Clinical Appearance of Vitiligo and Piebaldism: A Review Article

Abstract

Introduction: Vitiligo is idiopathic hypomelanosis characterized by the presence of white macules that can expand. Can affect all parts of the body that contain melanocyte cells, for example, hair and eyes. The cause is unknown, various trigger factors are often reported, for example emotional crisis and physical trauma. Pathogenesis of vitiligo still unclear, there is an association between vitilligo and Hashimoto’s thyroditis, pernicious anemia, and hypoparathyroid melanocytes found in the serum of 80% of vitiligo patients. Moreover, there is disease that similar to vitiligo, called piebaldism. Patches of skin that do not contain pigment that is found at birth and persists for life.The disease is inherited autosomally, due to differentiation and possibly the melanoblast membrane. Discussion: Inheritance of vitiligo can involve genes related to the biosynthesis of melanin, the response to oxidative stress and autoimmune regulation. The macula is white with a diameter of several millimeters to several centimeters, round or oval with defined boundaries, with no other epidermal changes. Hypomelanotic macules are sometimes seen in addition to apigmented macules. In vitiligo macules can be found macules with normal pigmentation or hyperpigmentation called perifollicular repigmentation. Occasionally there is a raised edge of the lesion, erythema and itching, which is called inflammatory. Piebaldism is In the form of skin patches that do not contain pigment on the forehead, median or paramedian, accompanied by white hair. White patches are sometimes also found on the upper chest, abdoment and legs. Normal skin color or hypermelanosis there are areas that are hypomelanosis. Ultrastructural investigation showed no visible melanocytes and melanosomes in hypomelanotic areas. On the other hand, hypemelanotic islets are found with melanocytes that produce melanosomes normally, but if abnormal spheric milanosomes and granules are found, abnormal spherical and ganular melanosomes are also found. Conclusion: It is distinguished from vitiligo which usually does not appear at birth, the shape and distribution are also different. On piebaldism. In piebaldism accompanied by white forlock and the presence of islets with normal pigments in hypomelanotic areas. Differentiated from the nevus with depigmentosus, in the nevus the number of melanocit is normal. If piebaldism is accompanied by abnormalities in the distance of the two pupils or is accompanied by deafness, then the possibility of Waardenburg syndrome should be considered.