6. genetically
Familial and twin studies:
Genetics role in development
Heterogeneous and complex disease
Wide genome linkage analysis:
Lucus and genes involved in
A. Immune and immune sys
Author: Mohammad Reza Khademi -
GUMS-Iran
7. Clinical features
Amelanotic macule and patch in milky- chulk white
surrounded by normal skin
Lesion’s shape: oval , round , irregular , linear
Convex border ,
enlargement centrifugally , rapid or slow
size : mm to cm
Diagnostic aid by 1.Wood’s lamp 2.Tanning
Pruritis in some cases
Most of time Asymptomatic
Author: Mohammad Reza Khademi -
GUMS-Iran
8. Clinical features Cont.
Develop anywhere, interested in hyper pigmented
area such as :
face , dorsal aspect of hand , nipples , axillary ,
umbilical , sacral , inguinal and anogenital
Friction, frequent trauma, pressure seen in many
sites of common vitiligo
Author: Mohammad Reza Khademi -
GUMS-Iran
9. vitiligo
Facial Vitiligo:
typically involve around eyes and mouth
Extremity Vitiligo:
elbows, digits, flexor wrist
knee,dorsal ankles ,shins
Author: Mohammad Reza Khademi -
GUMS-Iran
10. vitiligo
Acrofacial Vitligo:
preriungual involvement of 1 finger or more
P.S. : extremities‘ distal and face involvement
Scalp vitiligo:
1 or more localized patches of white-gray hair which
can be scattered
Author: Mohammad Reza Khademi -
GUMS-Iran
12. vitiligo
Difficult diagnose of VTligo without
Wood’s lamp in lightly pigmented @:
palm soles, lips, oral mucosa.
Leukotrichia of body varies from 10 to >60 %
Author: Mohammad Reza Khademi -
GUMS-Iran
17. LOCALIZED
Focal:
1 or more macule w/o segmental distribution
Unilateral/Segmental :
one or more macules involving a unilateral segment
of the body lesions usually stop abruptly at the
midline
Mucosal:
mucous membranes alone
Author: Mohammad Reza Khademi -
GUMS-Iran
19. Generalized
Vulgaris:
scattered patches that are widely distributed
Acrofacial:
distal extremities and face
Mixed:
various combinations of segmental, acrofacial
and/or vulgaris distribution pattern
Author: Mohammad Reza Khademi -
GUMS-Iran
21. Acrofacial
Author: Mohammad Reza Khademi -
GUMS-Iran
22. Universal
Complete or nearly complete depigmentation.
Author: Mohammad Reza Khademi -
GUMS-Iran
23. More than 90% R
generalized
Universal
Generalized
localized
Generalized Localized Universal
Author: Mohammad Reza Khademi -
GUMS-Iran
24. Course of disease
Insidious
Sun exposure & tanning
Case-by-case unpredictable
Extension by 2 forms
1.development of existing 2.new depigmented area
Natural course;usually slowly but can be rapid
Some degree of sun-induced or spontaneous
repigmentation not uncommon but complete and
stable spontaneous repigmentation is rare.
Author: Mohammad Reza Khademi -
GUMS-Iran
25. DDx
chemical or drug-induced ( imatinib) leukoderma,
Post inflammatory depigmentation,
the leukodermas associated with melanoma and
scleroderma
late stages of treponematosis & onchocerciasis.
stage III halo nevus
A nevus depigmentosus
post inflammataory hypopigmentation,
pityriasis versicolor,other cutaneous infections
Author: Mohammad Reza Khademi -
GUMS-Iran
26. Treatment
The aims :
1.repigmentation
2.stabilization of the depigmentation process.
The choice of therapy depends on :
extention, location, activity of disease , age, skin
type and motivation to undergo treatment.
The effectivity of A treatment needs to 2-3 month
Author: Mohammad Reza Khademi -
GUMS-Iran
