About Vitiligo
Vitiligo or Leucoderma is a chronic disorder of skin, which is characterized by total loss of pigment. The term Vitiligo was used for first time by a Roman Physician Celsus in 2nd century AD. The Atharvaveda mentioned leucoderma as a variety of Leprosy (Shwetakushtha) along with a prescription of several herbal remedies. This book dates back to 1400 B.C.

Vitiligo / Leucoderma affects all races the world over. The highest incidence has been recorded in India and Mexico. Incidence is roughly estimated 3% to 4% in India and 2% in the UK. People belonging to different races, religion, and socioeconomic groups, and with different dietary habits show similar incidence towards the disease.


Reasons for Occurence
The exact cause of the disorder is still not known. Only 20% to 30% of people suffering from the disease give a positive family history. Though heredity is one of the causes of disease, the transmission of disease to each generation is influenced by:

1) Autoimmunity:
Antibodies in the form of white blood cells (Lymphocytes) are formed in the body, which destroy melanocytes (pigment cells). Why this happens is not exactly known.

2) Neurogenic:
Some observers felt that there is an unknown chemical substance released at nerve endings which destroy pigment cells.

None of these causes have been proved conclusively yet.


Appearance
A typical vitiligo or leucoderma lesion is a well-defined milky-white patch. It usually appears between the ages of 10 and 20 years but can appear at any age. It can appear on any part of body.

Usually after an initial spread of the disease (unstable stage) there are long periods of stability. During this period patches don't increase in size and no new patches appear on the body. Appearance of a new patch may not necessarily affect the stability of older patches. This stable phase lasts for many years, and may be lifelong in some patients.

About 20% of patients experience spontaneous repigmentation of all or some of the patches. Small percentage of patients may experience reactivation of the disease. The exact cause of this recovery or deterioration is not known. Segmental vitiligo / leucoderma is localized and is the most stable type.


Diet and Leucoderma
Different dietary habits do not show any significant variation in the incident towards the disease. In India there is popular but incorrect notion that dietary or drug intake of vitamin C causes vitiligo / leucoderma. Other misconceptions about food are that consumption of white color food (eg Milk, egg white), or consuming milk with fish etc, worsens the disease. None of these are true.


Mental Trauma
There is no damage to any internal part of the body in this disease. Physically patients are as normal as others. Vitiligo or leucoderma is only a cosmetic disability. Unfortunately patients may experience discrimination because white patches can resemble a disease like Leprosy. In reality there is no relation between Vitiligo / Leucoderma and Leprosy whatsoever. It is also a misconception that vitiligo is contagious. Vitiligo or leucoderma does not spread from person to person by touch. It is also untrue that it is transmitted to the third generation.


Are there any Investigations that can done?
There is no laboratory investigation to determine the severity, future course and activity of the disease. The activity of the disease is determined by photographs and demarcation of patches.