Identification

• Melanocytes, or cells that produce skin pigment, stop making pigment when you have vitiligo. The disease usually begins by affecting small patches of skin, but progresses over time until more areas of the body are involved. While healthy people can develop vitiligo, it is more common in people with immune system disorders, such as pernicious anemia, an overactive thyroid gland, adrenocortical insufficiency or alopecia areata. In some cases, vitiligo may be inherited, and you are more likely to develop the disease if a close relative has it.
  
  

Symptoms

• You may first notice white patches on areas of your skin that are exposed to the sun, such as your face, lips, arms, hands and feet. When vitiligo occurs on the face, patches may develop around your nostrils, eyes and mouth. You also may find white patches around your navel, rectum, genitals, groin or armpits. The hair in your eyebrows, eyelashes, beard and scalp may prematurely gray if you have vitiligo. If your skin is dark, you may lose color in the inside of your mouth.
  
  

Types

• Focal pattern depigmentation occurs when white patches develop in only a few areas of your body. A generalized pattern, the most common pattern, may develop on both sides of your body, in a symmetrical pattern. Segmental pattern depigmentation, on the other hand, occurs on just one side of your body.
  
  

Diagnosis

• Your doctor will determine a vitiligo diagnosis based on your medical history, a physical examination and a biopsy of your skin in the affected area. If you have vitiligo, the test will show that there are no melanocytes producing pigment in the biopsied area. Your doctor may recommend a blood test to rule out other diseases and to check for a vitamin B12 deficiency. Some people with vitiligo also have pernicious anemia, a condition in which not enough B12 is absorbed. You also may need an eye exam if your doctor thinks you might have uveitis, an eye inflammation that can occur in people who have vitiligo.
  
  

Treatment

• Your doctor may prescribe topical corticosteroids to return pigment to small sections of yourskin. Another treatment, called psoralen and ultraviolet A therapy (PUVA), uses a combination of an ultraviolet light and a special chemical that makes skin sensitive to light to cause repigmentation in small areas. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, undergoing PUVA results in a 50 percent to 70 percent chance of regaining pigmentation on the face, trunk, upper arms and upper legs. Treatment usually lasts at least one year. Narrow Band UVB also uses a special light to return pigmentation, but is used less often than PUVA. In a small number of people, grafting skin from one area of the body to another may improve appearance, although grafting is not common for vitiligo.