255 Nursing Assessment, Management and Treatment of Autoimmune Diseases
Pathophysiology Vitiligo occurs when the body’s melano- cytes are destroyed by the body’s im- mune system. Smooth white areas on the skin are called macules if less than 5 mm, or patches if they are larger than 5mm (Cleveland Clinic, 2020). There are sever- al types of vitiligo that are classified by the extent and location of the pigment loss, as follows (Cleveland Clinic, 2020; Mayo Clinic, 2020d): ● Universal vitiligo : This type of vitiligo is characterized by a loss of color over nearly all (more than 80%) skin surfaces. ● Generalized vitiligo : This is the most common form of vitiligo. Generalized vitiligo is characterized by discolored patches (loss of pigmented skin) that generally progress symmetrically on corresponding body parts. ● Segmental vitiligo : Only one side or part of the body is affected. This type of vitiligo usually occurs at a younger age, progresses for a year or two, then stops. ● Localized vitiligo : Localized (focal) vitiligo affects one or only a few areas of the body. ● Acrofacial vitiligo : This form of vitiligo is characterized by a loss of pigment on the face and hands, and around body openings such as the eyes and nose. ● Mucosal vitiligo : Mucosal vitiligo affects mucous membranes of the mouth and/or the genitals. ● Trichome vitiligo : This type of vitiligo is characterized by a white or colorless center, an area of lighter pigmentation, and then an area of ormally colored skin.
is to achieve a relaxed state so that stress is reduced. ● Relaxation and breathing exercises : Relaxation breathing, yoga, and meditation may help to reduce stress and alleviate symptoms. Vitiligo Vitiligo is a painless autoimmune skin disorder that causes the skin to lose its color. It typically begins with a few small white patches that may gradually spread over the body over a period of several months (Cleveland Clinic, 2020). Vitiligo can affect the skin on any part of the body as well as the hair and the inside of the mouth (Mayo Clinic, 2020d). Vitiligo occurs in about one percent of the world’s population. The disease af- fects all races equally, but it is more visible in people whose skin is darker. Vitiligo af- fects men and women equally (Cleveland Clinic, 2020). Vitiligo is not life-threat- ening nor is it contagious. However, the obvious loss of pigment can be stressful and reduce self-esteem. It may even lead to patients being teased or bullied (Mayo Clinic, 2020d). Vitiligo can develop at any age. It ap- pears most often in people 10 to 30 years of age. The disease seldom appears in the very young or the very old (Cleveland Clinic, 2020). | NURSING CONSIDERATION Treatment may restore color to the affected skin in persons with vitiligo. However, it does not prevent contin- ued loss of skin color or a recurrence of the disease (Mayo Clinic, 2020d).
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