Focal Vitiligo vs Segmental Vitiligo

Vitiligo is an autoimmune disease that whitens the skin by targeting melanin-producing cells. Vitiligo causes the skin to lose its color, which can happen anywhere on the body, like face, hair, or eyes. Areas of the skin that are abnormally white or “bleached” in color are common symptoms of vitiligo.

About one percent of the global population suffers from this ailment, and people of all racial and cultural backgrounds are equally at risk. Vitiligo is a condition that has been studied extensively over the years due to the intricate genetic component that it possesses as well as its significant correlation with some other disorders.

Vitiligo is a disfiguring condition that frequently has a psychological impact on individuals. Losing skin color can be hard to deal with and can cause a lot of emotional stress in a person’s life. Vitiligo is an unusual skin illness because its symptoms can vary from case to case and its appearance can take on many different forms.

What is the difference between segmental and non-segmental vitiligo?

1. Vitiligo that affects multiple areas of the body, and may be symmetrical, is called non-segmental or generalized vitiligo. In severe situations, a significant portion of the body’s natural pigmentation may be lost.
2. Vitiligo that is confined to a single region or location on the body is referred to as segmental or localized vitiligo.

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A generalized or non-segmental form of Vitiligo

Non-segmental vitiligo is caused by an autoimmune disorder. According to several studies, persons who suffer from non-segmental vitiligo have antibodies in their systems that target pigment-producing cells. Patients who suffer from non-segmental vitiligo have an increased risk of developing another autoimmune illness that impacts the endocrine system. One example of this is Grave’s disease, which targets the thyroid gland. Consequently, immunosuppressive treatments are available for the treatment of vitiligo.

Sub-Types

Non-segmental is the most inclusive phrase for describing the many kinds of vitiligo. It is then further classified into a few different types based on the areas in which it is distributed. Non-segmental vitiligo typically begins in the mouth, eyes, and hands and then gradually spreads symmetrically to other regions of the body. It is progressive and has both active and inactive phases.

Vitiligo Vulgaris

• Defined by a dispersed appearance of several small, flat, white-colored patches that are found over a vast area on both sides of the body.
• Commonly impacts the hands, knees, feet, elbows, face, and armpits.

Acrofacial Vitiligo

• The hands, feet, and face are specifically impacted by acrofacial vitiligo.

Vitiligo Universalis

• Significant parts of the body are typically affected.
• The majority of the body’s pigmentation is frequently lost.

Segmental Vitiligo

This condition, known as segmental vitiligo, causes the skin to lose its pigmentation in an uneven pattern and manifests itself on one side of the body or in a particular area. The onset of segmental vitiligo is earlier than that of non-segmental vitiligo and often occurs before the age of 30.

One difference between segmental and nonsegmental vitiligo is that segmental vitiligo does not get worse after the first appearance. Segmental vitiligo is believed to have an underlying immunological etiology or neurological malfunction of the sympathetic system, though more research is needed to confirm this.

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Vitiligo Types That Are Not Segmental or Non-Segmental

Focal

Vitiligo comes in several subtypes, one of which is called “focal vitiligo,” which refers to the loss of pigmentation in a localized area of a few patches on the skin. Focal vitiligo can transform into segmental or nonsegmental vitiligo, and its course is frequently unpredictable. Little is known about the progression of localized vitiligo into other kinds of vitiligo, making therapy difficult.

Although the exact diagnostic criteria for focal vitiligo remain up for debate, it is generally agreed upon that a diagnosis of focal vitiligo can be made if pigment loss patches have ceased spreading and become segmental or non-segmental for at least 1-2 years. Focal vitiligo can transform into other forms of vitiligo after 5 years, making a correct diagnosis more difficult.

Mixed

Mixed vitiligo often manifests itself as segmental vitiligo at its onset, but it has the potential to develop into non-segmental vitiligo later on. 

Considerations Regarding Treatment

1. Phototherapy, topical therapy, laser therapy, and surgery are the main treatments for various vitiligo kinds. Segmental vitiligo is more difficult to treat, especially if it manifested at a young age (before the age of 14).
2. In some cases, surgery has been used to cure segmental vitiligo, but only if the affected area is very small and is not currently expanding.
3. Phototherapy is the treatment of choice for non-segmental vitiligo since it is the most cost-effective, safest, and best-tolerated option. It has also shown promising outcomes in the treatment of vitiligo.
4. Laser therapy has also yielded positive outcomes; however, the expense of this treatment is typically high, and some patients may not be able to afford it.
5. To get optimal outcomes, topical medicines are frequently coupled with additional treatment modalities like phototherapy and laser therapy.