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Vitiligo – The Path to Diagnosis

Posted on December 4, 2019

The path to vitiligo diagnosis is generally straightforward. Vitiligo is usually diagnosed by a dermatologist, a skin specialist who has training that allows them to distinguish between similar skin conditions.1 Typically a dermatologist will take a medical history, conduct a physical examination, and in some cases may order bloodwork or a biopsy depending on the type of vitiligo suspected.

How Is Vitiligo Diagnosed?

Medical History

The doctor will likely take a medical history during your appointment. They may ask questions including the following:

  • When did you first notice skin discoloration?2
  • Where did the first patches of skin discoloration occur?2
  • Did you experience skin trauma (such as a sunburn or skin injury) before your skin lost pigment?3
  • Did you experience an illness or stress preceding the loss of skin color?3
  • Do you have an autoimmune disorder or family history of autoimmune diseases?2
  • Does anyone in your family have vitiligo?2

Physical Exam

The dermatologist will conduct a full body examination to evaluate your skin.4 The doctor may use a Wood’s lamp, a type of ultraviolet light, to look at the skin more closely. Using a Wood’s lamp allows your doctor to see the areas of discoloration more clearly, especially for people with lighter skin tones. The Wood’s lamp can help determine if skin depigmentation is caused by vitiligo or another condition.2,5

Additional Tests

In some cases, a doctor may perform a biopsy, which involves removing a small area of skin for further evaluation in a laboratory.4 Analyzing a biopsy helps the doctor understand whether melanocytes, the cells that pigment skin, are missing or malfunctioning.2 Depending on the type of vitiligo diagnosed, a doctor may order blood tests or evaluations for other conditions related to vitiligo. Many people with vitiligo are otherwise healthy, but some types of vitiligo can be associated with a higher risk for thyroid problems and various autoimmune conditions.4,6

If you are diagnosed with generalized vitiligo, the doctor may also recommend visits to an ophthalmologist (eye specialist) or audiologist (hearing specialist).4 Melanocytes are found in the eyes and inner ears as well as the skin, and cells in these areas can be impacted by vitiligo too.6

Ruling Out Other Conditions

  • Vitiligo isn’t the only possible cause of skin depigmentation. The process of ruling out similar conditions is referred to as differential diagnosis. Other possible causes of skin discoloration include:4
  • Infections such as tinea versicolor, a common fungal infection
  • Skin exposure to certain chemicals
  • Scarring
  • Eczema
  • Melanoma, a type of skin cancer

Your doctor may be able to rule many of these conditions quickly based on a visual exam, your medical and family history, or simple blood tests.

Condition Guide

In partnership with the Global Vitiligo Foundation, which strives to improve the quality of life for individuals with vitiligo through education, research, clinical care, and community support.

References
  1. About Vitiligo. (n.d.). Retrieved October 31, 2019, from https://vrfoundation.org/about_vitiligo.
  2. Diagnosing Vitiligo. (n.d.). Retrieved November 15, 2019, from https://nyulangone.org/conditions/vitiligo/diagnosis.
  3. Medical Screening. (n.d.). Retrieved October 31, 2019, from https://www.avrf.org/facts/medical-screening.html.
  4. Lotti, T., & Salafia, A. (n.d.). Vitiligo Questions & Answers. New York, NY: VR Foundation.
  5. Overview: Vitiligo. (n.d.). Retrieved October 31, 2019, from https://www.nhs.uk/conditions/vitiligo/.
  6. Is vitiligo a medical condition? (n.d.). Retrieved October 31, 2019, from https://www.aad.org/diseases/a-z/is-vitiligo-a-medical-condition.
  7. Vitiligo. (n.d.). Retrieved November 15, 2019, from https://rarediseases.info.nih.gov/diseases/10751/vitiligo.

Posted on December 4, 2019
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Richard H. Huggins, M.D., Treasurer of the Global Vitiligo Foundation is the author of numerous journal articles and chapters studying treatments and quality of life for people with vitiligo and other skin conditions. Learn more about him here.
Alison Channon has nearly a decade of experience writing about chronic health conditions, mental health, and women's health. Learn more about her here.

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