Introduction

Vitiligo is an autoimmune condition which results in the loss of melanocytes and consequent depigmentation of the skin. It is thought to affect around 1% of the population and symptoms typically develop by the age of 20-30 years.

Epidemiology

  • Incidence: 20.00 cases per 100,000 person-years
  • Peak incidence: 20-30 years
  • Sex ratio: 1:1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Aetiology

Associated conditions
  • Type 1 diabetes mellitus
  • Addison's disease
  • Autoimmune thyroid disorders
  • Pernicious anaemia
  • Alopecia areata

Clinical features

  • Well-demarcated patches of depigmented skin
  • The peripheries tend to be most affected
  • Trauma may precipitate new lesions (Koebner phenomenon)

Management

  • Sunblock for affected areas of skin
  • Camouflage make-up
  • Topical corticosteroids may reverse the changes if applied early
  • There may also be a role for topical tacrolimus and phototherapy, although caution needs to be exercised with light-skinned patients
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