You can get a rash from poison ivy any time of the year. You can expect permanent results in all but one area. Do you know which one? If you want to diminish a noticeable scar, know these 10 things before having laser treatment. Having acne can feel devastating for a teenager. Here are 5 things you can do to help your teen. Find out what helps. If your child develops scabies, everyone in your household will need treatment. Follow this advice to treat everyone safely and effectively.
We're helping you achieve YourHealthiestSkin from head to toe. Use these tips from dermatologists to keep all your skin looking and feeling its best. AAD Shade Structures provide permanent outdoor shade in areas that are not protected from the sun. When it comes to treating the skin, plenty of people say they have expertise. Rashighi, M. Ahmed Refat, J. Richmond, and J. Konijnenberg, T. Dellemijn et al.
Mollet, S. De Schepper et al. Oiso, T. Suzuki, K. Fukai, I. Katayama, and A. Kotobuki, A. Tanemura, L. Yang et al. Moretti, A. Spallanzani, L. Amato, G. Hautmann, I. Gallerani, and P. Amato et al. Kim, S. Jeon, H. Lee, and A. Birol, U. Kisa, G. Kurtipek et al. Mohammed, A. Gomaa, and M. Gupta and A. Gupta, A. Gupta, S. Kirkby et al. Welz-Kubiak, A. Reich, and J. Ozawa, K. Tsuchiyama, R. Gomi, F.
Kurosaki, Y. Kawamoto, and S. Descombes, and L. View at: Google Scholar N. Shumway, E. Cole, and K. Yosipovitch, A. Goon, J. Wee, Y. Chan, and C. Seidenari and G. View at: Google Scholar G.
Yosipovitch, J. Reis, E. Tur, E. Sprecher, D. Yarnitsky, and G. Elias and R. Nojima, M. Carstens, and E. Yosipovitch, K. Fast, and J. Murota and I. Lucaciu and G. This should be treated to avoid permanent changes in the skin of that area, as well as prevent new spots from forming. Sarcoidosis can occasionally cause light spots on the skin that look like vitiligo, although it usually looks quite different. Sarcoidosis can also affect the lungs and other organs and should also be treated aggressively.
This is not usually dangerous but should also be treated to prevent it from becoming a more aggressive form of the disease. There are some VERY RARE infections that can cause light spots on the skin, and these include a form of leprosy tuberculoid leprosy , secondary syphilis a rash that occurs after the genital sore or chancre clears up , and pinta. Leprosy occurs most commonly in South Asia and South America although interestingly it can be spread by armadillos in the southern United States and is usually numb to light touch within the spot.
Syphilis is a sexually transmitted disease preceded by a genital sore sometimes not noticed, though , and easily treated by penicillin once diagnosed. Pinta is only found in small areas of northern South America and causes white areas on the hands, wrists, and feet.
Others are really rare and could require a lot of explanation better suited to residency training in dermatology, so I left them out! Remember, you could have BOTH vitiligo and another condition described here! Now you can go to your dermatologist appointment armed with knowledge, which should help both of you figure out what your white or light spots are, and how best to treat them! Facebook Twitter. Monday, January 20, Itch is a common symptom of many dermatological diseases.
It may originate in the skin or nervous system. Clinically, itch can be classified into itch associated with skin disorders e. However, itch associated with vitiligo is rarely mentioned in the literature.
In this study, the prevalence of itch in vitiligo patients is up to The prevalence of itch in this study is higher than a previous report. The higher prevalence of itch in our study could be due to the differences in the study population. Itch in several patients with depigmented lesions described by Levai, in fact, could possibly be from chemical leukoderma and postinflammatory depigmentation and, thereby, may not represent the exact prevalence of itch in true vitiligo patients.
Itch can occur as a consequence of treatment, for example, topical mediation and phototherapy. We have excluded this group from the study. Moreover, certain systemic disease associated with vitiligo could potentiate itch such as hyperthyroidism, hypothyroidism, diabetes mellitus, allergic rhinitis, or asthma. According to our study, there were no significant differences regarding the prevalence of these conditions among patients with and without itch. Therefore, we postulate that itch in vitiliginous lesion is a manifestation of vitiligo itself.
The pathogenesis of itch in vitiligo remains unclear. However, the possible concept of itch in many dermatological diseases is focused on neurogenic inflammation and mediators such as neuropeptides released from dermal nerve endings induced by various stimuli. There are many evidences to support the hypothesis of inflammation in vitiliginous lesion.
Other parameters such as cytokines and regulatory T cells may also play major roles in vitiligo pathogenesis [ 14 ]. In segmental vitiligo, dysfunction of the sympathetic nervous system can restrain melanin production and lead to depigmentation [ 19 ]. All these findings may illustrate neurogenic inflammatory mechanism of itch in vitiligo.
However, it is unclear whether primary immune response targets normal melanocytes or if immune activation is triggered by damaged melanocytes through exogenous or endogenous insult. Further studies are needed to explain the complex mechanisms of itch in vitiligo. There are several methods to assess the intensity of itch. In this study, the ratings were based on patients' point VAS self-evaluation scale.
Our patients rated this equivalent to the severity of itch caused by arthropod bite. However, the comparison itch intensity in different types of dermatoses is very difficult and no direct assessment has been performed.
Based on previous studies, using a similar VAS score, the intensity of itch in atopic dermatitis, psoriasis, and lichen planus was 4. In this study, This may result in psychological distress and potentiate the severity of several dermatoses including vitiligo.
Therefore, we emphasized the importance of itch in vitiligo which remains underrecognized. Among the clinical variants of vitiligo, pruritus was more common in focal vitiligo and significantly correlated with initial truncal distribution. Our finding supports previous evidence on the variations in area-specific innervation density and pruritic mediator release in different anatomical sites of the body [ 23 , 24 ].
In addition, the nerves which supply sensation to the upper trunk emerge from the 2nd to 6th thoracic segments of spinal cord. They run a long course up through the thick muscles of the back and make a right-angled turn before reaching the skin. These nerves appear to be vulnerable to compression or traction and lead to the symptom of itch [ 25 ]. When compared to other itchy dermatosis, pruritus in lichen planus tends to be more prominent on the extremities, while psoriatic patients experience itch on both the trunk and lower extremities [ 22 , 26 ].
However, the presence of skin dryness did not correlate with the degree of itch which is consistent with other pruritic dermatoses [ 27 — 29 ]. Several factors such as alteration stratum corneum surface lipid, water metabolism, pH, and cytokine levels may contribute to the sensation of itch [ 30 , 31 ]. Hot environment and sunlight were identified as an important aggravating factor of itch in our vitiligo patients, possibly from high temperatures in our tropical climate.
It was suggested that heat can increase itch sensation by its direct effect on dermal nerve endings or by indirect effect on neuroautonomic mechanism via sweating, as both itch and sweating are mediated by C nerve fibers [ 32 , 33 ]. According to recent data, heat stimulated itch through the activation of transient receptor potential cation channel subfamily vanilloid type 1 TRPV1 , the calcitonin gene-related peptide, the vesicular glutamate transporter 2, and accumulation of artemin [ 34 ].
Further investigations are needed to validate whether these receptors are involved in the pathogenesis of itch in vitiligo. The most common antipruritic treatment used was topical steroids. Due to the evidence of inflammatory cell infiltration and certain cytokines in vitiliginous lesion, anti-inflammatory therapies may result in cessation of itch.
Moisturizers in topical medication may have a contributing benefit in reducing the itch. In addition, cold environment and shower were found to alleviate itch in vitiligo.
These observations support a role for the cold-sensitive transient receptor potential melastatin-8 TRPM8 ion channel, the major receptor for sensing cold environmental, in the modulation of pruritus [ 35 ]. In contrast to other pruritic dermatoses, the role of antihistamines in relieving itch is questionable in vitiligo.
Only a few of our patients responded to oral antihistamines. According to a study by Van Geel et al. In our study, there is a tendency towards itch being more prevalent in patients presenting with KP type 2B Table 4. Therefore, it could be implied that the presence of itch may warrant active stage of vitiligo especially with the presence of KP type IIb.
A possible explanation to this phenomenon is that the inflammatory process of active vitiligo promotes pruritogenic cytokines and induces itch. There are some limitations in our study. Firstly, recall bias associated with self-responded questionnaire may influence the results. Secondly, as patients were gathered from university-based hospital, there is a possibility of subject selection election bias. Thirdly, our study involved patient subjected evaluation; an objective assessment was not performed.
Finally, further studies regarding the neurophysiology of itch including mechanism of itch in vitiligo are necessary. In conclusion, this is the first step towards enhancing comprehensive knowledge regarding itch in vitiligo.
As dermatologists, it is prudent to acknowledge that pruritus is an important aspect of vitiligo. Prompt detection to provide early treatment is mandatory in patients with active vitiligo. The authors declare that there are no conflicts of interest regarding the publication of this article. National Center for Biotechnology Information , U. Journal List Biomed Res Int v.
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