World Vitiligo Day: Rising Awareness to Erase StigmaBy Miriam Bello | Fri, 06/25/2021 - 14:52
June 25 is World Vitiligo Day, which aims to bring this forgotten condition back into the public eye and shine a light on the challenges faced by those suffering from it. This year also marks the first decade this day has been observed. Vitiligo, is an autoimmune dermatological condition that affects approximately 2 percent of the population worldwide, not only on their skin but also on their self-esteem.
Vitiligo causes discoloration of the skin in patches, explains Mayo Clinic. The condition can affect the skin on any part of the body, including the scalp and the inside of the mouth. Discolored areas generally enlarge over time. Vitiligo occurs when cells that make melanin die or stop working and affects people of all skin types but can be more noticeable in those with darker skin. To date, there is no cure for this non-transmissible disease, which, while not deadly, increases the risks for psychological or social distress, sunburn, eye problems and hearing loss.
Vitiligo is more common in young women and often begins before the age of 20. In Mexico, this disease occupies between the third and fifth places of all dermatoses and represents 2-4 percent of all dermatological patients, according to the Head of the Department of Dermatology of the Hospital Juárez de México, Miriam Puebla. This problem has also a genetic component as 10 to 30 percent of those with the condition have it in their family history.
Vitiligo diagnosis in Mexico is commonly made using a Wood's lamp, a hand-held ultraviolet light that makes areas of skin with less pigment appear bright white. Other options are through a skin biopsy to rule out other possible causes of loss of pigmentation or blood tests to check thyroid or other hormone levels, as well as vitamin B12 levels.
According to IMSS, there are two types of treatments:
- Topical treatment. In patients with newly onset vitiligo, treatment with a potent or very potent topical steroid should be considered for a trial period of no more than 2 months. In adults with symmetric vitiligo, topical pimecrolimus should be considered as an alternative to the use of topical steroids, especially in lesions located on the head, neck and genitals.
- Oral systemic treatment. The use of oral dexamethasone stops the progression of vitiligo, but due to common adverse effects it is not recommended as a first line for vitiligo treatment.
- Photochemotherapy. The use of narrowband ultraviolet B (Nb-UVB) light is recommended in the treatment of moderate to severe generalized vitiligo because of its efficacy compared to PUVA.
- Surgical Treatment. This is recommended in patients with scores on the LIFE scale of -1 or 0 (patients without lesion activity) and without Koebner phenomenon.
- Depigmenting treatment. Depigmentation with hydroquinone monobenzyl ether or 4-methoxyphenol should be reserved for adults with severe vitiligo disease or to whom repigmentation therapy cannot be offered.
- Non-pharmacological treatment: As additional support, psychological interventions should be provided to vitiligo patients. Parents of affected children can also be given counseling.