If the vitiligo is only affecting a small area of the body, it may be called focal vitiligo, but I find this usually spreads and evolves into another form pretty quickly. If affecting mostly the lips and fingertips, it’s called lip-tip vitiligo. This is really common, since vitiligo most frequently affects the face and/or hands (over 80% of those with vitiligo).
If it involves the lips or other parts of the face plus the hands and/or feet, it’s called acrofacial vitiligo (“acral” means hands and feet). Sometimes the spots are found only on mucosal parts of the body (like the lips, inner nose, or genital areas), and so the pattern is called mucosal vitiligo. If a spot is found near the center of the body, it will grow across the middle and involve the other side as well. So, if there is a spot on one side of the face, there is often a matching spot on the other side.
Usually vitiligo manifests as multiple spots on the skin that are found on both sides of the body, most commonly in a symmetric pattern. But then again, I’m a lumper, rather than a splitter, and maybe that’s why I feel the way I do. EXCEPT for segmental vitiligo (again, explained below). I think it’s much easier to simply call vitiligo “vitiligo”, and then tell the patient that hairless areas don’t respond very well to treatment. But I find that the forms don’t neatly fall into one of the clear designations, and I find it difficult to pick one. So, some doctors like to label the types because they know which ones have a better or worse prognosis with treatment based on their distribution in these areas.
If your pattern of vitiligo predominantly involves these areas (such as vitiligo on the lips and fingertips, for example), then it is more difficult to treat. Hairless areas on the body in most people include the lips, fingertips, knuckles, underside of the wrists, feet, and parts of the genital areas. It’s important to note that areas of the body without hair do not respond well to most medical treatments. That’s because all of the other forms are generally treated the same way and have a similar prognosis. I personally don’t think it’s THAT important to label the exact type of vitiligo that a patient has, except for segmental vitiligo, which I’ll describe below. It’s one of the things that makes my job a whole lot of fun! Since I have seen many patients over many thousands of visits in my Vitiligo Clinic, I have seen a LOT of patterns, but I still see new ones all the time. One woman outlined all of her spots with a pen, which I thought was really cool and I included her picture in my blog about vitiligo and tattoos here (with her permission, of course). It is most frequent on the face and genitals, then the hands and feet, and then the rest of the body. Vitiligo can appear on any part of the body, in many different shapes and forms. I have always thought that vitiligo was beautiful, including the many patterns that form on individuals with different skin colors, shades, and hues.