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        The elementary lesion is a vitiligo depigmented spot a white-ivory. Its shape and size vary. Its border, usually convex, may be the color of the surrounding skin, darker (hyperpigmented) or reddish. It may also have some relief. The lesions can sit anywhere on the skin, but there are areas of particularly frequent choice: back of hands, feet, elbows and knees, genitals, around the Orif these natural, under the armpits, folds of the groin and umbilicus (areas of friction). The appearance of vitiligo on a skin area subject to repetitive microtrauma (scratching, rubbing repeated cuts continues ...) is called "Koebner phenomenon." It is customary in vitiligo. Depigmented areas are very sensitive to sunlight (photosensitive) and exposure to relatively moderate, there may be redness and itching. The extension of the lesions is unpredictable. These may confl uence to induce a generalized depigmentation called vitiligo universalis (see below).

        An exceptional, it was described vitiligos trichrome (three colors) and even four-color and pentachromes, developed a skin mate. The alternating areas of depigmentation of skin and hair color can create the mottled vitiligo. It may also be marked: it consists in a multitude of rounded confetti macules. Depending on the location and extension of lesions, there are several forms of vitiligo. We distinguish the localized forms and generalized forms. The localized forms are the focal vitiligo, segmental vitiligo and vitiligo mucous. The focal vitiligo affects a small area of skin.

Segmental vitiligo

        Segmental vitiligo is a unilateral depigmentation corresponds roughly to an area of innervation. The area of skin innervated by a nerve is given dermatome. Segmental vitiligo affects one or more dermatomes. The face is most commonly achieved (in about half the cases it is the territory of the trigeminal nerve), but segmental vitiligo may be on any part of the body where it remains unilateral. This type of vitiligo is distinguished from other clinical forms by age earlier onset, a rapid extension of some lesions at the dermatome (in about a year) and then a stop its spread. It is not aggravated by microtrauma and local,depigmented halo around a mole or autoimmune disorders. These findings suggest that this clinical form of vitiligo has a mechanism distinct from other forms. Mucosal vitiligo affects mucous membranes (lips, genitals ...). In the generalized forms are included vitiligo vulgaris and vitiligo universalis.

Vitiligo Vulgaris

        Vitiligo Vulgaris also known as bilateral vitiligo is the most common form of vitiligo (nearly 90% of cases). The plates are scattered and often bilateral and symmetrical. It is preferentially in the face, hands and feet. The extension becomes unpredictable in the most advanced. The micro appear to contribute to the clinical expression of this generalized form. The pigment cells of the eye and the ear (with decreased hearing certain frequencies) can be achieved respectively in 40 and 16% of cases. Three evolutionary stages are described for this type. In Stage 1, the spots are slightly pigmented with persistence of a few melanocytes in the epidermis, at stage 2 the spots are completely discolored with black hair (disappearance of epidermal melanocytes, but persistence of follicular melanocytes) at 3 spots are totally depigmented with white hair (complete disappearance of melanocytes).

Vitiligo universalis

        In vitiligo universalis, almost the entire body is affected. Vitiligo may be associated with autoimmune diseases including diseases of the thyroid (thyroid deficiency, Basedow disease and Hashimoto thyroiditis). Vitiligo is common in people with multiple concomitant endocrine diseases. It also aligns itself with Addison's disease with glucocorticoid hormones hyposecretion, pernicious anemia, lupus erythematosus, or inflammatory bowel disease. It can also arise in certain syndromes: the syndrome of Vogt-Koyanagi-Harada combining vitiligo, depigmentation of the eyelashes and / or eyebrows (Poliosis), Alopecia areata; syndrome Alezzandrini which combines a facial vitiligo (with achievement of eyelashes and eyebrows) with deafness and hereditary retinal degeneration associated with the presence of pigment cells in the retina (retinitis pigmentosa); cutaneous candidiasis of the skin and mucous membranes with sympathetic ophthalmia (autoimmune uveitis).