INVITED ARTICLES

VITILIGO:BEYOND COLOR CHANGES

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Volume 11 Issues 5 May, 2021

Dr. Mansak Shishak; MD; DNB (Dermatology) Consultant Dermatologist ISIC Multispecialty Hospital , Delhi, Email : mansakshishak@gmail.com

We live in a world of multicolour. But when it comes to the human species, we do not enjoy the privilege of the diversity of visible light spectrum. We are controlled by our melanosomes and its functional byproduct-melanin.

Vitiligo, in common parlance referred to as “leukoderma” is a condition that is characterized by milky white depigmented patches of skin due to the loss of melanocytes; the cells responsible for manufacturing melanin pigment.

In ancient times, patients of vitiligo were subjected to the same level of social ostracism as that meted out to leprosy afflicted/lepers. Vitiligo was, in fact, referred to as Sweta Kustha meaning “White leprosy”. The unfortunate construction and maintenance of separate sanatoriums for leprosy is historical proof of how the stigma of such conditions has been allowed to perpetuate over many years.

The psychological burden of vitiligo is tremendous even today. Ever so often, distressed, misinformed and anxious individuals turn up, with expectations of cure and return of their skin colour to the homogenous baseline state. While as physicians we tend to only take “seriously” the complaints based on severity of extent or involvement, or a scoring system; for the patient, there is no such uniform direct extrapolation of response to disease severity.

A seemingly innocuous lesion to us could still mean life-changing for the patient, in the world of skin colour.

Some of the associated conditions include anxiety, depression, schizophrenia, ADD/ADHD and conduct
disorder, childhood and adolescent psychiatric illnesses. Suicidal ideation is not uncommon.

In the Rigveda, a person who suffers from Switra (vitiligo) along with the person’s progeny were forbidden
from marrying. Up until today, many continue to be haunted by marriage/ divorce doubts and chances of
offspring getting affected by vitiligo.

Upto 92% patients are reported to have experienced low-key stigmatization.
Self-consciousness, fear, embarrassment and bullying are reflective of adolescent years while in later years
there is heightened anxiety, social isolation, depression and low self-esteem.

Dermatologists and psychiatrists should encourage bi-directional consultations, form multidisciplinary
teams, look beyond physical symptoms and be vigilant to the presence of stressors and low quality of
life. Applying appropriate interventions to address psychological impairments in a timely manner helps
promote recovery in vitiligo patients and bring back the colour in their lives.

World Vitiligo Day is observed on June 25 each year ; while June is considered Vitiligo Awareness month