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Vitiligo: At a Glance

Vitiligo is a cutaneous disease characterized by the presence of white patches on the skin where the melanocytes are absent.

 

Although there are no reliable data about the real prevalence of the disease, it is estimated that Vitiligo affects about 0.5-2% of the world population, with a peak of 8% in some regions of India. Translated into numbers, this means that about 70-100 million people worldwide are affected by this disease.

 

Even if the onset of vitiligo can occur at any age, the population group most affected is usually from 10 to 30 years old, with a peak around 20 years old. From recent studies, it seems that there are no substantial differences between male and female patients.

 

The most common form of vitiligo (called non-segmental) is unfortunately the most disfiguring because in most cases is localized to the face, hands and feet, as well as in other cutaneous sites such as elbows, knees and diffusely in the trunk. Sometimes vitiligo can also affect hairs, resulting in whitening of the hair shaft involved.

 

Vitiligo may be associated with autoimmune diseases. It has been estimated that approximately one third of patients with vitiligo suffer also from thyroid diseases. Other associations have been reported with celiac disease and other autoimmune diseases, but in a much lesser extent.

 

The treatments currently available for vitiligo are unfortunately often totally ineffective and are substantially represented by immunosuppressants (topically or orally administered ), as well as by phototherapy. There are also a number of surgical treatments, the results of which are still not standardized and often controindicated.

 

In the U.S., the estimated cost of care for patients with vitiligo starts at around $ 1000-1500 / year to over $ 10,000 / year for more expensive treatments.

 

Although someone considers vitiligo only a "cosmetic" disease because it does not affect other organs of the human body and therefore it does not limit life expectancy, this cutaneous disordes is one of the skin diseases with the lowest quality of life index. For many authors, the psychological impact of the disease is defined as "devastating." Because of the expression of the disease in visible sites (mainly face and hands), patients with vitiligo are often subject to discrimination and tend to hide with various methods (from clothing to make-up)the patches present on their body. Darker skin patients pay the most elevated psicological costs of the disease.

 

The often ineffective "official" treatments and the elevated psychological impact create a continuous research by the patients suffering from vitiligo of  "alternative" therapies, often very imaginative and poorly effective.

 

The lack of a really effective therapy for vitiligo is mainly due to the fact that the cause of this disease is still (up to now..) unknown. A better definition of the cause could certainly define a new approach for vitiligo treatment and bring new hope to all patients suffering from this disease.

 

 

VITILIGO IN SUMMARY

 

 

Estimated worldwide prevalence: 0,5-1 % of population - 70-100 million people affected

 

 

Medium onset age: 10-30 years. Childhood-onset is rising.

 

 

Vitiligo type: non-segmental and segmental.

                 

                  The non-segmental form is the most common and progressive type, and affects particularly

                  face, trunk, hand and feet.

 

                  The segmental form is rare and it affects characteristically just one part of skin surface, with

                  no tendence to progression or to spread simmetrically.

 

 

Available therapies: corticosteoids, other immunosuppressants (oral or topical), UVB-NB phototherapy, PUVA-therapy, oral or topical antioxidants, surgical methods, others. Often totally ineffective.

 

 

Social impact of vitiligo: defined by some authors as "devastating", particularly in the most advanced cases.

 

 

Famous people affected by vitiligo: Michael Jackson. Richard Hammond, Doc Hammer, etc.

 

 

 

Bibliography

 

- emedicine.medscape.com – vitiligo

- health.costhelper.com – vitiligo treatment costs

- Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: a comprehensive overview Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up. J Am Acad Dermatol. 2011 Sep;65(3):473-91

- Felsten LM, Alikhan A, Petronic-Rosic V. Vitiligo: a comprehensive overview Part II: treatment options and approach to treatment. J Am Acad Dermatol. 2011 Sep;65(3):493-514.