Etiopathogenesis of vitiligo : Are we dealing with an environmental disorder ?

The increasing incidence of vitiligo in this part of the world (4.25%), prompted us to study 5000 fresh vitiligo patients. Several triggering factors were elicitable. Malnutrition and intake of junk food were very common in childhood vitiligo. Intercurrent infections as well as intake of antibotics were also significant, immediately preceding the development of depigmented patches in younger age group. Genetic predisposition was uncommon. Autoimmune disorders were infrequent and usually accompanied late onset vitiligo. For management, vitiligo was classified into VI (active), V2 (quiescent) and V3 (improving) stages. The therapy administered varied in each stage. As a common denominator, all out efforts were made to eliminate possible trigger factors in individual cases throughout the period of treatment, and building the general health to prevent recurrence in future. The study strongly points out that vitiligo is a multifactorial disorder. It can be effectively managed after each patient is individually assessed. Elimination of possible triggering factors may form the mainstay of vitiligo therapy along with controlled pharmacological intervention. The improvement of general resistance of body may bring spontaneous repigmentation.