the-psychological-impact-of-vitiligo-in-adult-sudanese-patients-jop-12-267 - ORIGINAL Afr J Psychiatry 2009;12:284-286 The psychological impact of

The-psychological-impact-of-vitiligo-in-adult-sudanese-patients-jop-12-267

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ORIGINAL Afr J Psychiatry 2009;12:284-286 African Journal of Psychiatry • November 2009 284 Introduction Vitiligo is the most common pigmentary disorder worldwide affecting 0.1-2% of the world’s population, irrespective of race and gender. 1 It is an acquired chronic skin condition that causes loss of pigment, resulting in irregular pale patches of skin. The precise cause of vitiligo is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic, and environmental factors. Vitiligo is characterized by the appearance of patchy discoloration evident in the form of typical chalky-white or milky macule(s). The macules are round and / or oval in shape, often with scalloped margins. 2,3 The size of the macules may vary from a few millimeters to several centimeters with the lesions affecting the skin and / or mucous membranes. Generally, the lesions are asymptomatic, although itching / burning may precede or accompany the onset of the lesions in a few patients. 3,4 Vitiligo is a slow and progressive disease and may have remissions and exacerbations correlating with triggering events. 3,5 Occasionally, the lesions of vitiligo may begin to form around a pigmented nevus [Sutton's nevus, leukoderma aquisitum centrifugum] and then go on to affect distant regions. 6,7,8 Although any part of the skin and / or mucous membranes may be affected, the disease has a predilection for normal hyperpigmented regions such as the face, groin, axillae, aerolae and genitalia. Furthermore, lesions may develop in other areas like the ankles, elbows, knees, which are subjected to repeated trauma / friction, an outcome of Koebner's phenomenon. 9 Poliosis circumscripta, as well as canities and premature graying, can be observed; mucosae are rarely involved. In the event of extensive disease, the lesions are symmetrically distributed with an exclusive dermatomal distribution or mucous membrane involvement. 10 Lip-tip syndrome, another variant of vitiligo is characterized by depigmentation of the terminal phalanges and the lips. Vitiligo may show morphological variations in the form of: trichrome, quadri-chrome, penta-chrome or blue vitiligo. The psychological impact of vitiligo varies greatly from person to person, depending on their condition, their social and occupational situation and their psychological wellbeing. Vitiligo is often most obvious in darkly pigmented individuals, in whom the disease can have profound psychological consequences. These effects range from mild embarrassment to a severe loss of self-confidence and social anxiety, especially for those who have lesions on exposed skin. 11,12 The psychological impact of vitiligo in adult Sudanese patients AM Osman 1 , Y Elkordufani 1 , MA Abdullah 2 1 University of Juba, 2 University of Khartoum, Sudan Abstract Objective: Vitiligo is a chronic skin disease that causes loss of pigment, resulting in irregular pale patches of skin. The disease has profound psychological consequences. These effects range from mild embarrassment to a severe loss of self-confidence and
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