Vitiligo is a pigmentation disorder in which special skin cells that produce the pigment melanin in the skin as well as the tissues that line the inside of the mouth, nose, and genital and rectal areas, and the retina of the eyes are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo may also turn white.

Vitiligo is the most common skin disorder.

Now the disease is most prevalent all over the world. his non-infectious skin ailment appears as white patches all over the body, symmetrically or asymmetrically. Vitiligo or Leucoderma is localized to a part of the skin whereas the vitiligo is a skin disorder in which smooth white areas appear on a person's skin. The condition occurs when the body's melanocytes are destroyed. In addition to the skin, vitiligo can affect the mucous membranes. Eyes, inner ears, and hair. The patient becomes a social stigma. They are humiliated and boycotted socially. This would be really an unfortunate situation for them. If the victim is a woman she is much depressed because she has lost her beauty and charm as well and becomes a victim of humiliation.

What causes vitiligo?

• Although the causes of vitiligo aren't completely understood, there are a number of different theories:
• Auto immune disorder-the effected person's immune system may develop antibodies that destroy melanocytes.
• Genetic factors-certain factors that may increase the chance of getting vitiligo can be inherited. About 30% of vitiligo cases run in families.
• Neurogenic factors-a substance that is toxic to melanocytes may
• be released at nerve endings in the skin.
• Self-destruction-a defect in the melanocytes causes them to destroy themselves.

Vitiligo may also be triggered by certain events, such as sunburns or emotional stress; however, this has not been proven. Because none of the explanations seem to completely account for the condition, it's possible that a combination of these factors is responsible for vitiligo.

What are the types of vitiligo?

There are several variations of vitiligo. The most common are:

Marginal inflammatory vitiligo-the macules are surrounded by a red, raised border. Usually the border is seen several months after the initial onset of vitiligo.

Trachoma vitiligo: an intermediate shade of color appears between the macula and the unaffected skin. Heredity plays a major role. The disease tends to run in families, most patients have a relative who suffers from this illness.

Clinically this disease : diabetes mellitus, thyroid disorders, endocrine disorders and anemia, gastrointestinal disorders or chronic Amoebic dysentery ,Typhoid and Jaundice.

Injury Cause: rubber footwear, synthetic underwear, tight thing had been reported often to my clinic. In many cases of burns, hyp pgmentations occurs. Psoriasis, eczema shall interfere with melanin synthesis in a few patients who reports with white discolorations. Long-time in take of certain material medicines is found to produce this pigment disorder. Emotional and physical stress may precipitate the onset more.

The Fungal infections: Tinea alba, Tinea versicolor looks similar to vitiligo patches which requires differential.The typical appearance of Vitiligo is a milky white de-pigmented spot or spots

Sine and Symptoms:

1. It may vary from a single white spot to multiple spots.
2. The shape too is a variable. In some cases generalized de-pigmentation observed all over the body. It has a tendency to start as a single spot and gradually grow in size and number.
3. It may present with a single or several spots on limbs or abdomen or back and then spreading to other parts of the body.
4. Who is affected by vitiligo?
5. About 1 to 2% of people in the world, or 40 to 50 million people, have vitiligo. In the United States alone, 2 to 5 million people have the disorder.
6. Ninety-five percent of people who have vitiligo develop it before their 40th birthday. The disorder affects all races and both sexes equally.

Diet & Regimen:

There are a few instructions for patients regarding their diet in vitiligo especially with mention of what they should avoid during the treatment of vitiligo.

Foods that are excessively sour should be avoided. The ascorbic acid in sour foods tends to reduce melanin pigmentation. So the patients should restrict their intake of citrus foods.Non vegetarian foods are also to be avoided as they act as a foreign body to pigment cells.Flavoured drinks are to be avoided.

Artificial colours used in various food preparations should also be avoided.

There may not be enough scientific evidence to prove how these foods worsen vitiligo but our clinical experience has shown that many patients report worsening of their vitiligo from these items and hence they are better avoided.

Usually small amounts of milk, for example in tea or coffee, do not cause any problems. Dairy products such as butter, cheese and yoghurt are also well tolerated. If milk is excluded, it should be replaced with low lactose milk or with Soya milk. This should be discussed with a dietician to ensure that the nutritional balance is maintained.

Is vitiligo inherited?

In some cases it is. Vitiligo may be hereditary and run in families. Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder.

There are a sizable number of inherited disorders associated with vitiligo. To illustrate, they include: albinism of the ocular type, auto immune polyendocrinopathy syndrome, congenital deafness with vitiligo and achalasia, dyschromatosis symmetrica hereditaria, ermine phenotype, familial histiocyctic reticulosis, kabuki

Other therapy vitiligo or leucoderma treated?

There is no cure for vitiligo. Common treatments include:

Using sunscreen with an SPF of 30 or higher. Also, the sunscreen should shield ultraviolet B light and ultraviolet a light

Topical immunomodulators Psoralen photo chemotherapy

Depigmentation: the drug monobenzone is applied to pigmented patches of skin so that they match the macules. The main potential side effects are inflammation, redness, swelling, itching, and dry skin.

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