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Skin Care and Diseases

Vitiligo

11/30/2006

Question:

I have been dx`ed with vitiligo about 3 -4 yrs ago. It mainly has affected my hands, arms, chest and abd. Will it continue to spread? Also, would having this cause a positive ANA? I also have hashimoto`s but the ANA (1:640 speckled) has always been attributed to the vitiligo and the hashimoto`s. Have a great day!

Answer:

Vitiligo is a rather unpredictable disease process.  Distribution in the periorbital / paranasal tissues along with the distal fingers, toes, umbilicus, and genitalia are frequently the first areas to become affected.  These may spread so that all of the pigment, including the pigment of the hair, is lost.  

The same kind of discoloration may be seen if topical hydroquinones are applied to the skin, either deliberately or accidentally.  There are a number of diseases that have been loosely associated with vitiligo. 

I would pay attention to your internist who is directing your care.  A 1:640 speckled ANA is not to be ignored and there are a number of entities that may have variations of patterns in the laboratory on the ANA tests. 

In very early vitiligo, topical steroids and ultraviolet light and ultraviolet light plus oral psoralens may be of help in early repigmentation.  The last areas to repigment are often the tips of the fingers and toes where there are no hair follicles. 

To be certain of the disease processes that you are dealing with, talk carefully with your internist or your board certified dermatologist.  Other tests may be done to be certain of the cause of your elevated ANA.

 

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati