8 Differences between Vitiligo and Leucoderma

Vitiligo and Leucoderma are often used interchangeably. They are both conditions that cause white patches appear on skin. it is difficult to distinguish between the two as they have similar symptoms.

What causes the light patches?

The reason is the pigment producing  cells known as melanocytes. The quality and quantity of the cells dictate the colour of the skin. when melanocytes produce extra pigment, the colour is dark and vice a versa. When the normal skin starts to become paler than normal in big or small patches it is because of the lack or absence of pigmentation by the melanocytes.

Both Vitiligo and Leucoderma are non-contagious diseases in which pale patches appear on the skin but there is no oozing or pus formation. The skin conditions can effect all races and age groups and are more visible in people with darker skin. people with vitiligo and leukoderma are born with normal skin and the depigmentation happens later in life. Vitiligo and Leucoderma patches become more noticeable during summers. But this is where the similarity of the two ends.

For the correct diagnosis and vitiligo and leukoderma treatment in Mumbai, it is important that one understands the difference between the two. Here are some common differences between the two

Definition:

Vitiligo:

Vitiligo is a chronic skin disorder characterized by the loss of pigment-producing cells (melanocytes) in certain areas of the skin, resulting in white patches or depigmentation.

Leucoderma:

Leucoderma, on the other hand, is a broader term used to describe any condition that leads to the loss of skin pigmentation. It can include vitiligo as well as other forms of depigmentation disorders.

What Causes this:

Vitiligo:

The exact cause of vitiligo is not fully understood, but it is believed to involve a combination of genetic, autoimmune, and environmental factors. Autoimmune factors are thought to play a role in which the body’s immune system mistakenly attacks and destroys the melanocytes. Apart from these autoimmune diseases such as hyperthyroidism, alopecia areas and pernicious anaemia might also cause vitiligo. Emotional trauma, recurrent jaundice or typhoid fever, corticosteroid treatment, and prolonged antibiotic treatments have also been known to trigger vitiligo in a person.

Leucoderma:

Leucoderma, as a term, does not specify a particular cause. It can be used to describe any condition where there is loss of skin pigmentation due to various causes, including  vitiligo, chemical exposure, burns, trauma, or even certain infections. by congenital abnormalities like Tuberous sclerosis, Partial albinism, Piebaldism, and Waardenburg syndrome may also cause leukoderma. There is a belief that undue stress can also trigger instances of leukoderma.

Presentation:

Vitiligo: Vitiligo typically presents as milky-white patches on the skin, which may be localized or spread over larger areas. The patches may be symmetrical and commonly appear on the face, hands, feet, elbows, knees, and genital area. Hair and mucous membranes can also be affected in some cases. Vitiligo is more prominent on the areas of skin that are exposed to the sun such as the hands, face and legs. It is noticed on both sides of body the as the melanocytes die over a period of time.

Leucoderma: Leucoderma, as a general term, can encompass various patterns of depigmentation. It may include localized or generalized white patches, streaks, or spots on the skin. The appearance and distribution may vary depending on the underlying cause. The patches often start in the form of a scratch or a small cut and then manifest into a white patch. When it is because of an allergy the complete loss of pigmentation melanocyte the leukoderma causes gradual development of white patch.

Difference by Colour:

Vitiligo: the vitiligo patches can be pale white, pink, copper or dull coloured and they turn white over time with sharp margins.

Leukoderma: On the other hand, in this condition the patches are always white in colour and spread from the nucleus of the cut or the scar. The white patches also appear closely bonded with the skin as compared to the vitiligo patches.

Difference by Types:

Vitiligo: There are mainly two types of vitiligo, segmental and non-segmental. The non-segmental vitiligo is the most popular one  and in this the disease affects both side of body and the patches expand over time. In segmented vitiligo there is no expansion and the patch size usually remains the same. The treatment for both types is determined by correct diagnosis.

Leucoderma: This condition covers many different types of pigment disorders such as

1. Post-inflammatory Hypopigmentation: This type of leukoderma occurs as a result of inflammation or injury to the skin. It can develop after various skin conditions, such as eczema, psoriasis, acne, burns, or trauma. The inflammation or trauma disrupts the melanocytes, leading to the loss of pigmentation in the affected area.
2. Chemical Leucoderma: Chemical leukoderma refers to depigmentation caused by exposure to certain chemicals or substances. It can occur when the skin comes into contact with chemicals like certain dyes, cosmetics, hair products, or industrial chemicals. The chemicals can damage the melanocytes, resulting in localized or widespread depigmentation.
3. Halo Nevus: A halo nevus, also known as Sutton’s nevus, is a type of mole surrounded by a depigmented halo. It typically appears as a dark pigmented mole with a white ring around it. The cause of halo nevus is not well understood, but it is thought to involve an immune response that leads to the destruction of melanocytes around the mole.
4. Piebaldism: Piebaldism is a rare genetic condition that presents with a congenital absence of pigment in certain areas of the skin and hair. It is characterized by large white patches of depigmentation, typically on the forehead, chest, abdomen, and extremities. Piebaldism is caused by mutations in certain genes involved in melanocyte development and migration.
5. Nevus Depigmentosus: Nevus depigmentosus is a type of leukoderma characterized by a stable, well-defined depigmented patch of skin present at birth. It is not associated with inflammation or itching and remains unchanged over time. The exact cause of nevus depigmentosus is unknown, but it is believed to be a localized defect in the development of melanocytes.

Progression:

Vitiligo: Vitiligo can be progressive, meaning that the depigmented patches may spread over time, enlarging and joining together. However, the rate and extent of progression can vary among individuals. Some may experience a slow progression, while others may have a more rapid spread of the condition.

Leucoderma: The progression of leukoderma depends on the underlying cause. In cases where the cause is not progressive, the depigmentation may remain stable or may improve with treatment. However, if the underlying cause is progressive or ongoing, such as autoimmune conditions or chronic inflammation, the depigmentation may continue to spread.

Associated Conditions:

Vitiligo: Individuals with vitiligo may have a higher risk of developing other autoimmune conditions, such as thyroid disorders, diabetes, rheumatoid arthritis, and pernicious anaemia. There is also an increased risk of developing certain skin conditions like alopecia areata (patchy hair loss) and halo nevi (white rings around moles).

Leucoderma: Since leukoderma is a general term, the associated conditions will depend on the underlying cause. For example, leukoderma resulting from burns or trauma may have distinct associated symptoms or complications compared to vitiligo-related depigmentation.

Treatment:

Vitiligo: The treatment of vitiligo aims to repigment the affected areas or even out the skin tone. Treatment options may include topical corticosteroids, topical calcineurin inhibitors, topical psoralen plus ultraviolet A (PUVA) therapy, narrowband ultraviolet B (NB-UVB) therapy, excimer laser.  In cases of stable vitiligo (where the depigmentation has stopped spreading), surgical interventions may be considered. These include procedures like autologous skin grafts, punch grafts, blister grafting, and micropigmentation (tattooing) to transfer pigment to the depigmented areas. Surgical treatments are generally recommended for smaller, well-defined areas of vitiligo.

Leucoderma: The leukoderma treatment in Mumbai depends on the stages of depigmentation, the age of the patient and the patient’s preferences. The common treatment options include corticosteroids, topical calcineurin inhibitors, Topical Psoralen Plus Ultraviolet A (PUVA) Therapy, Narrowband Ultraviolet B (NB-UVB) Therapy, excimer laser, depigmentation, and cosmetic camouflage. Additionally, maintaining a healthy lifestyle, protecting the skin from excessive sun exposure, and managing stress can also contribute to the overall management of leukoderma.

Both conditions can affect males and females of any age. Treatment at an early stage is more effective than when both conditions are wide spread.