Our Vitiligo Perspective
Types of Vitiligo
Generalized Vitiligo/ Non-Segmental Vitiligo
Generalized Vitiligo, also known as Non-Segmental Vitiligo, is a skin condition characterized by the development of white patches on the skin. It is believed to be a result of free radical damage in the body, which can potentially be considered as lifestyle disoder. Free radicals are harmful toxins that are produced during metabolic processes.
It is worth noting that autoimmunity refers to the immune system mistakenly attacking the body’s own cells.The onset of autoimmunity may not be the primary sole causative factor in Non-Segmental Vitiligo. Instead, individuals with this type of vitiligo may have genetic susceptibility in their melanocytes, the cells responsible for producing skin color which can not handle the toxins. Alternatively, they may have an increased production of free radicals or a decreased ability to neutralize them. Once cells are damaged, the autoimmunity sets in and removes the colour giving cells and hence white patches in skin.
In Non-Segmental Vitiligo, autoimmunity may not play a significant role in the initial stages of the disease. This could be an affect in response to the other cause/triggers. Hyperactive immune system due to a genetic susceptibility also a concern here.
Additionally, many patients with Non-Segmental Vitiligo often have a deficiency in Vitamin D. This vitamin plays a crucial role in preventing autoimmunity. However, it is important to highlight that a genetic susceptibility to vitiligo does not necessarily mean that the condition is hereditary.
Therefore, in the case of Non-Segmental Vitiligo, it is likely that there are genetic susceptibility at various levels mentioned above. However, the development of vitiligo requires the presence of multiple external and internal factors to trigger the condition.
Unilateral Vitiligo/Segmental Vitiligo
In some cases, cutaneous nerve damage or death can occur for unknown reasons. When this happens, the damaged nerves release certain chemicals/neurotoxins that can harm the delicate melanocytes in the skin. The body’s immune system or hyperactive immune system or aptly autoimmunity, will then eliminate these damaged cells resulting in one or few white patches limited to one side of the body but not necessarily limited to one segment. The damage of melanocytes are so much that one can have white hairs on the patch or even normal skin surrounding the patch. We have observed bi -segmental and multi segmental vitiligo in few, where two or multiple such segmental vitiligo arise in same individual.
Focal Vitiligo
Focal vitiligo is a subtype of vitiligo where depigmented patch appear in specific area of the body and may remain localized without spreading to other parts of the body. Focal vitiligo can be considered as an abortive or early stage of either generalized or segmental vitiligo. In most cases, focal vitiligo eventually progresses and evolves into one of these subtypes. However, in some cases, it may remain as focal vitiligo without further spreading.
Mixed Vitiligo
In some cases, segmental vitiligo can progress and evolve into non-segmental vitiligo, where depigmented patches appear in multiple areas of the body and may spread over time. This progression is a combination of the processes explained above, with the initial segmental vitiligo expanding to involve multiple sites as well.