Vitiligo: Perbedaan antara revisi

{{Infobox medical condition|name=Vitiligo|synonym=|image=Vitiligo2.JPG|image_size=|alt=|caption=Non-segmental vitiligo of the hand|pronounce={{IPAc-en|ˌ|v|ɪ|t|ɪ|ˈ|l|aɪ|ɡ|oʊ|audio=LL-Q1860 (eng)-Vealhurl-vitiligo.wav}}|specialty=[[Dermatology]]|symptoms=Patches of [[depigmentation|white skin]]<ref name=Andrew2020>{{cite book |last1=James |first1=William D. |last2=Elston |first2=Dirk |last3=Treat |first3=James R. |last4=Rosenbach |first4=Misha A. |last5=Neuhaus |first5=Isaac |title=Andrews' Diseases of the Skin: Clinical Dermatology |date=2020 |publisher=Elsevier |location=Edinburgh |isbn=978-0-323-54753-6 |page=871-874 |edition=13th |chapter-url=https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |language=en |chapter=36. Disturbances of pigmentation |access-date=4 May 2023 |archive-date=2 July 2023 |archive-url=https://web.archive.org/web/20230702070605/https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |url-status=live }}</ref>|onset=Childhood, young adult<ref name=Andrew2020>{{cite book |last1=James |first1=William D. |last2=Elston |first2=Dirk |last3=Treat |first3=James R. |last4=Rosenbach |first4=Misha A. |last5=Neuhaus |first5=Isaac |title=Andrews' Diseases of the Skin: Clinical Dermatology |date=2020 |publisher=Elsevier |location=Edinburgh |isbn=978-0-323-54753-6 |page=871-874 |edition=13th |chapter-url=https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |language=en |chapter=36. Disturbances of pigmentation |access-date=4 May 2023 |archive-date=2 July 2023 |archive-url=https://web.archive.org/web/20230702070605/https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |url-status=live }}</ref>|duration=Long term<ref name=Andrew2020>{{cite book |last1=James |first1=William D. |last2=Elston |first2=Dirk |last3=Treat |first3=James R. |last4=Rosenbach |first4=Misha A. |last5=Neuhaus |first5=Isaac |title=Andrews' Diseases of the Skin: Clinical Dermatology |date=2020 |publisher=Elsevier |location=Edinburgh |isbn=978-0-323-54753-6 |page=871-874 |edition=13th |chapter-url=https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |language=en |chapter=36. Disturbances of pigmentation |access-date=4 May 2023 |archive-date=2 July 2023 |archive-url=https://web.archive.org/web/20230702070605/https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |url-status=live }}</ref>|causes=Unknown<ref name=Lancet2016>{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref>|risks=Family history, other [[autoimmune diseases]]<ref name=NIH2014>{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref>|diagnosis=[[Tissue biopsy]]<ref name=NIH2014>{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref>|differential=|prevention=|treatment=[[Sunscreen]], [[makeup]], topical [[corticosteroid]]s, [[phototherapy]]<ref name=Lancet2016>{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref><ref name=NIH2014>{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref>|medication=|prognosis=|frequency=1% of people<ref name=Wh2016>{{cite journal|last1=Whitton|first1=M|last2=Pinart|first2=M|last3=Batchelor|first3=JM|last4=Leonardi-Bee|first4=J|last5=Gonzalez|first5=U|last6=Jiyad|first6=Z|last7=Eleftheriadou|first7=V|last8=Ezzedine|first8=K|display-authors=3|title=Evidence-based management of vitiligo: summary of a Cochrane systematic review.|journal=The British Journal of Dermatology|date=May 2016|volume=174|issue=5|pages=962–69|pmid=26686510|doi=10.1111/bjd.14356}}</ref>|deaths=}}'''Vitiligo''' adalah kondisi [[kulit]] yang dimana terjadi menghilangnya warna asli kulit. <ref name="Andrew2020">{{Citecite book |last1=James |first1=William D. |last2=Elston |first2=Dirk |last3=Treat |first3=James R. |last4=Rosenbach |first4=Misha A. |last5=Neuhaus |first5=Isaac |title=Andrews' Diseases of the Skin: Clinical Dermatology |date=2020 |publisher=Elsevier |location=Edinburgh |isbn=978-0-323-54753-6 |page=871-874 |edition=13th |chapter-url=https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |language=en |chapter=36. Disturbances of pigmentation |access-date=4 May 2023 |archive-date=2 July 2023 |archive-url=https://web.archive.org/web/20230702070605/https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA871 |url-status=live |last=James|first=William D.}}</ref> Bagian kulit yang mengalami vitiligo terlihat berwarna putih dengan ujung-ujung tajam. <ref name="Lancet2016">{{Citecite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7|last=Ezzedine|first=K}}</ref> Kemudian penderita vitiligo bukan hanya mengalami warna asli dari kulit namun, juga bagian-bagian pada rambut berubah warna menjadi putih juga. <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> Tidak hanya bagian luar tubuh pada mulut dan hidung dibagian dalam juga bisa terkena. <ref name="NIH2014">{{Citecite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|access-date=11 August 2016|archive-urlarchiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archive-datearchivedate=21 August 2016|df=dmy-all}}</ref> Umumnya bagian tubuh akan terkena luar dan dalam. <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> Tanda-tanda bercak putih biasanya akan dimulai di area kulit yang sering terpapar sinar matahari. <ref name="NIH2014">{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref> Vitiligo akan nampak terlihat jelas pada orang dengan kulit lebih gelap. <ref name="NIH2014">{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref> Penderita vitiligo bisa menyebabkan [[stres psikologis]] dan mereka bisa saja mendapatkan [[stigma sosial]] . <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref>

Vitiligo belum diketahui secara pasti penyebanya. <ref name="Lancet2016">{{Cite journal|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7|last=Ezzedine|first=K}}</ref> Hal ini dipercaya disebabkan kerentanan genetik yang dipicu oleh faktor lingkungan sehingga menjadi [[penyakit autoimun]] . <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> <ref name="NIH2014">{{Cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|date=June 2014|url-status=live|access-date=11 August 2016|archive-url=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archive-date=21 August 2016}}</ref> Vitiligo menyebabkan rusaknya [[melanosit]] pada tubuh. <ref name="NIH2014">{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref> Beberapa faktor risiko lainnya yang bisa menyebabkan vitiligo antara lain seperti riwayat keluarga dengan kondisi vitiligo juga ataupun penyakit autoimun lainnya, seperti [[hipertiroidisme]], [[alopesi]], dan [[anemia pernisiosa]] . <ref name="NIH2014">{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref> Vitiligo bukan termasuk penyakit yang [[Penyakit menular|menular]] . <ref>{{Cite book|last=Chopra|first=Parul|last2=Niyogi|first2=Rageshree|last3=Katyal|first3=Gauri|date=2009|url=https://books.google.ca/books?id=UtxySGP6kQsC&pg=PA2|title=Skin and Hair Care: Your Questions Answered|publisher=Byword Books Private Limited|isbn=978-8181930378|page=2|archive-url=https://web.archive.org/web/20170323235431/https://books.google.ca/books?id=UtxySGP6kQsC&pg=PA2|archive-date=23 March 2017|url-status=live|df=dmy-all}}</ref> Vitiligo dapat diklasifikasikan menjadi dua jenis yakni segmental dan non-segmental. <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> Kejadian vitiligo seringnya bersifat non-segmental, yang artinya mempengaruhi kedua sisi badan; dan juga seiringnya waktu area yang terkena akan meluas. <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> Kemudian ada 10% kejadian vitiligo yang bersifat segmental, artinya sebagian besar melibatkan satu sisi tubuh; dan dalam kasus ini, area kulit yang terkena tidak meluas seiring berjalannya waktu. <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> Untuk mendiagnosis bisa dipastikan dengan metode [[Biopsi|biopsi jaringan]] . <ref name="NIH2014">{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref>

Vitiligo tidak memiliki obat untuk mengatasinya . <ref name="Lancet2016">{{Cite journal|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7|last=Ezzedine|first=K}}</ref> Untuk penderita yang memiliki [[Warna kulit terang|kulit cerah]], biasanya direkomendasikan untuk [[Tabir surya|menggunakan tabir surya]] dan [[Kosmetik|riasan]] . <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> Alternatif pengobatan untuk vitiligo yakni pemberian krim [[Glukokortikoid|steroid]] atau tindakan seperti [[fototerapi]] untuk menggelapkan bercak-bercak yang terang pada kulit. <ref name="NIH2014">{{Cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|date=June 2014|url-status=live|access-date=11 August 2016|archive-url=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archive-date=21 August 2016}}</ref> Alternatif lainnya, usaha untuk mencerahkan kulit yang tidak terkena vitiligo, bisa menggunakan [[Hidrokuinona|hidrokuinon]]. <ref name="NIH2014">{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref> Beberapa tindakan seperti pembedahan bisa menjadi terapi bagi penderita yang tidak membaik dengan terapi alternatif lainnya. <ref name="NIH2014">{{cite web|title=Questions and Answers about Vitiligo|url=http://www.niams.nih.gov/health_info/Vitiligo/default.asp|website=NIAMS|accessdate=11 August 2016|date=June 2014|url-status=live|archiveurl=https://web.archive.org/web/20160821083604/http://niams.nih.gov/health_info/Vitiligo/default.asp|archivedate=21 August 2016|df=dmy-all}}</ref> Pengkombinasian terapi biasanya akan memberikan hasil yang lebih baik. <ref name="Wh2016">{{Citecite journal|last1=Whitton|first1=M|last2=Pinart|first2=M|last3=Batchelor|first3=JM|last4=Leonardi-Bee|first4=J|last5=Gonzalez|first5=U|last6=Jiyad|first6=Z|last7=Eleftheriadou|first7=V|last8=Ezzedine|first8=K|display-authors=3|title=Evidence-based management of vitiligo: summary of a Cochrane systematic review.|journal=The British Journal of Dermatology|date=May 2016|volume=174|issue=5|pages=962–69|pmid=26686510|doi=10.1111/bjd.14356|last=Whitton|first=M|displayauthors=3}}</ref> Pemberian konseling untuk penderita bisa memberikan dukungan emosional yang membantu. <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref>

Penderita vitiligo secara global diperkirakan ada 1%. <ref name="Wh2016">{{Cite journal|last2=Pinart|first2=M|last3=Batchelor|first3=JM|last4=Leonardi-Bee|first4=J|last5=Gonzalez|first5=U|last6=Jiyad|first6=Z|last7=Eleftheriadou|first7=V|last8=Ezzedine|first8=K|title=Evidence-based management of vitiligo: summary of a Cochrane systematic review.|journal=The British Journal of Dermatology|date=May 2016|volume=174|issue=5|pages=962–69|pmid=26686510|doi=10.1111/bjd.14356|last=Whitton|first=M|displayauthors=3}}</ref> Dalam beberapa populasi, kejadiannya diperkirakan sekitar 2% hingga 3%. <ref>{{Cite journal|last=Krüger C|last2=Schallreuter KU|date=October 2012|title=A review of the worldwide prevalence of vitiligo in children/adolescents and adults|journal=Int J Dermatol|volume=51|issue=10|pages=1206–12|arxiv=0706.4406|doi=10.1111/j.1365-4632.2011.05377.x|pmid=22458952}}</ref> Pria dan wanita bisa terkena dampaknya dalam artian kejadiannya sebanding. <ref name="Lancet2016">{{Cite journal|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7|last=Ezzedine|first=K}}</ref> Vitiligo bisa muncul pada usia sebelum 20 tahun dan sisanya akan mengalami sebelum usia 40 tahun <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref> Vitiligo sudah ada sejak dahulu kala, dan sudah tercatat di [[sejarah kuno]]. <ref name="Lancet2016">{{cite journal|last1=Ezzedine|first1=K|last2=Eleftheriadou|first2=V|last3=Whitton|first3=M|last4=van Geel|first4=N|title=Vitiligo.|journal=Lancet|date=4 July 2015|volume=386|issue=9988|pages=74–84|pmid=25596811|doi=10.1016/s0140-6736(14)60763-7}}</ref>