Vitiligo is not contagious — Expert
Vitiligo is not contagious — Expert
July 9, 2014
In this interview with MOTUNRAYO JOEL,
Consultant Physician/Dermatologist, Department of Dermatology,
University of Nigeria Teaching Hospital, Ituku-Ozalla, Dr. Onyekonwu
Chinwe, speaks about vitiligo
What is vitiligo?
Vitiligo is a disorder characterised by
the development of white patches on the skin or mucous membranes of
affected individuals as a result of the destruction of or damage to the
pigment cells (melanocytes) responsible for skin colour. This condition
may lead to severe psychological distress and reduced quality of life,
especially in dark-skinned people because such patches become more
noticeable.It is impossible to predict how much of the skin can be
affected. In the majority of cases, the affected areas remain affected
for the rest of the person’s life.
What causes it?
Melanin is the pigment that gives the
skin its characteristic colour. Vitiligo is caused by a loss of pigment
in the skin, due to destruction of pigment-forming cells known as
melanocytes. The exact cause of the destruction of these cells is not
known. One possible explanation might be that the body’s immune system
destroys the cells, as in other autoimmune conditions. Several theories
have been suggested but the current thought is that each of these
mechanisms cumulatively contributes to the disease process.
What are the symptoms of vitiligo?
Vitiligo signs and symptoms vary
considerably from person-to-person. It is by far more perceptible in
people with dark or tanned skinned. Some people may only acquire a
handful of white dots which develops no further, while others develop
larger white patches that join together affecting larger areas of the
skin. However, people with vitiligo are usually well. Vitiligo is not
sore or itchy. However, the appearance of the skin can be distressing,
particularly if the face or the hands are affected. There is no natural
protection from the sun in affected areas of skin. This means that skin
affected by vitiligo burns much more easily than normal skin if exposed
to sunlight.
How is vitiligo diagnosed?
The diagnosis can be made in the clinic
but in some situations, there may be need to carry out some
investigations including taking a surgical specimen of the skin and
sending it to a pathology lab. Some other skin conditions may sometimes
mimic vitiligo and so, when the attending clinician is unsure, it will
be best to refer such an individual to a dermatologist.
Who gets vitiligo?
Millions of people worldwide have
vitiligo. Nearly half get it before they reach 21 years of age. Most
will have vitiligo for the rest of their lives. It is very rare for
vitiligo to disappear. Vitiligo occurs about equally in people of all
skin colours and races. About half the people who get vitiligo are male
and half are female.
What treatment options are available?
Several treatment options exist. Some of
these treatments date back to several decades ago and with improvement
in the understanding of the disease, newer treatments are evolving. The
type of treatment will depend on the extent of the patches, whether it
affects a small area or the whole skin. There are a wide range of
helpful drugs (including creams that can be applied to the skin) and
non-drug therapies also exist, but it is important that people who
develop this condition should visit their health care provider early for
prompt initiation of treatment.
Is vitiligo infectious? What is the relation between leucoderma and leprosy?
Vitiligo is neither infectious nor
contagious. Leucoderma actually means ‘white skin’ and there are several
conditions that could lead to white skin. It is not synonymous with
leprosy. Although some cases of leprosy may present with white patches,
there are other forms of leprosy that will not show any pigment loss at
all.
Can one marry a person with leucoderma?
Leucoderma is a wide term that could mean
a lot of things and yes, why not? People marry for so many reasons and I
do not think there is any law prohibiting marriage to someone just
because they have white patches.
Will the vitiligo patches spread over time? Will they get larger?
Spread of vitiligo depends on several
factors including what type of vitiligo the person has. Some cases may
spread and get larger and a few may stay within the confines of the
initial patch or even reduce in size, over time.
What is segmental vitiligo?
Segmental vitiligo is the type that
usually affects one side of the body; it is commoner in childhood,
involves hair changes with whitening of the hair and does not spread
rapidly. It affects only about 10 per cent of people with this
condition. But unpredictably, segmental vitiligo is more noticeable in
the early ages affecting about 30 per cent of the children that have
been diagnosed with vitiligo.
What is generalised vitiligo?
In generalised vitiligo, the individuals
are usually older, the patches affect both sides of the body, the hair
may not be involved at the initial onset and it spreads rapidly to
involve wider areas. This type of vitiligo may occur in patients who
have other diseases called Autoimmune Diseases.
Do people with vitiligo transmit it to their children?
Although vitiligo may run in families,
the inheritance is multifactorial. That means there is a mix of several
factors which all add up to cause vitiligo in affected individuals.
There is no gene that is isolated alone that one can say this is the
main cause and therefore transmitted to the children.
What happens once a person develops vitiligo? How long does it last?
The duration for vitiligo is not uniform
across all individuals. It depends on what triggers it and other
associated conditions or diseases. Some may progress very fast once it
is noticed while some others may linger for years before involvement of
other sites. It may occur in childhood or in adults and age of onset can
vary from as early as in infants of a few weeks old to the elderly
population.
Can vitiligo be cured?
There is no known way to prevent or cure
vitiligo. However, several methods, including cosmetics, re-pigmentation
using UV light therapy, corticosteroid creams, depigmentation of
unaffected skin areas, and skin grafting, can be used to improve the
appearance of skin severely affected by vitiligo.
Are there things that a person with vitiligo should avoid?
Essentially, especially in our
environment, it may be better to avoid unnecessary sun exposure to avoid
the risk of skin cancers, although this does not occur commonly.
If a woman is pregnant and has vitiligo, will her child develop vitiligo?
There is no documented scientific
evidence that a pregnant woman will transmit vitiligo to her unborn
child as may happen in certain diseases like HIV infection.
Is one at greater risk of skin cancer because of my vitiligo?
There may be an increased risk of skin cancer but the evidence in support of this is moderate at this time.
Are cosmetics which have been manufactured to cover vitiligo spots safe to use?
Yes, they are. There are several camouflage cosmetics that are available.
What is the relationship between vitilago and leprosy?
There is no relationship between vitiligo
and leprosy.Vitiligo is a disease of as yet, undetermined cause.
Several factors have been postulated as to the cause of vitiligo. It is
neither infectious nor contagious. Leprosy is an infectious condition
caused by a bacteria. It is contagious and can lead to severe
disfiguring sores on the body and damage to the nerves. Some
complications include loss of fingers and toes and other deformities.
0 comments: