Vitiligo Skin Disorder Stages: Early, Mild, Focal and Segmental

Underdiagnosed and misdiagnosed, many people don’t even realize they have vitiligo until it advances. It is daunting for physicians to diagnose early vitiligo stages and they often label it something else entirely. The beginning might be obscured and you think you have something else entirely or you simply discredit your symptoms as being dry skin until the spread becomes more pronounced.

Learning About Vitiligo Stages

At first, you might not realize that you have vitiligo. One of the first stages that people overlook is premature graying of the hair. A white streak can blaze across your hair or occur on the eyebrows or eyelashes. Even hair sprouting on the affected areas of skin will lose pigment.

The mucous membranes on the entire of your mouth might also lose pigment. Up to 40 percent will also sustain eye color lose. The melanocytes in the eyes lose pigment. The retinal pigment epithelium will whiten. These changes hallmark the early stages before the skin whitens. In some Uveitis occurs as the body’s immune response targets the eyes with an onslaught.

The Early Stages of Vitiligo

When the white patches appear they will be either generalized, which means they occur on both sides of the body, or segmental where only one side displays pigment demise.

Focal vitiligo targets only certain parts. The early stages of vitiligo do vary among users. Vitiligo is not curable. The disease may stall or continue to progress through the early stage of vitiligo to more extreme discoloration.

Understanding Types of Vitiligo

Vitiligo is categorized by patches and formation of the discoloration.

Types of vitiligo include:

  • Focal: If you only have a few areas of spotting then you will be categorized with focal vitiligo.
  • Generalized: This is very unusual because the spotting is a mirror image on both sides of the body.
  • Segmental: If you have spots on only one section and nowhere else then you are called segmental.

Coping With Mild Vitiligo

During childhood, small patches might appear. They might consider babies or toddlers as having mild vitiligo. Also, stress and trauma might cause a mild form during adulthood. During the early stages, the spots are easier to conceal and abstain from treatment.

What is Focal Vitiligo?

Depigmented patches in a very localized area that is often small and does not readily spread over a year or two. Focal vitiligo is a semi-occasional subtype. Progression often goes on to non-segmental. No clinical signs exist to predict what will occur. There is usually amelioration in 11 percent. The condition is not curable. Please see pictures.

Understanding the Opposite of Vitiligo

Your skin color can darken or become lighter. Hyperpigmentation is the opposite of vitiligo. There is an increase in melanin. Pregnancy or an adrenal gland malfunction such as Addison’s disease causes hyperpigmentation. Exposure to sunlight (suntan) is also hyperpigmentation. Drugs such as antiarrhythmics and antimalarial prescriptions rapidly increase the melanin. Melasma causes tan or brown patches on the facial region. They often call this the ‘mask of pregnancy’. Men are also prone to melasma caused by hydroquinone. If you have these disorders, then you must conquer them by wearing sunscreen with zinc oxide or titanium dioxide to block UVA. They often use re-vitiligo regarding these conditions. Liver spots are re-vitiligo. Lentigo occurs as a rounded spot with hyperplasia of melanocytes. There is often a linear spread

What is Albinism?

Many confuse albinism with vitiligo. Both are rare genetic diseases that are inherited. Albinism occurs because the body lacks the enzyme needed to produce melanin. There is absolutely no pigment anywhere on the body. The abnormal gene restricts the crucial production of melanin.

Albinism belongs in a group of disorders called oculocutaneous. All have a vision involvement. Many are legally blind. Inheritance usually occurs in a very autosomal recessive fashion. They confuse the two disorders because not all albinos are pure white. Many have pronounced spotting which can lead the confusion and misdiagnosis in infants or children. Ocular albinism has an X-linked pattern of inheritance.

What is Hermansky-Pudlak Syndrome?

Hermansky-Pudlak syndrome is a form that is a hemorrhagic diathesis but has pigmented reticuloendothelial cells. The blood platelet dysfunction causes the sufferer to experience prolonged bleeding. There is also a visual impairment of varying degrees. The sufferer has light colored sin with patches of darkness.

Also, oculocutaneous albinism of the eyes with a rapid movement (Nystagmus). In addition, sufferers often have pulmonary fibrosis, colitis, and kidney failure. There are nine variations. The partial albinism is what confuses people when it is compared to vitiligo. The skin might appear similar. Immunodeficiency, neutropenia, and abnormalities of the optic nerve all might occur. Healthcare professionals might misdiagnose this disorder as vitiligo because of its rarity and similar demonstrations that mimic each other. With HPS, the prognosis is often fatal if there is pulmonary involvement. Clinical research that involves pulmonary alveolar proteinosis and lymphangioleiomyomatosis is underway at many facilities and might hold the promise of offering longevity.

Misdiagnosed Spotting

Other conditions frequently misdiagnosed as vitiligo:

  • Guttate hypomelanosis’
  • Tinea versicolor
  • Pityriasis alba
  • Milia en plaque
  • Candidias
  • Actinic keratosis
  • Ephelide
  • Periorbital hyperpigmentation
  • Lichen planuspigmentosus
  • Maturational dyschromia
  • Acanthosis nigricans
  • Lentigines
  • Post‐chikungunya pigmentation
  • Dermatosispapulosa nigra
  • Naevus of Ota
  • Riehl melanosis

 

 

Article References:

  1. https://www.medicalnewstoday.com/articles/245081.php
  2. https://kidshealth.org/CookChildrens/en/teens/vitiligo.html#
  3. https://www.ncbi.nlm.nih.gov/pubmed/27061013
  4. http://www.avrf.org/facts/vitiligo-signs-symptoms.html
  5. https://www.mayoclinic.org/diseases-conditions/albinism/symptoms-causes/syc-20369184
  6. https://rarediseases.info.nih.gov/diseases/6643/hermansky-pudlak-syndrome

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