The depigmentation caused by the absence or decrease of melanin leads to the main characteristic of vitiligo : the spots on the skin.
Although the disease does not offer physical or cognitive limitations and is not transmitted from one person to another, misinformation and prejudice contribute to the stigma associated with the condition.
O world vitiligo day celebrated this Sunday (25), promotes awareness on the subject, highlighting that the erroneous understanding that vitiligo is contagious contributes to discrimination against patients.
Understand what vitiligo is
Vitiligo is a non-contagious, autoimmune manifestation that can be caused by several factors. Although the causes are not fully understood by the scientific community, the emergence may be related to a genetic predisposition.
According to the Brazilian Society of Dermatology, external factors can contribute to the appearance or worsening of spots that result from the gradual loss of pigmentation due to the formation of T lymphocytes that destroy melanocytes, cells responsible for the production of melanin in the body.
Dermatologist Renata Janones, from the Clinical Hospital of the Federal University of Uberlândia (UFU), says that the development of the disease can also be influenced by genetic factors and emotional impacts.
“There is a genetic predisposition: about 30 to 40% of individuals diagnosed with vitiligo are able to identify a family history. Like any autoimmune disease, we don’t know exactly what triggers it. It could be an infection or emotional stress, such as the loss of a relative or a change of city”, he explains.
Vitiligo affects men and women of any ethnicity and of all ages.
“Signs usually appear, on average, at age 24. Prevalence data may differ from one country to another. In Anglo-Saxon countries, on average, 1% develop the disease, in Brazil, 0.5% of the population manifests the condition, while in China this percentage reaches 0.1% and in India 5%”, says the dermatologist Caio Castro, specialist of the Brazilian Society of Dermatology.
Vitiligo can present itself in at least six clinical forms:
- Focal: small spots in a specific area of the body;
- mucosal: stains only on the mucous membranes, such as the lips and genital region;
- segmental: patches distributed unilaterally, only on one part of the body;
- crofacial: spots on the fingers and around the mouth, eyes, anus and genitals;
- common: spots on chest, abdomen, legs, buttocks, arms, neck, armpits and other acrofacial areas;
- universal: spots spread over almost all regions of the body.
Impacts on mental health
Psychologist Leonardo Alves, from the Vitiligo Treatment Center, in Rio de Janeiro, says that the spots on the skin caused by vitiligo are the cause of constant anxiety.
“Vitiligo does not hurt, does not itch, does not burn and does not present any real risk to the physical integrity of the patient. What, most of the time, happens is a condition where the patient suffers a shock to his self-image, and this can be a huge source of suffering, ”he says. “It is correct to say that psychological symptoms are the ones that most affect those who suffer from the disease. The person’s life starts to revolve around the spots and the most common feelings are: anguish, social phobia and depression”, he adds.
The expert recommends strengthening patients’ self-esteem, with approaches that can reframe the individual’s relationship with their own stains.
“Whatever the approach used, psychological support contributes to the acceptance of the patient’s suffering. It is important to offer conditions to focus on the future and be fully involved in their own treatment. Introduce tools to manage the social confrontations that the disease can bring. And, above all, giving the patient the chance to speak and elaborate their feelings in a frank and genuine way, allowing their emotions to be expressed through their speech and not through spots on their skin”, says Alves.
How the diagnosis is made
In general, patients with vitiligo only have white spots on the skin as a symptom. In some cases, there may be tenderness and pain in the area of the lesions. Diagnosis should be performed by dermatologists during clinical consultation.
“The clinical diagnosis is made, in principle, with the naked eye, only with the aid of a special lamp. When there is doubt, a biopsy of the lesions is performed, since the spots of vitiligo can be confused with those of other skin diseases, such as hypochromic mycosis fungoides or discoid lupus”, says Castro.
The doctor Renata Janones says that the spots do not show signs of irritation or itching. In addition, the disease does not cause other symptoms, such as illness or loss of function.
“The most common places are around the eyes, on the eyelids, near the mouth and on the genitals. The spots can also appear on the extremities, hands and feet, although they can happen anywhere”, explains Renata.
Basic care and treatment of vitiligo
Vitiligo has no cure, but it has control. Therapeutic approaches can be used based on the evaluation of the patient’s profile by the dermatologist.
Among the therapies available to control the disease are the use of drugs that induce repigmentation of the affected skin, creams based on corticosteroids and other anti-inflammatory drugs, technologies such as laser and phototherapy, in addition to surgery and melanocyte transplantation.
“With medical help, using scientifically recognized medication and therapies, some patients can repigment the affected areas or even depigment the entire body,” says Castro.
In addition to treatment, patients must follow a care routine that mainly involves preventing exposure of the affected areas to the sun. The guidelines include the use of sunscreen (with a protection factor above 50), in addition to clothing and accessories such as hats and caps that protect the skin.
“Patients with this condition have a greater tendency for their skin to age, especially in depigmented areas, in addition to being more likely to feel the effects of ‘burns’ in the area due to excessive exposure to the sun,” says Castro.
Source: CNN Brasil
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