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Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Classical vitiligo can begin anytime after birth and often appears as a white spot without other symptoms on a background of normally pigmented skin. The only detectable change in affected areas is the loss of color, which can begin with lightening but will progress to complete loss of color. If vitiligo involves hair-bearing areas, it is not unusual to note the development of gray, pigment-free hair growing from involved follicles. There may be one or more of these patches that may gradually enlarge and rarely progress to involve the entire skin surface.

There are clinical subtypes of vitiligo that extend in a linear fashion down an entire limb (segmental vitiligo). Vitiligo often involves the genitalia and is predisposed to appear in areas of previous skin trauma. Obviously, completely depigmented skin can be much more cosmetically significant in those with racially darker pigmentation. Skin affected by vitiligo is particularly susceptible to sunburn and photo-damage.

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