Local depigmentation

The distribution of melanin in the human body is in a relatively balanced state. If too much melanin accumulates, dark spots will appear, affecting the normal appearance. If the human body lacks these melanins, it will cause harm to the body. Vitiligo patients suffer from a skin disease caused by a lack of melanin. This type of disease not only affects their appearance, but also threatens their physical health.

Vitiligo is a primary, localized or generalized depigmentation of the skin and mucous membranes. The incidence rate is related to skin color. The darker the skin color, the higher the incidence rate. The incidence rate among Asians is between that among whites and blacks. The disease is caused by a decrease in or loss of the tyrosinase system in the melanocytes of the skin and hair follicles. Clinical manifestations: Vitiligo can occur anywhere on the body, and the skin at the affected area loses color and turns white. It is prone to occur in areas that are easily rubbed and exposed to the sun, as well as in wrinkled areas, palms and soles, and mucous membranes. Most of the white spots are distributed symmetrically, and some are distributed along nerve segments. The initial lesions are the size of a fingernail to a coin and are round, oval or irregular in shape. The onset of the disease is as punctate hypopigmented spots with clear boundaries and pigmentation or pigment bands around the edges. In some white spots, there will be an increase in follicular punctate pigmentation, which will gradually increase and fuse to form pigment islands. In addition to loss of pigmentation, vitiligo does not cause skin atrophy, scarring, or desquamation. Some hair may turn completely white. The number of white spots is variable, a few can be confined to a certain part, and very few disappear on their own. In most cases, the spots will gradually expand and merge into large patches of white spots with irregular shapes that resemble a map. Vitiligo generally progresses faster in summer and stops spreading or slows down in winter. The course of the disease varies in length. It will progress rapidly under stressful conditions such as exposure to the sun, mental trauma, surgery, and emergency illness, and the area of ​​the rash will expand rapidly. Vitiligo can be divided into active and stable stages according to the disease stage; divided into segmental type and common type according to the site of onset; divided into complete vitiligo and incomplete vitiligo according to the situation of depigmentation.

Diagnosis and Differentiation

The diagnosis of typical vitiligo is not difficult. The diagnosis can be made based on the appearance of clearly defined depigmented spots on the skin, supplemented by WOOD, skin CT and other examinations. Early damage with incomplete depigmentation and blurred edges needs to be differentiated from the following diseases: anemic nevus, pityriasis alba, acquired hypopigmented macules, pityriasis versicolor, discoid lupus erythematosus, mucosal leukoplakia, etc.

Treatment principles

Vitiligo is a difficult disease to treat and requires a long time to treat. The goal of treatment is to give local abnormal pigment cells the ability to regenerate melanin, inhibit the progression of the disease, control the expansion of the rash area, make the hypopigmented area of ​​the rash lighter, and make the edges blurred and difficult to identify. The main treatment for progressive vitiligo is to quickly control the progression of the disease. Generally, the system is given small doses of glucocorticoids orally, topical glucocorticoids, and traditional Chinese medicine for treatment. Vitiligo in the stable stage is treated with photochemotherapy, surgical treatment, etc. It has been found that external use of vitamin D3 derivatives such as calcipotriol ointment, tacalcitol ointment, and tacrolimus ointment have certain effects on vitiligo. Avoid using irritating drugs, avoid trauma and local irritation, combine work and rest, strengthen exercise, get appropriate sunbathing, avoid excessive fatigue, and eat less drugs and foods rich in vitamin C.