Vitiligo
Vitiligo

Vitiligo is a disease also known as ala disease in the community. In vitiligo, cells called melanocytes, which give the color of our skin, are destroyed by the body's immune system cells. The disappearance of color-producing cells shows itself as whitening in that area of ​​our skin.

Vitiligo is in the group of autoimmune (unknown cause) diseases. In autoimmune diseases, the body's immune system cells cause damage to some target tissues due to unknown reasons. In vitiligo, the target cells are the cells called melanocytes that give the skin its color. Therefore, vitiligo is a disease with a high probability of being seen together with other autoimmune diseases. It is generally recommended to investigate other rheumatic (autoimmune) diseases simultaneously in patients diagnosed with vitiligo.

White areas on the skin differ from person to person. Generally, the spread of vitiligo is classified as segmental and nonsegmental vitiligo. This classification is helpful in estimating the place of onset and spread of the disease and sometimes the age of onset. While segmental vitiligo is used to describe the types that are common in the pediatric age group, usually unilateral and limited to involvement in one area, the term nonsegmental is a term used for many scattered white plaques.

The prevalence and severity of vitiligo varies considerably from patient to patient. Sometimes there are situations that start and end with a single white plaque, while sometimes there are patients that start and progress rapidly and the whole body becomes almost completely white. Sometimes it stops after it starts and a certain amount of residue, but it can recur from time to time in attacks. It is often difficult to predict the course of the disease.

Although it is seen at a rate of 1-2% in the society, it may not be noticed when the contrast difference between vitiligo lesion and normal skin color is not large in white-skinned individuals. Sometimes, the awareness of the society decreases because the vitiligos located on the trunk are camouflaged by the patients with clothes. It is seen equally in men and women.

The diagnosis of vitiligo is made by wood light examination in patients who apply to a doctor with the suspicion of white spots in daylight. In Wood's light, the vitiligo lesion shows itself as whiter than normal skin color (lime color). Wood light examination is a reliable diagnostic method as white spots on the body can sometimes be confused with some skin diseases such as fungal disease or pityriasis alba. In uncertain cases, a skin biopsy can help clarify the diagnosis.

In the treatment of vitiligo, it is primarily aimed to bring the skin to its own color. For this purpose, cream treatments containing cortisone and tacrolimus are used to regulate the immune system, treatments such as excimer laser and phototherapy to stimulate melanocytes are used. The patient's stress factor, comorbidities and the age of onset of vitiligo affect the treatment process. In addition, the newer the vitiligo lesion, the better the response to treatment. Response decreases in patients whose treatment process is delayed.

Antioxidants may be recommended to support immunomodulatory treatments. Psychotherapy treatments will also help regulate stress-related immune system damage.

Permanent concealers and tattoos can be applied to reduce the visibility of vitiligo lesions. In addition, whitening (depigmentation) of the remaining normal skin areas can be applied in patients whose body is widely affected.

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