Vitiligo is one of the types of skin disorder which is characterized by white patches on the skin due to the loss of normal skin pigment. Vitiligo is defined as a non-contagious acquired pigmentation disorder.
Depigmentation of patches of skin is the characteristic symptom of this skin disorder Initially, it begins as small patches on the skin but as this disease progresses, these patches are enlarged over time. Most often, the patches affect the face, wrist, and hands. Vitiligo is categorized into three types:
1. Localized Vitiligo - It is the first form of vitiligo which is subdivided into two forms - focalis and segmented. Focalis form indicates one or more patches in one area but not in segmented pattern. Segmented form indicates one or more patches with a unilateral distribution that can totally or partially match a dermatome.
2. Generalized Vitiligo - It is subdivided into three groups - acrofacial, vulgaris, mixed form. Acrofacial form is a group that affects the face and distal extremities. Vulgaris is the most common type which indicates the distribution of lesions in typical zones. Mixed form is a group involves segmental vitiligo, vulgaris vitiligo, and acrofacial vitiligo.
3. Universal Vitiligo - It is a type of vitiligo in which almost 80% of the body is affected.
Loss of functionality of melanocytes is considered to be the primary cause of the development of vitiligo. Melanocytes are the cells that are responsible for producing pigment in the skin. However, there are some conditions that can play a role in the occurrence of vitiligo such as autoimmune disease, genetics, neural, viral infection, and oxidative stress.
Some of the health conditions that are associated vitiligo are as follows:
1. Autoimmune thyroid disorder
Autoimmune disease is one of the common cause of vitiligo. Autoimmune disease indicates the problem with acquired immune system’s reactions. In an autoimmune reaction, antibodies and immune cells mistakenly target the own healthy tissues in the body and signaling the body to attack them.
Autoimmune thyroid disorder is strongly associated with vitiligo. Autoimmune thyroid disease is a common disorder which mainly affects women. Autoimmune thyroid disorder is defined as a group of diseases which indicates the presence of serum thyroid autoantibodies directed against thyroglobulin, thyroperoxidase or thyroid-stimulating hormone receptor.
The occurrence of autoimmune thyroid disorder can be due to an interaction between the environmental and genetic predisposing triggers that could lead to dysregulation of immune tolerance. The level of specific autoantibodies against specific cells such as thyroid cells and gastric parietal cells or adrenal cells can be higher in patients who suffer from vitiligo.
The autoimmune thyroid disease causes the accumulation of reactive oxygen species and exerts a toxic effect on the cells in the body. It can trigger the development of melanocytic antigens.
Psoriasis and vitiligo are known to be closely linked with each other. Psoriasis is a chronic and painful skin condition which is characterized by sharply marginated scaly, erythematous plaques that develop in a relatively symmetrical distribution. Most commonly psoriasis affects the scalp, palms, tips of fingers and toes, soles, umbilicus, gluteus, under the breasts and genitals, elbows, knees, and shins, but it can affect other parts of the body as well. Psoriasis is a non-contagious disease.
Psoriasis and vitiligo are associated with each other. Psoriasis may occur coincidentally with vitiligo. Psoriasis is of many types in most cases of psoriasis coexisting with vitiligo were the plaque-type of psoriasis.
3. Diabetes mellitus
Diabetes mellitus is a metabolic disease which is characterized by hyperglycemia or in simple terms, the high glucose level in the blood. It is a serious disorder associated with various other health problems, especially heart disease.
Diabetes mellitus is of three types type 1 diabetes, type 2 diabetes, and gestational diabetes. Type 1 diabetes is a type in which high blood sugar level occurs due to the lack of production of the hormone, insulin. Insulin is the primary hormone which regulates the glucose level in the blood and it is produced by the pancreas. Type 2 diabetes is a type in which high glucose level results from the inability of the body to use produced insulin effectively. Lastly, gestational diabetes occurs in women during the pregnancy.
Studies have stated that vitiligo is correlated with type 1 diabetes. Type one diabetes occurs due to the destruction of insulin producing cells. IN the body of patients having vitiligo, the immune system attacks the insulin producing cells. As a result, there is a lack of insulin production in the body.
4. Addison’s disease
Addison’s disease is an endocrine disease which can affect people of all ages and of all sexes. Addison’s disease is considered to be a life threatening disorder because it does not show any symptom or clinical sign of the disease until the disease reaches its advanced level. Chronic addison disease is accompanied by symptoms like worsening fatigue, loss of appetite, generalized weakness, hypotension, and weight loss.
Generalized hyperpigmentation of the skin has also been seen to be associated with addison's disease. Certain studies have also stated the correlation between addison’s disease and vitiligo. Vitiligo can be seen in association with hyperpigmentation in addison’s disease and this is due to the autoimmune destruction of melanocytes.