Vitiligo, a skin disorder characterised by the emergence of white patches, is often mistaken for other diseases that cause similar symptoms, such as scleroderma. How can we differentiate between these two conditions? Here are some keys.
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How to differentiate scleroderma from vitiligo?
Summary
- Scleroderma and Vitiligo, in brief
- Vitiligo and Scleroderma: How not to confuse these diseases?
- Sources
Published November 28, 2024,
updated on November 28, 2024,
by
Pauline, Head of Scientific Communication
—
5 min read
Scleroderma and Vitiligo, in brief.
Scleroderma is a chronic disease characterised by an abnormal thickening of the skin and certain internal tissues. It is often accompanied by hypopigmentation or hyperpigmentation. Still poorly understood, this disease is partly explained by an excessive production of collagen which leads to a gradual hardening of the skin. Scleroderma can remain localised or affect the entire body surface, including internal organs. The latter is often associated with Raynaud's syndrome, a blood circulation disorder. Although the exact cause of scleroderma is unknown, genetic and environmental factors seem to play a role in its development.
The vitiligo is an autoimmune disease that manifests itself through the appearance of white patches on the skin. It is also linked to genetic and environmental factors and is explained by the destruction of melanocytes, the skin cells that produce the melanin that colours the skin. A common mistake is to consider vitiligo as a mere aesthetic concern. However, its conspicuous and stigmatising nature can be a heavy psychosocial burden for patients.
Vitiligo and Scleroderma: How not to confuse these diseases?
An appropriate management of vitiligo and scleroderma involves their respective identification. Although both these diseases can cause depigmentation, certain elements allow us to differentiate between them.
White spots not so similar between vitiligo and scleroderma.
While scleroderma can indeed lead to hypopigmentation, it is primarily characterised by a thickening and a hardening of the skin, which can sometimes limit mobility. Vitiligo macules are different: these are depigmented spots of varying size but always smooth. No change in skin texture is observed in the case of vitiligo, unlike scleroderma, which is the first key to identifying these diseases.
The systemic involvement differs between vitiligo and scleroderma.
Although vitiligo is associated with an increased risk of thyroid disorders, such as Hashimoto's thyroiditis or type 1 diabetes, it is primarily a skin disease that does not affect the functioning of other body systems. This is different for scleroderma, which can affect both the skin and also the internal organs. Systemic forms of the disease can lead to more or less serious complications, such as lung, heart or kidney disorders. Thus, hypopigmentation accompanied by respiratory distress or digestive disorders is more indicative of scleroderma than vitiligo. Furthermore, in some cases, scleroderma can cause joint pain or deformities, due to the skin's excessive production of collagen, which is not the case with vitiligo.
Consulting a doctor, the only way to confirm whether it's vitiligo or scleroderma.
The best way to be certain of the presence of vitiligo or scleroderma, and most importantly to receive appropriate care, is to consult a healthcare professional. They will be able to diagnose the condition and establish a plan of action. Most often, the diagnosis of vitiligo and scleroderma is clinical, meaning it is made by simple observation of symptoms. In case of suspected vitiligo, a Wood's lamp, emitting long-wave UVA, can be used. When exposed to this light, vitiligo lesions emit a very bright and brilliant fluorescence, with a clear demarcation. If there is doubt about scleroderma, biological tests can be carried out, for example by looking for the presence of anti-nuclear antibodies in the blood.
Sources
BLACK C. & al. Scleroderma—clinical and pathological advances. Best Practice & Research Clinical Rheumatology (2004).
KRIEG T. & al. Scleroderma. The New England Journal of Medicine (2009).
BORRADORI L. & al. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).
EZZEDINE K. & al. Vitiligo: A Review. Dermatology (2020).
HARRIS J. & al. Vitiligo: Mechanisms of Pathogenesis and Treatment. Annual Review of Immunology (2020).
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