Dear Doctor
I have one white spot over a year it’s slightly increased. I am scared it’s vitiligo but the hair coming out is black thankfully. I am hypothyroid and on 50 mcg thyroxine. I was b12 deflect and took injectioin now it’s normal my calcium is borderline. please please help. i showed to doctor they said it’s not vitiligo but didn’t tell what exactly it is.
Dear Client
I think that white patch on your forearm is caused by vitiligo.
Vitiligo Repigmentation
Repigmentation (return of normal skin color) in vitiligo usually begins around hair. This is because the hair follicle contains many undifferentiated (immature) cells which mature into the melanocytes that produce the pigment known as melanin which gives skin its color. These melanocytes then spread from the hair follicle to the rest of the epidermis (top layer of skin).
Vitiligo Associated Diseases
Vitiligo is an autoimmune disease. This means that cells from the immune system attack those which produce melanin and thus white patches develop on the skin. Many patients with vitiligo also have other autoimmune diseases like:
1. Grave’s disease
This is a thyroid disorder which causes hyperthyroidism (over-performing thyroid) and the production excessive amounts of thyroid hormone.
2. Hashimoto’s thyroiditis
This is another thyroid disease which cause hypothyroidism (underperforming thyroid) which does not produce enough thyroid hormones . It is treated with medications like thyroxine.
3. Pernicious anemia
In this condition the body is unable to absorb adequate levels of vitamin B12 from the diet. It is treated with vitamin B12 injections.
4. Addison’s disease
This condition develops when the adrenal glands are unable to produce adequate amounts of hormones.
Therefore you can see that you are also being treated for two other vitiligo associated diseases. This fact does not confirm that you have vitiligo but it is highly suggestive of vitiligo.
To confirm the diagnosis of vitiligo you can:
1. Have your doctor examine the white patch with a Wood’s lamp which accentuates the ivory white patches of vitiligo.
2. Do KOH skin prep test in which scrapings from the white patch are mixed with potassium hydroxide (KOH) in the lab to look for fungal elements and rule out/in Tinea versicolor.
Vitiligo Treatment
Once the fungal infection is ruled out, I would advise you to treat that small patch of vitiligo by:
1. Applying a broad spectrum sunscreen with a SPF of 30 everyday.
2. Consider using self tanning lotions.
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