Vitiligo is a commonly acquired, idiopathic, heritable de pigmentary disorder of the skin and mucous membranes. It is of major social and cosmetic concern, characterized by de pigmented macules of varying size and shape. There are no other textural changes besides loss of color. Vitiligo occurs worldwide with an overall prevalence of 1%. Widespread prejudices, ignorance, taboos, lack of scientific appraisal about vitiligo and confusion with leprosy all make it a social embarrassment for the patient. However, life expectancy is unaffected.

Vitiligo is a de pigmenting skin condition characterized by specific melanocyte depletion, resulting in melanin attenuation inside the skin's damaged regions. A distinguishing feature is a completely amelanotic, non-scaly, chalky-white macule with clear borders. The understanding of the etiology of vitiligo has advanced significantly in recent years. It is now categorically recognized as an autoimmune disorder associated with metabolism and oxidative stress, including cellular detaching diseases, as well as hereditary and environmental factors. The consequences of vitiligo can be mentally distressing and frequently have a significant impact on daily life; thus, this should never be dismissed as an esthetic or minor illness. The two main types of the condition recognized by a global consensus in 2011 were non-segmental vitiligo (NSV) and segmental vitiligo (SV).

The term "vitiligo" was chosen to refer to all non-segmental vitiligo types (including acrofacial, mucosal, generalized, universal, mixed, and rare variants). One of the most important critical decisions made by this consensus was to distinguish segmental vitiligo from other types of vitiligo, especially given the implications for prognosis. Vitiligo is still a common and identifiable condition among dermatologists, most doctors, and several wise members of the general population. The disease's defining feature is hypo pigmented patches, which are frequently first noticed on the fingertips, knuckles, and area surrounding the lips, eyes, toes, and reproductive organs. The two most common ways for the skin to turn white are as follows. Melanocytes produce melanin and then pack them into melanosomes that are transferred to the surrounding keratinocytes through their dendritic processes, which are then injected into neighboring keratinocytes. Keratinocytes transport melanins and melanosomes through the epidermis's basal layer to the stratum corneum, where cells are desquamated and released into the surrounding environment.

Certain diseases prevent or slow melanin production, causing the epidermis to become hypo pigmented. Among these conditions are pityriasis alba, tinea versicolor, oculocutaneous albinism, and nevus depigmentosus. Melanocytes in the epidermis are generally present in healthy quantities; however, in several diseases, they produce less melanin than usual. Typically, the skin has mild to severe hypopigmentation. The overall loss of melanocytes in vitiligo patients appears to be caused by three major factors. The argument is that people with vitiligo have three "vitiligo' alleles that predispose them to melanocyte degeneration. Because no two people can have the same three alleles, there are potentially many different combinations of three genes that can cause vitiligo. The second anomaly ultimately affects these melanocytes. Melanocytes from vitiligo patients differ from those from non-vitiligo patients.

The treatment of Vitiligo many therapies are used like topical treatment, Immunosuppressant, Phototherapy, chemotherapy etc. The collection of information regarding plants having potential in treatment in Vitiligo is used in the traditional Indian system of medicine. according to Ayurveda medical discipline for treatment of vitiligo, treatment of vitiligo including remedies used, type of formulation used by vaidhy as and tribal people, active components of the plants, their role in treatment of vitiligo and amount to be given as therapeutic against vitiligo, plants are collected and kept in herbarium for further.

Surgical procedures aim to replace the melanocytes with ones from a normally pigmented autologous donor site. Several melanocyte transplantation techniques can be performed under local anaesthesia in an outpatient facility. However, transplantation for extensive areas may require general anaesthesia. All methods require strict sterile conditions. Punch grafting (tissue graft) is the easiest and least expensive method, but it is not suitable for large lesions and seldom produces even re-pigmentation. Epidermal blister grafting gives excellent cosmetic results, but it is time consuming, and large areas cannot be treated.

Published : Nov 5 2023