Definition:

Vitiligo is an acquired idiopathic depigmentation condition in which loss of Melanin pigment causes white discolouration. This non-contagious disorder gives embarrassment, anxiety and depression to the victims.

Aetiology:

• Genetic Mutation
  Mendelian theory
• Autoimmunity
  Neurochemical mediators
• Self Destruction
  Metabolic product of Melanin
• Neural blocks
  Problems in Melatonin ,causing tyrosinase
• Digestive Upsets and liver Disorders
  Amoebiaisis, Dyspepsia, Chronic Dirrhea, Dysentery and Intestinal Worms
• Nutritional factors
  Anaemia - Copper, proteins, and vitamins
• Endocrine disorders
  Diabetes Mellitus,Thyroid Disorders, Addison's
• Drugs and Chemicals
  Antibiotics Chlormphenicol and Streptomycin leads
• Stress and Emotions

Pathophysiolgy

• Melonocytes synthesis Melanin from Tyrosine by the action of enzyme tyrosinase
• The oxydised melanin combines with Copper to give dark colour
• MSH from Anterior pituitary controls the secretion
• Sun, UVR X ray stimulates formation, while ascorbic acid tends to reduce it

Clinical Features:

The White discolouration of the skin affects around 1% of the population in all races. The lesion is restricted to one part of the body in some cases and generalized in most cases. Usually the generalized varieties often are symmetrical and involves hand, wrist, knees and neck as well as around the body orifice. The lesions are with sharp margins; No scales; normal texture with intact sensation; appears typical milk white colour;

Diagnosis:

Diagnosis is very easy by history and physical findings. Skin biopsy shows absence of melanocytes. Antinuclear antibodies can be detected in blood.