What Is Meant by Leukoderma?
Leukoderma, also known as achromoderma, is characterized by complete loss of epidermal melanin, which results in a localized region of depigmented skin tone. They are present as smooth or light areas known as macules or patches. They are known as macules if the depigmented site is less than one centimeter, and if the depigmented region is more than one centimeter, it is called a patch. This condition makes the skin appear lighter than the normal skin tone. This condition has many causes.
Who Is Usually Affected by Leukoderma?
Leukoderma condition occurs in all age groups and both sexes. Female predominance is more due to cosmetic concerns. It is more evident in darker skin tones than in white skin-tone people. The macules or patches usually become noticeable after 30 years of age.
What Are the Causes of Leukoderma?
Leukoderma is caused due to loss of epidermal melanin. Melanocytes are cells that produce melanin which provides the skin its color. These melanocytes may be absent or present, or when present, they do not produce melanin. There are various causes of leukoderma; some are
- Autoimmune conditions, such as
- Vitiligo is the most typical cause.
- Lichen sclerosis causes small white patches in the skin.
- Systemic sclerosis causes tightening and hardening of the skin.
- Morphoea.
- Scarring
- Severe skin condition.
- Infection like herpes zoster.
- Burns.
- Certain procedures like chemical peels, chemotherapy, etc.
- Occupational and contact leukoderma.
- Drug-induced vitiligo.
- Congenital leukoderma.
What Are the Features of Leukoderma?
Leukoderma is characterized by a well-demarcated macule or patch of lighter-toned skin with normal skin texture or atrophy. The white patches are usually asymptomatic. Contact leukoderma is confined to the area of contact, with multiple small white spots spreading to other regions than the contact area.
What Is the Diagnostic Method for Leukoderma?
Some tests are carried out to rule out the diagnosis of leukoderma. Some are
- Wood Lamp Examination: This method is used to determine the presence of any fungal infection of the scalp or skin. This procedure uses UV (ultraviolet) light to determine the condition.
- Dermoscopy: Dermoscopy can be used to rule out the presence of certain forms of leukoderma. In this procedure, a dermatoscopy is used to examine the skin.
- Skin Biopsy: Skin biopsy is rarely done, which can determine the presence of melanocytes in the epidermis. There can also help to rule out any other underlying skin condition.
How Is Leukoderma Managed?
Some of the treatment methods are
- Sun protection.
- Cosmetic camouflage is the application of cream, powder, or liquids to correct the irregularities in the skin tone.
- Treating any other underlying skin condition.
- Melanocyte grafting surgery.
- Medications do not help to stop the depigmentation process but can help to slow down the process.
- Counseling.
- Light therapy is used to bring back the skin tone with the help of UVB light, medical-grade laser light, or light boxes. It takes many sittings for evident results.
Do Elderly People Get Leukoderma?
A person changes in many different ways as they get older. Some older people tend to show changes in their skin condition. Some skin conditions are temporary and can be treated, while others are permanent. Some leukoderma conditions, such as vitiligo, cannot be cured completely, but medications can help prevent them from spreading. Older people also get affected by leukoderma when the melanocyte cells get destroyed, which are responsible for skin color. Due to this reason, the skin color starts to disappear and causes depigmentation. This condition seems painless, but the chance of sunburns is higher in these conditions. The people affected by this condition should also protect their skin from clothing or sunscreen. This condition does not cause any pain but has a psychological effect on the person.
What Are the Symptoms of Leukoderma or Vitiligo?
The symptoms of this condition are very evident and are characterized by the presence of white or depigmented skin tone in those areas where the melanin cells are destroyed. They are of two types.
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Segmented: Segmented vitiligo is characterized by small white spots, usually occurring on one side of the body instead of both. They spread in and around one area at a very slow pace. This can spread for some time and pause and continue to spread again.
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Non-segmented: This is characterized by larger, wide-spread depigmented patches, usually seen on both sides of the body. They can affect normal melanin cells in any part of the body. The doctors cannot determine when the condition will start or take a pause or where it spreads.
What Increases the Risk of This Condition in Older People?
There is no proper cause for this condition. Some older people would have experienced this condition and grown with it at a young age. Some studies say that people with a family history and autoimmune conditions get this condition, but it is still a mystery. No pain or itching is associated with this condition, but it can psychologically impact the affected person. They tend to withdraw themselves from social activities or social gatherings.
How Can Leukoderma Condition Be Prevented?
The occurrence of this skin condition cannot be prevented, but the risk of its occurrence can be reduced by,
- Proper and safe sun exposure habits.
- Following skin care routine by using moisture and sunscreen regularly.
- Avoiding stress or injury.
- Management of any underlying autoimmune disease.
What Are the Complications Caused Due to Leukoderma?
- Sensitive Skin: The affected area lacks melanocytes which make the skin very sensitive and increases the chance of sunburns.
- Eye Abnormalities: People may experience some abnormalities in the retina and iris. They can also be sometimes affected by inflammation, but the vision does not get affected.
- Autoimmune Condition: The affected people risk acquiring autoimmune conditions depending on how the immune system works.
- Emotional Status: This condition has a psychological impact on the affected people. They lose their self-esteem, which can result in stress and depression, and they tend to isolate themselves from the gathering or public places.
Conclusion
Leukoderma is a skin condition that causes depigmentation in some parts of the body due to the destruction of melanocytes. They can be present as macules or patches. They do not cause pain but enhance the risk of skin burns and greatly impact the patient's psychology. They cannot be cured completely, but treatment can reduce the pace at which the condition spreads.
