Vitiligo Definition Classification Treatment and Prognosis A Personal Opinion
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3
Abstract
Vitiligo has no respect for race, socioeconomic status or age. The following are celebrities who have or have had Vitiligo. Michael Jackson, Lee Thomas Americo Garcia Holly Marie Combs, Winnie Harlow, Rasheed Wallace, Tamar Braxton Joe Rogan Sisqo Richard Hammond Thomas Lennon [1]. Vitiligo is a cutaneous pigmentary disorder caused by selective destruction or ‘temporary sickness’ of melanocytes presenting with complete or partial loss of skin color. Broader definitions are available from different authors and medical scientists [2]. I have defined the entity in the first instance in this way because it would explain many aspects and features of Vitiligo. A definition from the researcher referred to above [2] has the following key words: ‘Vitiligo, an autoimmune disorder characterized by localized and / or generalized depigmentation of the skin and / or mucous membranes’. The downside of such definition is that it does not cover what Vitiligo is all about. It focuses on ‘autoimmunity’ which is a big issue in Europe and the Americas. Diseases considered to be ‘Autoimmune’ -pernicious anemia, Graves’s disease Hashimoto’s thyroiditis are rare in Nigeria despite the high prevalence of Vitiligo [3]. In a search for autoimmune diseases by Greenwood [4,5] at the University College Hospital, Ibadan one of the largest hospitals in the world he found pernicious anemia (PA) in 4 patients out of over 90, 000 screened patients. Furthermore three of these were Caucasians and one an Indian-out of a sea of ‘black’ skinned Nigerian patients [6] documented only 10 cases of PA in a period of 15 years (1973-1988) in Lagos University Teaching hospital Nigeria’s second largest hospital. The definition by Sehgal also in its emphasis on ‘autoimmunity’ fails to consider the possibility of chemicals in the causation of Vitiligo which some like Stevenson have referred to as ‘Occupational Vitiligo’ [7], Other chemicals not ‘occupational’ with chemical similarities abound in Nigeria [3] and are regularly used as cosmetics. These include hydroquinone containing creams -with over 50 brands, phenol solutions and bar soaps -‘Dettol’, ‘Septol’.Classification of Vitiligo may be clinical -focal, segmental, acrofacial, universal as well as based on age of onset. Some experts consider Vitiligo in children to be a subset or a different disease from that of the adult [8,9].
Authors and Affiliations
Adekunle George
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