Vitiligo, possible complications?

Manifesting as depigmented patches on the skin, vitiligo is an autoimmune disease resulting from the selective loss of melanocytes in the epidermis, mistakenly destroyed by the immune system. As a reminder, melanocytes are the cells responsible for the production of melanin, the pigment that gives skin its colour. Although vitiligo is considered an autoimmune disorder, genetic and environmental factors are also involved. Vitiligo patches can appear on any part of the body, but they frequently develop on the face, hands, feet, and skin folds. Depending on the individual, vitiligo can be localised, segmental, meaning it only affects one side of the body, or generalised, involving large areas of skin.

The vitiligo is not considered a dangerous disease and does not present risks of complications.

Unlike other dermatoses, such as eczema, vitiligo does not come with risks of direct complications, such as infections, and is not painful. It is also worth noting that, contrary to some misconceptions, the depigmented areas of vitiligo do not present an increased risk of skin cancer. However, some nuances should be added: while vitiligo does not pose risks of direct complications, it is frequently associated with autoimmune diseases, such as Hashimoto's thyroiditis or type 1 diabetes. This was notably demonstrated in a retrospective study conducted between 1996 and 2011 with 14,883 vitiligo patients and 59,532 controls. The researchers observed that 14.3% of the patients had at least one other autoimmune disease, while this was the case for only 6% of the controls.

Furthermore, it is crucial not to view vitiligo merely as a simple aesthetic concern and to not overlook the psychological impact it can have on patients and their quality of life. The white patches of vitiligo can indeed be very noticeable, particularly in patients with darker skin, and can lead to stigmatisation or a sense of exclusion in these individuals. Several studies have indeed shown that, compared to the general population, patients with vitiligo tend to have a poorer body image, lower self-esteem, and higher levels of social and psychological distress.

While vitiligo does not lead to direct physical complications, it is crucial to not underestimate its indirect consequences, particularly in identifying potential associated autoimmune disorders and offering psychological support to patients who feel the need for it.