Vitiligo is a skin condition characterized by white patches of the skin, surrounded by areas of normal pigmentation. It can be described as the absence of melanocytes, hypopigmentation or depigmentation of the skin.

Skin color is the result of the melanin pigment created by cells (melanocytes) in the skin. Although the cause of vitiligo is unknown, the skin condition may be associated with systemic diseases, such as hypothyroidism (see Diagnostic Code: 7903 Hypothyroidism), hyperthyroidism (see Diagnostic Code: 7900 Hyperthyroidism), diabetes mellitus (see Diagnostic Code: 7913 Diabetes mellitus), Addison's disease (adrenocortical insufficiency) (see Diagnostic Code: 7911 Addison's disease), pernicious anemia, or leprosy (see Diagnostic Code: 6302 Leprosy (Hansen's disease). The condition may be autoimmune in origin, genetically influenced, acquired due to exposure to chemical or pharmacologic agents, and result from burns, trauma, inflammation, and infection. Vitiligo is not contagious.

Loss of melanin results in white, depigmented areas of the skin. The size and location of the affected areas vary, and the depigmentation is usually symmetric. Vitiligo is most noticeable in dark-skinned persons and those with a summer tan.

History and physical examination are necessary to diagnose the condition. Skin biopsy may be done to confirm the diagnosis. Skin biopsies demonstrate the absence of melanocytes. Appropriate laboratory tests may be done to exclude other disorders of metabolism and to identify circulating autoantibodies.

Treatment of vitiligo is focused on the cosmetic disfigurement of the disorder. It may include topical corticosteroids and attempts to repigment skin with exposure to sun or ultraviolet light after sensitizing the area with topical medications (psoralens). When over 50% of the body is involved, the condition is considered to be extensive, and depigmentation of the pigmented skin may be done; cosmetics and stains may be used to camouflage and de-emphasize vitiliginous skin areas. Protection of the depigmented areas is especially important due to the increased risk for sunburn. Protection may include avoidance of the sun, protective clothing, and repeated applications of a sunscreen with a high sun protection factor (SPF).

Vitiligo is not life threatening. The depigmentation of the skin associated with vitiligo is permanent. The hair in the vitiliginous areas is usually white, and the affected skin areas are prone to sunburn.

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