What is Leucoderma?

Leucoderma is the name given to the disorder that results in white patches of the skin. This is a skin disorder in which patches of skin tend to lose natural color.

Leucoderma is regarded as the de-pigmentation of the skin which is marked by the localization or complete destruction of melanocytes in the body. Melanocytes may be absent or present but unable to synthesize melanin that gives the pigment color to the skin.

It is a clinical sign describing a localized area of white depigmented skin.

It is not a diagnosis and has many causes.

Who gets leucoderma?

Leucoderma can be seen in people of all ages and races, and both sexes. There may appear to be a female predominance due to cosmetic concerns. Leucoderma is more apparent in skin of colour than in ethnic white skin, but prevalence rates are difficult to determine.

What causes leucoderma?

There are many causes of leucoderma

• Autoimmune diseases
  • Vitiligo
  • Lichen sclerosus
  • Systemic sclerosis
  • Morphoea
• Scarring
  • Severe skin disease — atopic dermatitis, allergic contact dermatitis, Stevens-Johnson syndrome/toxic epidermal necrolysis
  • Infection — herpes zoster
  • Burns and other injuries
  • Procedures — cryotherapy, chemical peels, laser treatment
• Chemical leucoderma including occupational and contact leucoderma
• Drug-induced vitiligo (leucoderma)
• Congenital patterned leucoderma
  • Piebaldism
  • Waardenburg syndrome
• Miscellaneous
  • Idiopathic guttate hypomelanosis
  • Halo naevus
  • Melanoma-associated leukoderma
  • Onchocerciasis – ‘leopard skin’ appearance

What are the complications of leucoderma?

• Psychosocial and cosmetic effects
• Susceptibility to sunburn and perhaps the development of skin cancer

How is leucoderma diagnosed?

1. Wood lamp examination.
2. Dermoscopy can be helpful in the diagnosis of some forms of leucoderma.
3. Skin biopsy is not routinely required but can confirm the absence of melanocytes and/or melanin in the epidermis. A biopsy may be taken to determine an associated underlying skin condition.
4. Laboratory test for example: liver enzymes, Vitamin D levels, Zinc levels.

What is the treatment for leucoderma?

Here are some treatments or recommendations:

1. Sun protection
2. Cosmetic camouflage
3. Treatment of an associated or underlying cause
4. Complementary therapies: homeopathic, supplements, creams.
5. Surgery — melanocyte grafting.

What is the outcome for leucoderma?

Leucoderma may recover slowly if the cause can be avoided, such as cessation of a drug or chemical exposure, or treated such as inflammatory dermatoses. Leucoderma of the congenital patterned form or due to scarring is likely to be stable and persistent.