Vitiligo history and symptoms: Difference between revisions
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==History== | ==History== | ||
[[Vitiligo]] is one of the most common diseases of [[depigmentation]]. It affects 0.5% to 1% of the world population, without preference for a particular [[race]], [[gender]], [[age]] or country. For patients presenting for the first time with patches of [[skin]] [[depigmentation]], a thorough history and [[physical examination]] should be performed, including examination under the ''Wood's lamp'' in order to rule out other potentially life-threatening disorders. The initial onset of the condition may be abrupt, however, afterwards it usually progresses slowly, with expansion of [[skin]] [[depigmentation]] with no concomitant [[symptoms]].<ref name="TaïebPicardo2009">{{cite journal|last1=Taïeb|first1=Alain|last2=Picardo|first2=Mauro|title=Vitiligo|journal=New England Journal of Medicine|volume=360|issue=2|year=2009|pages=160–169|issn=0028-4793|doi=10.1056/NEJMcp0804388}}</ref><ref>{{cite book | last = Soutor | first = Carol | title = Clinical dermatology | publisher = McGraw-Hill Education/Lange Medical Books | location = New York | year = 2013 | isbn = 978-0-07-177296-9 }}</ref><ref name="pmid831622">{{cite journal| author=Howitz J, Brodthagen H, Schwartz M, Thomsen K| title=Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark. | journal=Arch Dermatol | year= 1977 | volume= 113 | issue= 1 | pages= 47-52 | pmid=831622 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=831622 }} </ref><ref name="pmid10651958">{{cite journal| author=Boisseau-Garsaud AM, Garsaud P, Calès-Quist D, Hélénon R, Quénéhervé C, Claire RC| title=Epidemiology of vitiligo in the French West Indies (Isle of Martinique). | journal=Int J Dermatol | year= 2000 | volume= 39 | issue= 1 | pages= 18-20 | pmid=10651958 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10651958 }} </ref> There may be two major subdivisions of [[vitiligo]] which may influence the presence of different characteristics and the [[natural history]] of the disease. They may be present individually or concomitantly, in which case the segmental lesions will respond poorly to the treatment:<ref name="TaïebPicardo2009">{{cite journal|last1=Taïeb|first1=Alain|last2=Picardo|first2=Mauro|title=Vitiligo|journal=New England Journal of Medicine|volume=360|issue=2|year=2009|pages=160–169|issn=0028-4793|doi=10.1056/NEJMcp0804388}}</ref><ref name="pmid12859615">{{cite journal| author=Gauthier Y, Cario Andre M, Taïeb A| title=A critical appraisal of vitiligo etiologic theories. Is melanocyte loss a melanocytorrhagy? | journal=Pigment Cell Res | year= 2003 | volume= 16 | issue= 4 | pages= 322-32 | pmid=12859615 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12859615 }} </ref> | [[Vitiligo]] is one of the most common diseases of [[depigmentation]]. It affects 0.5% to 1% of the world population, without preference for a particular [[race]], [[gender]], [[age]] or country. For patients presenting for the first time with patches of [[skin]] [[depigmentation]], a thorough history and [[physical examination]] should be performed, including examination under the ''Wood's lamp'' in order to rule out other potentially life-threatening disorders. The initial onset of the condition may be abrupt, however, afterwards it usually progresses slowly, with expansion of [[skin]] [[depigmentation]] with no concomitant [[symptoms]].<ref name="TaïebPicardo2009">{{cite journal|last1=Taïeb|first1=Alain|last2=Picardo|first2=Mauro|title=Vitiligo|journal=New England Journal of Medicine|volume=360|issue=2|year=2009|pages=160–169|issn=0028-4793|doi=10.1056/NEJMcp0804388}}</ref><ref>{{cite book | last = Soutor | first = Carol | title = Clinical dermatology | publisher = McGraw-Hill Education/Lange Medical Books | location = New York | year = 2013 | isbn = 978-0-07-177296-9 }}</ref><ref name="pmid831622">{{cite journal| author=Howitz J, Brodthagen H, Schwartz M, Thomsen K| title=Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark. | journal=Arch Dermatol | year= 1977 | volume= 113 | issue= 1 | pages= 47-52 | pmid=831622 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=831622 }} </ref><ref name="pmid10651958">{{cite journal| author=Boisseau-Garsaud AM, Garsaud P, Calès-Quist D, Hélénon R, Quénéhervé C, Claire RC| title=Epidemiology of vitiligo in the French West Indies (Isle of Martinique). | journal=Int J Dermatol | year= 2000 | volume= 39 | issue= 1 | pages= 18-20 | pmid=10651958 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10651958 }} </ref> There may be two major subdivisions of [[vitiligo]] which may influence the presence of different characteristics and the [[natural history]] of the disease. They may be present individually or concomitantly, in which case the segmental lesions will respond poorly to the treatment:<ref name="TaïebPicardo2009">{{cite journal|last1=Taïeb|first1=Alain|last2=Picardo|first2=Mauro|title=Vitiligo|journal=New England Journal of Medicine|volume=360|issue=2|year=2009|pages=160–169|issn=0028-4793|doi=10.1056/NEJMcp0804388}}</ref><ref name="pmid12859615">{{cite journal| author=Gauthier Y, Cario Andre M, Taïeb A| title=A critical appraisal of vitiligo etiologic theories. Is melanocyte loss a melanocytorrhagy? | journal=Pigment Cell Res | year= 2003 | volume= 16 | issue= 4 | pages= 322-32 | pmid=12859615 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12859615 }} </ref> | ||
===Generalized or | ===Generalized or Nonsegmental=== | ||
*The most common form of the disease, present in about 85-90% of the cases. | |||
*Common later onset. | |||
*Continuous progression with periods of exacerbation. | |||
*[[Hair]] is usually affected later in life. | |||
*Individual or family history of other [[autoimmune diseases]]. | |||
*Frequently occurs in areas of the [[body]] susceptible to [[trauma]] or keen to pressure. | |||
*Bad response to [[autologous]] [[grafting]], commonly recurring on the same location. | |||
===Segmental=== | ===Segmental=== | ||
:*Commonly has an earlier onset in [[childhood]]. | :*Commonly has an earlier onset in [[childhood]]. | ||
Revision as of 18:23, 25 June 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Vitiligo constitutes one of the most frequent pigment disorders, affecting about 1% of the world's population, with no preference of race, age, gender, or country. It commonly starts to manifest around the second decade of life, with a gradual progress of depigmentation, mostly due to loss of melanocytes.[1][2]
History
Vitiligo is one of the most common diseases of depigmentation. It affects 0.5% to 1% of the world population, without preference for a particular race, gender, age or country. For patients presenting for the first time with patches of skin depigmentation, a thorough history and physical examination should be performed, including examination under the Wood's lamp in order to rule out other potentially life-threatening disorders. The initial onset of the condition may be abrupt, however, afterwards it usually progresses slowly, with expansion of skin depigmentation with no concomitant symptoms.[3][4][5][6] There may be two major subdivisions of vitiligo which may influence the presence of different characteristics and the natural history of the disease. They may be present individually or concomitantly, in which case the segmental lesions will respond poorly to the treatment:[3][7]
Generalized or Nonsegmental
- The most common form of the disease, present in about 85-90% of the cases.
- Common later onset.
- Continuous progression with periods of exacerbation.
- Hair is usually affected later in life.
- Individual or family history of other autoimmune diseases.
- Frequently occurs in areas of the body susceptible to trauma or keen to pressure.
- Bad response to autologous grafting, commonly recurring on the same location.
Segmental
- Commonly has an earlier onset in childhood.
- Has an abrupt onset, stabilizing afterwards.
- Rapidly evolves to involve hair regions.
- Commonly involves the face.
- Generally no other autoimmune diseases are present.
- May be confused with nevus depigmentosus.
- Commonly responds well to autologous grafts.
Common Symptoms
Less Common Symptoms
References
- ↑ Soutor, Carol (2013). Clinical dermatology. New York: McGraw-Hill Education/Lange Medical Books. ISBN 978-0-07-177296-9.
- ↑ Taïeb, Alain; Picardo, Mauro (2007). "The definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force". Pigment Cell Research. 20 (1): 27–35. doi:10.1111/j.1600-0749.2006.00355.x. ISSN 0893-5785.
- ↑ 3.0 3.1 Taïeb, Alain; Picardo, Mauro (2009). "Vitiligo". New England Journal of Medicine. 360 (2): 160–169. doi:10.1056/NEJMcp0804388. ISSN 0028-4793.
- ↑ Soutor, Carol (2013). Clinical dermatology. New York: McGraw-Hill Education/Lange Medical Books. ISBN 978-0-07-177296-9.
- ↑ Howitz J, Brodthagen H, Schwartz M, Thomsen K (1977). "Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark". Arch Dermatol. 113 (1): 47–52. PMID 831622.
- ↑ Boisseau-Garsaud AM, Garsaud P, Calès-Quist D, Hélénon R, Quénéhervé C, Claire RC (2000). "Epidemiology of vitiligo in the French West Indies (Isle of Martinique)". Int J Dermatol. 39 (1): 18–20. PMID 10651958.
- ↑ Gauthier Y, Cario Andre M, Taïeb A (2003). "A critical appraisal of vitiligo etiologic theories. Is melanocyte loss a melanocytorrhagy?". Pigment Cell Res. 16 (4): 322–32. PMID 12859615.