Universal vitiligo is an uncommon type of vitiligo in which more than 80% of the skin is covered in white, milky lesions. It is characterized by the wide distribution of the vitiligo patches throughout the body with only isolated islands of normal pigmentation remaining.
Universal vitiligo ultimately leads to complete depigmentation of the skin, mucosa, and hair. Since this kind of vitiligo represents the high end of the spectrum in general vitiligo. This is represented by a high prevalence of comorbidity.
While it’s a little easier for people with this kind of vitiligo to deal with the condition compared to those living with aggressive nonsegmental vitiligo, it’s a bit of a struggle having to deal with the racial dynamics of turning white.
Quality of Life in People with Universal Vitiligo
So far, studies about health-related quality of life (HRQOL) in patients with universal vitiligo have been conducted with a limited sample size. However, as per a study (with the sample size of 29) conducted by the Netherlands Institute for Pigment Disorders (NIPD), patients with vitiligo of universal nature reported considerably more comorbidities (the presence of one or more additional conditions) than the patients with general vitiligo. The most frequently comorbidities mentioned in the studies were Thyroid Dysfunction, Diabetes Mellitus, Rheumatoid Arthritis and Alopecia areata.
As per this study, people with universal vitiligo seem to experience 15% Rheumatoid Arthritis (RA) compared to patients with general vitiligo that experience 3% RA. Additionally, Alopecia areata was reported in 4 patients with universal vitiligo, but none of the patients with general vitiligo had Alopecia areata. Statistically, noteworthy differences were also seen in physical HRQOL between two groups of patients with a poorer outcome in patients with universal vitiligo.
Depigmentation Therapy for People with Universal Vitiligo
At times, people with universal vitiligo have one or more pigmented patches that remain pigmented, most frequently over the malar area of the face and dorsal areas of forearms. Since total repigmentation may not occur even after receiving 150 sessions of PUVA therapy alone, these patients are naturally more interested in depigmentation therapy to achieve uniform skin tone.
Removal of the residual pigmented patches can be attempted in patients with universal vitiligo with 1-3 sessions of cryotherapy (with 4-6-week intervals), using a closed contact CO2 cryogun.