White spots on the neck

The neck is a very sensitive part of the human body. There are many diseases related to the neck. Once any abnormality occurs in this area, it must be taken seriously. Some people have white spots on their necks. This phenomenon requires special attention because it is a skin disease called vitiligo, which is very harmful and difficult to treat. Once diagnosed, it must be controlled in the early stages to avoid spreading to other parts of the body.

White spots on the neck may be vitiligo. Vitiligo is a common acquired localized or generalized skin depigmentation disease. It is caused by the disappearance of melanocyte function in the skin, but the mechanism is still unclear. It can occur in any part of the body, most commonly on the back of the fingers, wrists, forearms, face, neck, and around the genitals. It can also occur in the female vulva, mostly in young women.

Clinical manifestations

There is no significant difference in gender, and the disease can occur in all age groups, but it is more common in adolescents. The skin lesions are depigmented spots, which are often milky white but can also be light pink, with a smooth surface and no rash. The boundaries of the white spots are clear, the pigmentation of the edges is increased compared to normal skin, and the hair inside the white spots is normal or whitened. The lesions often occur in areas exposed to sunlight and damaged by friction, and are often distributed symmetrically. White spots are often distributed according to nerve segments and arranged in bands. In addition to skin lesions, the mucous membranes of the lips, labia, glans penis and inner foreskin are also often affected.

Most patients have no subjective symptoms, and a small number of patients experience local itching in the affected area before or during the onset of the disease. Vitiligo is often accompanied by other autoimmune diseases, such as diabetes, thyroid disease, adrenal insufficiency, scleroderma, atopic dermatitis, alopecia areata, etc. The specific classification is as follows:

1. Limited type

(1) Focal type: one or more white spots are confined to one area but not distributed segmentally;

(2) Unilateral type (segmental type): One or more white spots are distributed segmentally and suddenly disappear at the midline;

(3) Mucosal type affects only the mucosa.

2. Scattered

(1) Common type with widespread and scattered white spots;

(2) Facial acrofacial type distributed on the face and limbs;

(3) Mixed distribution: segmental, facial acral and/or common types.

3. Generalized

Complete or almost complete loss of pigmentation.

More than 90% of vitiligo is of the scattered type, and among the remaining vitiligo, localized vitiligo is more common than generalized vitiligo.

According to the degree of pigment loss in the lesions, the disease can be divided into complete and incomplete types. The former has a negative reaction to dihydroxyphenylalanine (DOPA), melanocytes disappear, and the treatment response is poor. The latter reacts positively to DOPA, and the melanocytes do not disappear but only decrease in number, so the chance of cure is high.