MY HUSBAND has developed white patches on his hands, elbows and knees. Although the skin feels normal, the areas look very noticeable, particularly as he is dark skinned. What could they be?
What you describe sounds like vitiligo, a skin condition where melanin – the skin’s pigment – is lost from areas of skin, resulting in irregular white patches. Typically, these patches look lighter in comparison to the surrounding skin. The lesions remain flat and have a normal skin texture. Vitiligo may appear suddenly or gradually over time. It frequently affects the face, elbows and knees, hands and feet, and genitalia. Vitiligo is often more noticeable in darker skinned people because of the contrast of white patches against dark skin. The cause of vitiligo is unknown and it can develop at any age. However, it may be linked to the autoimmune system and is associated with a number of autoimmune disorders including hyperthyroidism (overactive thyroid), pernicious anaemia and Addison’s disease. There is also a tendency for the condition to occur in families, and it is estimated to affect up to 1 per cent of the population.
Will I need any special tests to confirm the diagnosis?
Examination by your family doctor or a dermatologist is usually sufficient to confirm the diagnosis. However, your doctor may recommend that a skin biopsy be carried out to rule out other causes of pigment loss. Blood tests may also be performed to check hormone and vitamin B12 levels.
How can it be treated?
Although vitiligo tends to be difficult to treat, early treatment with light therapy (exposure to controlled intense ultraviolet light) and the used of oral medications may help. Other medicines applied to the skin such as corticosteroid creams, immunosuppressants or repigmenting agents may also be prescribed. In severe cases skin may be grafted or removed from normal areas and placed onto areas of pigment loss. Skin that has lost its natural pigment is extremely susceptible to the sun’s damaging effects, so your husband should apply a high-SPF sunblock and take other measures to protect himself against sun exposure. While fake tans will not disguise the patches, specially formulated cover-up make-up or skin dyes are available and can be used to mask patches of vitiligo. The course of vitiligo varies from person to person and while some areas may regain pigmentation, other new areas may appear.
