Vitiligo
Introduction
Introduction to skin leukoplakia Skin leukoplakia refers to patches on the skin and mucous membranes that are lighter than normal skin, mainly due to hypopigmentation or hypopigmentation. White spots can be congenital or acquired. White spots can occur in any part of the body, but are more common in the face, neck, back of the hand and other exposed parts and external genital wrinkles. Most of them are limited, isolated, and can also be symmetrically distributed, or distributed along the nerves, and can also spread throughout the body. The cause of congenital leukoplakia may be caused by various reasons during embryonic development. Generally, white spots appear on the skin at birth or shortly after birth, such as non-pigmentation, anemia, and pigment-free pigment incontinence. The distribution of these white spots is generally limited or has certain characteristics, and the color of the white spots is not very white. As they grow and develop, these white spots will neither regress nor become significantly enlarged around when they stabilize. At the time of treatment, the patient needs to go to the hospital for examination in time to determine the cause of the disease and then carry out targeted medication, and the effect of symptomatic treatment is achieved to achieve the best therapeutic effect. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people. Mode of infection: non-infectious Complications: Diabetes Chronic adrenal insufficiency
Cause
Skin leukoplakia
Congenital body factors (75%)
The cause of congenital leukoplakia may be caused by various reasons during embryonic development. Generally, white spots appear on the skin at birth or shortly after birth, such as non-pigmentation, anemia, and pigment-free pigment incontinence. The distribution of these white spots is generally limited or has certain characteristics, and the color of the white spots is not very white. As they grow and develop, these white spots will neither regress nor become significantly enlarged around when they stabilize.
Environmental factors (20%)
There are many reasons for acquired white spots. Because the skin is directly in contact with the external environment, the white spots on the skin are both internal and may be caused by external factors such as sun exposure, chemicals, and fungal infections. There are many skin diseases that can cause skin hypopigmentation and hypopigmentation.
Disease factor (5%)
Some inflammatory skin diseases can cause white spots on the skin. These leukoplakia usually have other inflammatory skin diseases, such as eczema and psoriasis, which destroy the melanocytes of the basal layer of the skin and cause skin pigmentation. Lost.
Prevention
Skin leukoplakia prevention
1. Do not use fungicide or disinfectant in the cleaning method to avoid irritating the skin; choose neutralization, weak acidity or soap-free ingredients as much as possible. However, the best method is to clean the water, and remember not to use too hot water, so as not to exacerbate the symptoms of inflammation.
2, develop good daily habits, for example: wash your hands immediately after going to the toilet, the size of the wipe should follow the operation from the vaginal opening to the anus.
3, try to avoid sedentary, to reduce the sultry, damp, keep dry for the purpose.
4, clothing should wear less pants, tight pants and tights, and as fast as possible with breathable cotton. Usually there is not a lot of secretions, no need to use pads, in case of moisture it is easy to aggravate or bring vulva skin problems.
Complication
Skin leukoplakia Complications Chronic chronic adrenal insufficiency
In clinical manifestations, it may be complicated or secondary to hyperthyroidism or hypothyroidism, diabetes, chronic adrenal insufficiency and chronic active hepatitis.
Symptom
Symptoms of leukoplakia common symptoms leukoplakia pigmentation on children's face pigmentation and hypopigmentation facial leukoplakia leukoplakia on the back of the hand
1. White spots caused by various reasons, the white spots themselves have different characteristics. First, according to the color of the white spot, it can be divided into hypopigmentation spots and plain color loss spots. The color of the hypopigmented spot is lighter than normal, but does not change to porcelain white. These white spots are mainly found in some congenital white spots and simple pityriasis, tinea versicolor, and solar leukoplakia. Depigmentation of pigmentation means that the white spot color is pure white or porcelain white, mainly seen in vitiligo and some white spots appearing after inflammatory skin diseases that are more serious to the destruction of melanocytes, such as white atrophy and lupus erythematosus.
2, followed by different white spots, their skin texture also has its own characteristics. Some white spots have different degrees of scaly adhesion, such as simple pityriasis, tinea versicolor, etc.; some white spots have atrophy, such as pigmentation after ulceration, discoid lupus erythematosus; some white spots are dry, No sweat, no hair, such as leprosy; in addition, the edges of different white spots also have their own characteristics. Some white spots have clear borders, and there may be pigmentation deepening around them, such as white atrophy, discoid lupus erythematosus, etc.; some white spot boundaries are blurred, generally with hypopigmentation spots.
Examine
Examination of leukoplakia
Blood test
The blood pH of patients with vitiligo is slightly lower than that of normal people. Most patients with vitiligo have anemia, white blood cells and thrombocytopenia.
2. Immunological examination
There are various autoantibodies in the serum of patients with vitiligo, including thyroglobulin, anti-thyroid microsomes, anti-stomach cells, anti-adrenalin, anti-smooth muscle, anti-myocardial, anti-insulin, anti-platelet and anti-nuclear antibodies. The discovery of anti-melanocyte surface protein antibodies in the serum of vitiligo patients is of great significance for this disease.
3. Trace element inspection
Patients with vitiligo are closely related to low copper. The patient's serum copper oxidase activity decreased, serum monoamine oxidase increased, and serum ceruloplasmin increased.
4.Wood light check
Wood lamps are very helpful in judging the subtle differences in pigmentation. Melanin absorbs all-wavelength ultraviolet light. If melanin is reduced, it is light-refractive and light-colored. The increase in melanin is weaker and darker.
5. Histopathological examination
Determine whether there are melanocytes, especially melanocytes that are positive for dihydroxyphenylalanine (dopa), for reference. Some patients have immunoglobulin G or (C3) deposition in the basement membrane and immunoglobulin G or complement (C3) deposition in the keratinocytes.
Diagnosis
Diagnosis of skin leukoplakia
diagnosis
Do not think that skin white spots are vitiligo. Skin leukoplakia involves many skin diseases, it can be an independent skin disease, or it can be a symptom of a certain skin disease. It was found that skin leukoplakia should go to the hospital for a clear diagnosis.
First, the basic diagnostic points of vitiligo: hair, face, trunk and limbs, etc., irregular, white plaques of different sizes, single or multiple, the area of white spots gradually expanded, the number increased. The white spot is clear, the hair inside the spot is also white, the surface is smooth, no scales or crusting, and the sensory and secretory functions are normal. White spots are more sensitive to daylight, and they become red when exposed to light.
Differential diagnosis
Second, vitiligo needs to be identified with the following diseases:
1, anemia : limited local pigmentation spots, but not pigmentation. Since childhood, there is no tendency to expand, rubbing the skin lesions with force, local redness, and normal skin around the redness.
2, mottled disease: is an autosomal dominant genetic disease, the skin lesions are born at the time, the most common in the forehead, combined with white hair, white spots often triangle or diamond, chest, abdomen, proximal extremities can also rash, The size of the lesion does not change with age, and some patients may also have other developmental abnormalities.
3, no pigmentation sputum: occurs shortly after birth or after birth, is a clear pigmentation spots in the realm, and will remain unchanged for life. Histopathology showed that the number of melanocytes was normal or decreased, and the size and function of melanosomes were normal.
4, idiopathic drops of hypopigmentation and senile leukoplakia: the former is a clear circular or polygonal white spot with multiple boundaries, diameter 2 ~ 6cm, common in the forearm and calf extension side, with the increase in age and number. The latter is common in the elderly, mainly found in the chest, back, and limbs. It is a large round white spot of the bean, slightly concave, scattered and not fused.
5, mucosal leukoplakia: lip mucosa and perineal vitiligo often mistaken for mucosal leukoplakia. The mucosal leukoplakia is mostly reticular or flaky, which is white keratotic damage and often itchy. While vitiligo is only pigment loss, the epidermis is normal, and decolorizing lesions can often be found in the adjacent skin or elsewhere.
6, tinea versicolor: infants and young children, its pale white spots often occur in the cheeks, forehead and eyebrows, because the surface is often scrubbed, it is not easy to attach scales, it is easy to be confused with early vitiligo, should pay attention.
7, simple pityriasis: more common in children, good for the face, round or oval, common in 1 to 3 color reduction spots, skin lesions are pale or gray, covered with a small amount of sputum desquamation, the edge is not clear, no The characteristics of the surrounding pigment deepening. Or itchy, mostly in the spring, but also in early summer or winter.
8. Albinism: This disease is a congenital non-progressive disease, often with a family history, the iris of both eyes is transparent, and the choroidal pigment disappears. In childhood, it does not enlarge or disappear, and the pigmentation around the lesion does not increase.
9. Discoid lupus erythematosus: discoid lupus erythematosus, especially on the cheeks and lips. When cured, it often leaves a well-defined warm pigmented patch with a vitiligo, but this warm stain always has some atrophy and telangiectasia. There are fashions that can find sticky scales, and the enlarged hair follicles and horny plugs.
