Non Segmental Vitiligo: Symptoms, Types, and Causes

Non Segmental Vitiligo

Non segmental vitiligo is commonly characterized as a loss of pigment in certain portions of the skin.

It is known to affect all sorts of people from every culture, region, race, and gender. This form of vitiligo is more common than segmental one which only occurs in 5-16% of patients [ref].

There are several factors involved in its onset which may include genetic or autoimmune causes. The specific underlying mechanism is still unknown, though.

Current studies are exploring non-segmental vitiligo and new therapies to find a possible permanent cure.

Since it can visibly harm a person’s mental and social well-being, it continues to impact their quality of life. However, finding support groups and consulting physicians can be of great help to such people.


Signs and Symptoms of Non Segmental Vitiligo?

non segmental vitiligo

  1. Patches of depigmented skin

Your immune system is behind the destruction of melanocytes (cells making the melanin) in non-segmental vitiligo.

This results in a lighter and whiter appearance. Such patches may develop gradually at any spot of the body. People with darker skin tones experience a more visible loss of pigmentation.

  1. Loss of pigment in areas commonly exposed to the sun

Melanocytes are the main victims of non-segmental vitiligo, and they’re responsible for protection against the hazardous effects of UV rays.

Therefore, such cells are more common in areas repeatedly exposed to the sun, including the face, neck, arms, and feet.

The immune system kills melanocytes residing there, leading to signs of depigmented areas. This is why the condition is characterized by patches of lighter skin in sun-exposed areas.

  1. Premature greying or whitening of hair

As melanocytes are consistently destroyed, hair in affected areas may lose pigments. The loss of color is not restricted to only skin and can expand to regions like hair and eyes.

This condition is often named premature greying, but it is crucial to know that it can be because of other conditions like genetic predisposition and not necessarily vitiligo.

  1. Variability in the size, shape, and location of depigmented patches

There is no defined shape or size for the depigmented areas, and they may range from dots to completely covering a body part.

Their occurrence and size are unpredictable both in presentation and progression. Each patch is unique and rarely resembles other ones, and this is why non-segmental vitiligo can be distinguished from other conditions.

  1. Sensitivity to sunlight or sunburn in depigmented areas

As melanin is responsible for protecting from sun rays, its destruction leads to damage in the affected areas.

With no melanocytes present to prevent sun damage, the depigmented patches become more susceptible to sunburn and increase sensitivity.

This is why patients are asked to wear sunscreen and take measures to protect themselves against possible skin cancers.


What is the Non Segmental Vitiligo Spreading Time?

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It can vary from one person to another, but in some cases, the disease may remain stable for some time.

It may not progress any further during that time while in other cases, the condition keeps spreading.

In a study from 2022, researchers compared the disease stability in segmental and non-segmental vitiligo.

They concluded that segmental vitiligo patients with stable periods of over 2 years did not experience re-activation of the disease, while 80-100% of non-segmental patients experienced reactivation regardless of any stable period. [ref]

So, this tells a lot about the rate at which non-segmental vitiligo may spread. The disease may relapse even in patients who went through surgical or medical repigmentation procedures [ref].

Factors like immune system function, environmental triggers, and treatment interventions can become the reason behind the relapse or an increased spreading time.

Research has not evaluated the stable period after which the relapse becomes less likely.

Therefore, one should continuously monitor changes in the skin patterns and consult dermatologists if you’re concerned about your non-segmental vitiligo spreading time.


Non-segmental Vitiligo Causes:

  1. Autoimmune disorder

This is connected to immune system dysfunction, where the body’s immunity mistakenly attacks the melanocytes.

This response leads to the mass destruction of melanin, resulting in a lack of pigmentation. The proper pathway behind the autoimmune process in non-segmental vitiligo is unknown.

However, research has suggested genetic susceptibility and environmental triggers to be behind this trigger.

  1. Genetic predisposition

Studies have identified genes involved in the predisposition of non-segmental vitiligo [ref].

Furthermore, changes in genes related to the immune system and the functioning of melanocytes are also involved in causing this condition.

This also explains why people with a family history are more likely to develop the disorder later in life.

  1. Oxidative stress

Reactive oxidative species may trigger protective mechanisms like autophagy and the Nrf2 pathway in melanocytes.

If this trigger is excessive, it may disrupt cell function and induce decreased pigmentation. It eventually leads to the development of vitiligo and loss of skin color. [ref]

  1. Neurogenic factors

Melanocytes can be affected by neurotransmitters, stress, and neuropeptides. This impact can lead to an imbalance in pigment production.

Certain nerve endings near melanocytes may also release factors that modify the immune response.

This can be a trigger for the autoimmune destruction of melanocytes seen in non-segmental vitiligo.


Is Non Segmental Vitiligo Curable?

According to the American Academy of Dermatology, no treatment can cure non-segmental vitiligo.

Patients undergo procedures to fix depigmented areas, but the color may fade over time. Therefore, people get maintenance treatment done for this reason.

Topical steroids are used to limit the growth of white patches, and they may restore some of the skin pigment.

Such creams are prescribed if you have non-segmental vitiligo on less than 10% of your total body area. [ref]

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Non Segmental Vitiligo ICD-10

L-80 is designated as the ICD-10 code for vitiligo. It is under the ‘other disorders of the skin and subcutaneous tissue’ L80-L99. [ref]

The L-80 code does not signify any other subcategories; therefore, here is a table for codes from L-80 to L-99.

Other disorders of the skin and subcutaneous tissue

L81 Other disorders of pigmentation
L82Seborrheic keratosis
L83Acanthosis nigricans
L84Corns and callosities
L85Other epidermal thickening
L86 Keratoderma in diseases classified elsewhere
L87 Transepidermal elimination disorders
L88Pyoderma gangrenosum
L89 Pressure ulcer
L90Atrophic disorder of the skin
L91Hypertrophic disorders of the skin
L92Granulomatous disorders of skin and subcutaneous tissue
L93Lupus erythematosus
L94Other localized connective tissue disorders
L95 Vasculitis limited to skin, not elsewhere classified
L97 Non-pressure chronic ulcer of the lower limb, not elsewhere classified
L98Other disorders of skin and subcutaneous tissue, not elsewhere classified
L99 Other disorders of skin and subcutaneous tissue in diseases classified elsewhere

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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