1, site: lesions can occur in any part of the body, generally preferably in exposed areas, folds and easy friction damage and other parts, that is, normal people more pigmented parts. It is common in the face, neck, waist and abdomen (girdle), sacral tail, forearm extension and finger back; in addition to skin damage, the lips, labia, glans and inner plate of foreskin mucosa are often involved. The white spots are mostly symmetrically distributed, and there are also many cases where the damage is arranged along the nerve segments.
2, lesion characteristics: typical damage at the complete loss of pigment, milky white, clear borders, the degree of pigment loss can also vary from person to person. The size and shape of the white spots vary, the number is variable and can gradually increase and expand, and adjacent white spots can fuse with each other to form irregular swaths, spreading throughout the body, like a map. Sometimes there can be scattered pigmented areas in the white spots in the form of islands, and the hair can lose pigment or even turn completely white, or it can be normal. In the clinic can be seen due to mechanical stimulation, such as the belt on the skin too tight pressure, friction, etc. prompted the appearance of white spots, and is called homomorphic reaction.
In the progressive stage, commonly due to various stress states, such as external drugs, mechanical stimulation, mental trauma, surgery, etc., so that the normal skin appear white spots or make the original white spots expand, increase, and even generalize the whole body; this period is prone to homomorphic reaction, summer development is fast, winter slowdown or stop spreading. In the stationary phase, the white spots can stop developing, the boundaries are clear, and the pigmentation of the edges of the white spots deepens. In the improvement period, the edge of the white spot pigment deepens and gradually infiltrates to the center of the white spot and makes the white spot shrink, and some appear in the white spot around the pores scattered islands of pigmented areas, and the number of white spots is gradually reduced.
4, clinical typing: clinically, according to the shape, location, scope and treatment response of the white spots are generally divided into five types.
Limited type: white spots are single or clustered in a certain area.
Sporadic: white spots are scattered, varying in size, but mostly symmetrically distributed.
Generalized type: often developed from the limited or disseminated type, the total area of white spots is greater than l/2 of the body surface area.
Extremity type: The white spots first appear on the extremities of the body, such as the face, hands and feet, fingers and toes and other exposed areas.
Segmental type: The white spots are distributed according to the dermatomes or a certain nerve distribution area.
5, diagnosis and differential diagnosis The disease is dominated by milky white pigment loss, no self-perceived symptoms, and occurs later in life. Typical vitiligo is not difficult to diagnose in general, but the damage with incomplete depigmentation and blurred edges in early stage needs to be distinguished from the following diseases.
Anemic nevus It is a congenital hypochromic spot, rubbing local, the pale spot itself does not redden, while the surrounding skin reddens. The slides are the same as the surrounding skin color on compression.
Nevus anemarrhea is a patchy, confined pale spot distributed unilaterally along a ganglion.
Pemphigus foliaceus Round or oval pale spots caused by Sphaerococcus furfur.
Pityriasis simplex Round or oval pale spots covered with furfuraceous scales.
Discoid lupus erythematosus, which leaves depigmented spots with atrophy and dilated capillaries after healing.
Mucocutaneous leukoplakia White spots are mostly reticulate, striated or flaky, with white keratotic damage and itching.