Vitiligo Basics

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How is vitiligo recognized

The dermatologist diagnoses the disease by considering the appearance of the skin and analyzing it with Wood’s Light (wavelength 365 nm), a tool that highlights spots in particular.

In cases where there is an ambiguity, he performs the differential diagnosis through a skin biopsy, the removal of a fragment of skin followed by its microscopic analysis. The differentiation must be made with respect to:

Mycosis: diseases such as Pityriasis versicolor, which causes the onset of asymptomatic light spots on the skin, can be confused with vitiligo;

Pityriasis alba: this is a pathology whose cause is not ascertained, which appears in association with other dermatological diseases; it differs from vitiligo for the flaking that occurs within the spots that accompany its onset;Post-inflammatory hypopigmentation;Piebaldism: rare genetic disease that causes the appearance of areas of depigmentation;Morphea: this is the localized form of scleroderma;

Lichen sclerosum.

Is there a relationship between vitiligo and psoriasis? Although vitiligo can coexist with many other dermatological disorders, it is very rare to find both diseases in the same patient.

What tests to do for vitiligo?

Due to its links with the onset of Hashimoto’s thyroiditis and other thyroid alterations, doctors generally prescribe laboratory tests to evaluate the functionality of this organ. Why Vitiligo Appears

The most accredited theory on the pathogenesis of vitiligo is the autoimmune one: it would be the result of an abnormal reaction of the immune system which, in order to defend itself from possible enemies, gets confused and attacks structures belonging to the body itself, in this case the melanocytes. This consideration derives from the fact that many people with vitiligo also suffer from other autoimmune diseases (hyperthyroidism, alopecia areata, diabetes).

The causes of vitiligo related to the thyroid.

The most powerful association is that between vitiligo and thyroid disease, mainly hyperthyroidism and Hashimoto’s thyroiditis. About 10 DNA alterations common to these pathologies have been identified, but to date it is only possible to state that those suffering from vitiligo are 2.5 times more likely than normal to suffer from thyroid disease and that this risk increases with age. .

  • The causes of vitiligo related to the thyroid.15% of vitiligo patients suffer from thyroiditis and about 21% produce autoantibodies directed against the thyroid.
  • Vitiligo sufferers should keep their thyroid under control, undergoing regular examinations over time.

This correlation was also observed at an experimental level, when a group of Indian researchers administered a supplement of thyroxine (the hormone secreted by the thyroid which is deficient when it becomes ill and undergoes functional deficit) to people with vitiligo.

The supplementation produced skin re-pigmentation.

More circumstantial, however, is the link with celiac disease, which seems to be accidental. Therefore, choosing a gluten-free diet in an attempt to cure vitiligo has no supporting scientific evidence.