<p>Vitiligo is an unknown autoimmune and non-communicable skin disease that has a genetic origin and is an acquired disease that causes symmetrical depigmented spots on the skin and destroys melanocytes. Vitiligo, known too as leukoderma, is a disorder of pigment production in body skin, in which melanocytes (cells that produce pigment) are destroyed in parts of the skin, mucous membranes, and retina. The disease can affect the skin of various parts of the body, including around the mouth and eyes, fingers and wrists, armpits, groin, bony parts such as the elbows and knees, the genitals, as well as the hair and the inside of the mouth.<br />
As a result, skin blemishes appear on different parts of the body. Skin discoloration occurs gradually and lasts for months or even years.<br />
Hair that grows on areas affected by vitiligo usually turns white. The cause of this disease is not yet known.<br />
The disease is depressing and has more clinical manifestations in patients with dark skin.</p>
<p><br />
<strong>What causes vitiligo?</strong><br />
Vitiligo has genetic roots and is caused by high stress, severe sunburn, or skin damage from chemicals. In general, it has no destructive effect on other organs of the body, while having many negative effects on the emotional and psychological aspects of the person. The discolored areas usually spread over time. It affects all skin types, but it may be more noticeable in people with darker skin.</p>
<p><br />
<strong>Symptoms of vitiligo</strong><br />
Symptoms of vitiligo include:</p>
<ol>
<li> Patches of skin that have lost their pigment.<br />
These spots can occur anywhere on the body but are more common on the face and hands.</li>
<li> Patches of hair on head or face turn prematurely gray or white.<br />
In some cases, the hair in the affected areas also turns white because the hair follicle pigment is also lost.</li>
</ol>
<p>In most people with vitiligo, spots on the skin are created in a symmetric pattern.</p>
<p><br />
<strong>Topical treatment</strong><br />
There is a group of topical treatment modalities for vitiligo:</p>
<ul>
<li>Corticosteroids (topical, intralesional)</li>
<li>Tacrolimus 1% and pimecrolimus (It has minimal side effects and is considered safe for long term treatment.).</li>
<li>Monobenzyl ether of hydroquinone (MBEH): Patients with more than 50% of body surface area affected with vitiligo are candidates for complete depigmenting the remaining pigmented sites by taking monobenzone 20. It is rubbed on the skin twice a day for a period of one year to create permanent depigmentation over time. Side effects include dermatitis, erythema and itching. This method of depigmentation is irreversible and the patient should be aware of this and then be very careful about sun protection.</li>
<li>Sunless tanning lotions that actually color the skin and are very suitable for skin type 2 and 3.</li>
<li>Make-up and covering depigmented lesions with cosmetic concealers</li>
</ul>
<p><br />
<strong>Phototherapy</strong><br />
Phototherapy is the mainstay of vitiligo therapy.</p>
<ul>
<li>PUVA by oral 5- or 8-methoxypsoralen plus narrow band UVB exposure</li>
<li>Laser treatment for repigmentation, whose effects have not yet been established.</li>
</ul>
<p>Phototherapy using ultraviolet light may help, but it takes several months to take effect. Before phototherapy, you will be given Psoralen to increase your skin's sensitivity to light.</p>
<p><br />
<strong>Oral treatment</strong><br />
Oral treatment includes:</p>
<ul>
<li>5 or 8 oral methoxy psoralens in combination with controlled gradual exposure to the sun.</li>
<li>Pulse therapy with corticosteroids</li>
</ul>
<p> </p>
<p><strong>Surgical treatments</strong><br />
Autologous dermal grafting can be more helpful in severe vitiligo, compared to other treatments.</p>
<p> </p>
<p><strong>Laser therapy</strong><br />
Excimer laser: The wavelength of UVB light emitted by an excimer laser is about 308 nm, creating a narrow UVB bandwidth that has been successful in treating vitiligo.<br />
Surgical procedures are usually used in people whose disease is stable and has not progressed for at least six months and has not developed a new lesion and has not responded to common treatments.<br />
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