Having been born and raised in Arizona, I benefitted from being exposed to multiple ethnicities, religions, cultures and languages starting when I was just a kid. Many of my friends were Hispanic but we were all like a big, happy family. Differences in skin color were just not relevant. My best friend was Jorge (Spanish for “George”), and we played every day at the school playground, nearby parks or at each other’s homes where Jorge’s mother introduced me to my first homemade green chile and bean burrito. It was love at first bite.
Jorge’s mom had a very noticeable discoloration on her face that I couldn’t ignore, but it didn’t seem to bother her — at least to my five year-old eyes, and Jorge had no knowledge or even awareness of his mother’s condition.
“Oh, no,” he told me, “she’s always looked like that,” which ended the discussion so we could get back to the more important task of kickball.
Of course, as I got older, I learned that Jorge’s mom had vitiligo, which is a relatively common disease of unknown cause that affects 3 million people of all skin types per year in the United States. As this month’s issue on disorders of pigmentation, I thought I would use this opportunity to update my knowledge on vitiligo which would perhaps serve as an introduction to this month’s issue.
Since I have only treated a small number of patients with vitiligo and that was a while ago, I had a lot to learn. Here are some of the things that I learned:
The blotchiness of vitiligo is due to the death of melanocytes. The disease proceeds unpredictably as far as extent and rate of progression are concerned. It can last a life time or persist for just a few years. It can begin at any age, but often before 20 years of age. It may be familial or may develop following some stressful event or even a severe sunburn. It may also represent an autoimmune disease.