![]() If this happens, the skin in the area is depigmented, meaning there is no pigment or melanin. I look for the white spots to enhance, or become more apparent, under the Wood’s lamp compared to room light, they kind of fluoresce. This is sometimes fun for my younger patients, because not just vitiligo glows under the light, but also certain colors of clothing, teeth, peanut butter left over from lunch, rubies (discovered they REALLY glow), and even lint. The first order of business is to determine, “Are these white spots actually depigmented, meaning they do not have ANY pigment in them?” So, to do this, I turn out all the lights in the room and turn on my Wood’s lamp. Next, we gather more information to narrow down this list to one or just a few possibilities, and maybe biopsy the skin to get a really close look under the microscope. Combined with other pieces of information gathered by talking with the patient, we can usually diagnose vitiligo without a skin biopsy.īut what if it’s NOT vitiligo? What if the spots don’t fluoresce under Wood’s lamp illumination, or what if they do, but the other information doesn’t fit with what we know about vitiligo? Well, that’s when a dermatologist forms a “differential diagnosis”, or a list of diseases that might cause the skin changes. So, when the spots glow under Wood’s lamp, it narrows down the possibilities by a lot. It’s an incredibly useful tool for a dermatologist and vitiligo specialist, because very few other diseases turn the skin white like this. It has something to do with proteins in the skin absorbing UVA light and then emitting (or shining back) a longer wavelength that’s in the visible spectrum, so your eyes can better see it. ![]() When a patient has vitiligo, the Wood’s light makes all of the white spots fluoresce bright white, making them clearly visible in contrast to the normal skin color, even if the normal skin is very pale. So be careful when going to one of these places that uses a “black light” if you have vitiligo, because your spots will glow! Maybe you’ll think this is cool, and want to find one. It’s the same light used for highlighting fluorescent colors in the dark, like “midnight bowling”, “fluorescent mini golf”, and clubs in the 70s. The Wood’s lamp is a UVA light that looks dark purple, and it’s used by holding it close to the skin with all the lights in the room turned out. The details of these forms of vitiligo are for another blog post, but if you or your doctor knows these patterns it’s easier to determine if the spots are from vitiligo or a lookalike that causes the same pattern. Maybe most importantly, it can affect just one side of your body and stay in a small area, which is called segmental vitiligo. Universal vitiligo means that most of the skin has lost its pigment as vitiligo has spread all over, usually we reserve this term for when at least 80% is affected. It can affect the face and hands/feet, which is called acrofacial vitiligo. It can affect just the lips and genitals, called mucosal vitiligo, or those areas plus the fingertips, called lip-tip vitiligo. ![]() It can become widespread, often called generalized vitiligo. For example, vitiligo can affect a small area (usually early on before it spreads), called focal vitiligo. ![]() Vitiligo can sometimes have different appearances, so being familiar with the different patterns that can exist is helpful to recognize it and tell it apart from other conditions. So, if you’re wondering if you have vitiligo but aren’t sure, maybe this blog will help you figure that out, and clarify what’s distinct to vitiligo versus its lookalikes! There are different patterns of vitiligo Sometimes I’ve had vitiligo patients who notice new spots on their bodies that they think are vitiligo, but they’re something else, often things that are even easier to treat. But I’ve seen patients in my Vitiligo Clinic, some who’ve traveled a very long distance (even other countries), who didn’t actually have vitiligo, but had diseases that looked like vitiligo. It’s pretty distinctive and is frequently diagnosed by a dermatologist simply by looking at it, often with the aid of a special light called a Wood’s lamp. Vitiligo is an autoimmune disease of the skin that causes white spots. ![]()
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