PROF DR DWARIKA P SHRESTHA
I am a 21-year-old boy currently doing my engineering. Recently my mother noticed a small pale patch on the right part of my upper chest. There is a similar patch on my upper back. I was scared when she said that it could be vitiligo. I remember I had this patch a year ago too, but I did not give it attention. The size has not changed much till now. The hair on my scalp are turning grey and some of my relatives have
vitiligo too which makes me think I could have it too
and has disturbed me
emotionally. Is there any treatment for it if detected
at an early stage?
— Nabin Shrestha
If the pale patches are few and the paleness is marked, there is a possibility that it can be vitiligo (seto dubi). On the other hand, if there are many and the paleness is mild, it can simply be a fungus known as pityriasis versicolor (khairo dubi). But from your description it seems more likely to be a type of vitiligo, known as localised vitiligo.
First and important is not to be scared. Vitiligo is a very common problem; most people have a spot or two. Those with extensive white patches are very few and you should not think that having a spot will automatically extend to cover the face. But it is important to be aware of this problem and seek timely advice.
Vitiligo is a type of pigmentation disorder, where certain cells of the skin known as melanocytes tend to work less or get destroyed, hence producing less or not producing at all, a brown colour, called melanin. We do not know the reason for this, maybe there is an immunological base.
Seto dubi present as milky white patches, initially few, they can increase or remain as before. Any body site can be involved. In some cases they can resolve spontaneously.
There is no magical treatment for vitiligo, but no doubt, the different modalities of treatment available help a lot. The available treatment nowadays consists in topical steroids creams, tacrolimus creams, ultraviolet rays and surgical modalities. The treatment should always follow dermatological consultation.
There are preventions that should be followed —
• Do not use plastic and rubber shoes and watches. These contain a chemical which may induce vitiligo.
• Do not wear tika or bindi for a long time, for the same reason as above.
• Treat immediately wounds and boils, where after healing, there may be a white patch.
I do not think greying of hair is due to vitiligo. Usually before the hair, the skin on the scalp becomes white. Hair are the last to lose colour.
The doctors on THT Medical Board are
• Dr Sanduk Ruit
Medical Director, Tilganga Eye Hospital
• Dr Bhagwan Koirala
• Prof Upendra Devkota
Chief of Neurosurgery, National
Institute of Neurological and
• Dr Kundu Yangzom
Chief of OBGYN Services,
• Dr Kishore Pandey
• Dr Sameer Aryal
Dentist, Advanced Dental Care
• Dr Dwarika P Shrestha
Professor, Teaching Hospital and
Consultant, Dermato-Venereologist, B&B Hospital
• Dr Ranjeet Baral
Consultant Cardiologist-cum-physician at Shahid Gangalal National Heart
Centre and NORVIC Hospital