Vitiligo, which is characterized by sharply demarcated areas of depigmentation, occurs with an incidence of about 1% in most racial groups. The lesions, which develop gradually and which rarely resolve, may be solitary or multiple, in which case they are either distributed randomly (vitiligo vulgaris) or peripherally. Loss of melanin may result from an autoimmune mechanism since many of those affected also have other autoimmune disorders such as alopecia areata, Addison disease, hypo- or hyperthyroidism, diabetes or systemic sclerosis. Other cases of vitiligo can be caused by exposure to phenolic compounds.

Management

Camouflage cosmetics may help some patients to become socially integrated. Exposure to ultraviolet irradiation after oral or topical pretreatment with methoxsalen (PUVA therapy) may induce a small degree of pigmentation, but this form of treatment must be administered by specially trained dermatologists. Photoprotection is important to avoid sunburn in the depigmented areas.