Vitiligo

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Vitiligo is an acquired pigmentary disorder of the skin and mucous membranes characterized by circumscribed depigmented macules and patches that result from a progressive loss of functional melanocytes that are selectively destroyed.

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INTRODUCTION Vitiligo is an acquired chronic disease characterized by depigmented macular patches due to loss of epidermal melanocytes. It affects 1,6% of the general population in Croatia. Female patients are more affected (53,95%) than male patients, with no difference in the severity of vitiligo. Most of our patients were in generally good health, showing no association of vitiligo with thyroid dysfunction, diabetes mellitus, pernicious anemia nor gonadal failure. Localized form of vitiligo most frequently affects 21 to 28-year-old patients, while generalized form prevails in the age group from 29 to 36 years. Patients older than 77 years of age are very rarely affected. The most common localized type was focal (93,28%), and the most common generalized type was vitiligo vulgaris (53,7%). Most of our patients were admitted in September, probably due to increased contrast between involved and uninvolved skin. Most patients attribute the onset of their disease to specific life events (physical injury, emotional distress, illness or pregnancy). AIMS The aim of this case report was to present our patient suffering from vitiligo vulgaris, and to evaluate clinical presentation, diagnostic and therapeutic difficulties in this condition. CASE REPORT A 23-year-old Caucasian female patient was admitted to our Hospital in September 2010, due to prominent, generalized depigmented patches. The disease begun acutely, “over night” (in patients` own words), and progressed in the following order: dorsal aspects of hands, upper extremities, trunk, face and lower extremities. Within a few weeks 60% of her body was affected. On admission to our Hospital her height was 175 centimeters and weight was 60 kilograms, body mass index was normal (19,6). The affected area had no associated scaling. There was a lack of cutaneous induration or sclerosis. Skin lesions were asymptomatic and lack clinical sings of inflammation. During dermatological examination leukotrichia of the occipital area was found. There was no mucosal involvement. She was without any subjective difficulties (e.g. pain, fever, weight loss). There was family history of this disorder (her 12-year-old brother has acrofacial vitiligo). The disease appeared almost simultaneously with his sister`s condition. She attributed the onset of her disease to emotional stress, while her parents died in a car accident six months before she has noticed first signs of vitiligo. She had also noticed new depigmented lesions in sites of physical injury (Koebner phenomena). History of chronic sun exposure was negative. She was non-smoker. Illumination with Wood`s lamp showed no fluorescence of the affected depigmented skin.CL has been diagnosed based on the clinical picture and pathohistological appearance. - Disclaimer- This PPT is loaded as student material "as is", from the VRF Vitiligo Master Class Barcelona November 2011; VRF does not endorse or otherwise approve it.

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