonly involved followed by hands, face, and bony prominences, feet, trunk and neck in that order. The disease is classified according to the pattern of its distribution as segmental (localized, focal) and non-segmental (generalized or vulgaris, acrofacial, mixed) and universal (nearly complete depigmentation). Vitiligo vulgaris is the commonest variety and has circumscribed, scattered macular lesions distributed symmetrically. A plethora of literature available on the treatment of vitiligo itself reflects limitations of any single therapeutic modality. Selecting a treatment modality and therapeutic regimens is also confusing for their variable efficacy to induce repigmentation, reduce severity, decrease extent of the disease, and thus bring about psychosocial well-being and improve quality of life.

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Vitiligo

  • Vikram K. Mahajan

摘要

Vitiligo is a common acquired disorder of skin and mucous membranes (labial, oral, and genital mucosa) characterized by depigmented macules that result from decreased number and function of melanocytes. The other features observed in lesions include leukotrichia, trichrome morphology, and koebnerization. It affects 1–2% of world’s population without any racial predilection. Its prevalence varies between 3% and 4% in India, although an incidence as high as 8.8% has been reported. There is a preponderance of females in most studies based on outpatient attendance, but the frequency across populations is probably the same in both sexes. Its exact etiology remains obscure and is perhaps multifactorial. A positive family history in 30–40% of patients suggests a genetic predisposition. Various factors which may incite vitiligo include emotional stress, sunburn, a major illness or surgical procedure, pregnancy, parturition, physical trauma, and certain chemicals and drugs. The lower extremities are most commonly involved followed by hands, face, and bony prominences, feet, trunk and neck in that order. The disease is classified according to the pattern of its distribution as segmental (localized, focal) and non-segmental (generalized or vulgaris, acrofacial, mixed) and universal (nearly complete depigmentation). Vitiligo vulgaris is the commonest variety and has circumscribed, scattered macular lesions distributed symmetrically. A plethora of literature available on the treatment of vitiligo itself reflects limitations of any single therapeutic modality. Selecting a treatment modality and therapeutic regimens is also confusing for their variable efficacy to induce repigmentation, reduce severity, decrease extent of the disease, and thus bring about psychosocial well-being and improve quality of life.