Wednesday, December 19, 2007
Story of the Day-Disease Turning Black TV Anchor White
Vitiligo (pronounced /ˈvɪdlˈaɪgoʊ/) or leukoderma is a chronic skin condition that causes loss of pigment, resulting in irregular pale patches of skin. The precise cause of vitiligo is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic, and environmental factors. The population incidence worldwide is considered to be between 1% and 2% (0.74% in the United States).
According to Diseases Database: "A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached."
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Frequently Asked Questions About Vitiligo
`I was still brown on the inside'
WHAT if you were born into one race and found that because of a medical condition your skin colour changed and identified you with another?
That is one of the questions tackled dramatically by Manchester writer and performer, Rani Moorthy in her new one woman show, Shades of Brown.
The play, at The Library theatre this week, examines issues of skin colour seen through the eyes of three women, one of whom has the skin condition vitiligo.
The story was inspired by the real life experience of Sarojini Ariyanayagam, who began to lose her skin pigmentation due to vitiligo at the age of 12.
Now living in the US, Sarojini, who founded the Vitiligo Society, travelled the world for a cure to no avail. Eventually there was so little of her original colouring left she underwent a de-pigmentation treatment to make her completely white and virtually unrecognisable from the person she once was.
"I was struck by the idea that a Tamil woman, who lived in Britain, who was as brown as I was, could suddenly lose that colour. There came a point where she couldn't camouflage anymore. She realised she couldn't continue being a patch and in order to be whole she had to live as a white person," says Rani.
"It's being brown on the inside and white on the outside. It's very different to other skin disorders. There's no sense of a disease the way we associate with an illness. But what gets eroded is your sense of identity.
"My character is an Asian scientist - but when the science doesn't really help she's just got to deal with what's left. It's very emotional but I don't present her as a victim. She's courageous, she's got to make a decision that perhaps no-one in the audience has had to - what tribe she belongs to?"
Michael Jackson is the most famous sufferer of vitiligo. His extensive plastic surgery has left some sceptical about his condition and he's faced much criticism for rejection of his black identity because of his lightened skin colour. However, Jackson insists the lightening of his skin is due to vitiligo.
Both Jackson's and Sarojini's cases are extreme. However, to much lesser degrees the condition is fairly common, affecting about one in 100 people.
Dr Paul Griffiths, dermatologist at Octopus Health in Manchester city centre, explains: "You can get it on the whole of your skin, but that's not common.
"It's completely unpredictable, but if it's a small area that's been that way for some time then it's probably reasonable to presume that it's not going to develop dramatically."
Vitiligo isn't infectious and doesn't cause symptoms such as an itching or pain associated with other skin conditions. There is no effect on general health, although someone with vitiligo has to take extra care in the sun. Sunscreen of at least factor 20 is needed on the affected areas because the melanocyte cells, which produce melanin (skin pigment), are not active in these patches and don't provide any natural protection from the sun.
It's not clear what causes vitiligo although it is believed to have a genetic link. It is also thought to be an auto-immune condition, because it's sometimes linked to diabetes, thyroid disease and alopecia.
"There are probably many people with vitiligo who never visit their doctor," says Dr Griffiths. "But you should let a professional have a look at it because there are other medical reasons for loss of pigment. Using a special light we can see areas that aren't pigmented to make it easier to show the extent of the problem. The patient might also need to have some blood tests taken, just to make sure they haven't got any of the other auto-immune conditions sometimes associated with vitiligo such as diabetes and thyroid disease."
Treatments to restore pigmentation have variable success. The traditional treatment is steroid cream, which works in about 10-15 per cent of cases.
Tacrolimus, a cream recently licensed for eczema, is showing clinical evidence that it also helps with vitiligo but is not licensed for this yet.
"It's not easy to treat," Dr Griffiths adds. "It's more common on face, hands and feet, so sometimes you don't need to have the treatment all over.
"PUVA - involves taking a tablet that makes your skin sensitive to ultraviolet light. You then go into an ultraviolet light cabinet at the hospital a couple of times a week for the course of the treatment. This will improve maybe 50% of people.
"If the problem doesn't get better then you can either de-pigment the normal skin that's left or use a camouflage service run by the British Red Cross, which has a range of medical preparations to match to a person's skin type and hide the vitiligo."
'Nobody knows what causes it'
VITILIGO, although more noticeable on more highly pigmented skins, affects men and women of all races.
Jane Murphy, 38 from Chorlton, first noticed changes on her knees when she was 11, but it was another 14 years before she received a diagnosis of vitiligo.
"It was just a couple of small patches that didn't go brown when I tanned. I didn't really know what it was - most people with vitiligo don't."
Jane first visited a doctor about the complaint 10 years later when it began to spread to her face and other areas of her body but it was another four years before she finally got a diagnosis.
"It took ages to get a name put to it. Nobody really knows what causes it even now - it's all a bit of a mystery really."
Jane doesn't have any associated auto-immune conditions, although there are genetic links. Her mum developed vitiligo when she was pregnant which later cleared during the menopause. Her granddad also had vitiligo.
"There doesn't seem to be anything that definitely helps," Jane adds. "I was sent to the Red Cross camouflage service and they were really helpful.
"If I don't wear make-up on my face then I'm quite conscious of it, but it doesn't really bother me.
"I suppose I'm fortunate in that I'm quite pale skinned anyway.
"Some people ask me what it is, but you've just got to get things in perspective.
"I avoid getting a tan. I should really wear sun block all year round. If I don't, I regret it because I just look very odd - there is absolutely no protection and I go bright red in patches."
Disease Turning Black TV Anchor White
Lee Thomas' skin is betraying him.
His once brown, even complexion is now mottled with pale patches around his eyes and mouth, along his nose and on his ears; his arms, shoulders and chest are speckled and blotched.
"I'm a black man turning white on television and people can see it," says Thomas, an anchor and entertainment reporter for the local Fox Broadcasting Company affiliate. "If you've watched me over the years, you've seen my hands completely change from brown to white."
Thomas has vitiligo, a disorder in which pigment-making cells are destroyed. White patches appear on different parts of the body, tissues in the mouth and nose, and the retina.
"There is no cause. There is no cure, and it's very random," Thomas says. "I could turn all the way white or mostly white."
As many as 65 million people worldwide have the disorder, including up to 2 million in the United States.
Few people, outside medical professionals and those with the disease, had heard the term "vitiligo" until Michael Jackson revealed in the early 1990s that the disorder was behind his skin turning brown to white.
It's not fatal, but experts say vitiligo robs people of self-confidence, evokes ridicule and unpleasant stares, and pushes some into unforced seclusion.
The 40-year-old Thomas says that's not where the disorder needs to be. He openly talks about vitiligo and how it has affected his life and career, and has written a book about his journey titled "Turning White: A Memoir of Change." Along the way, Thomas says he's met others with the disorder and has become a celebrity spokesman for the Columbus, Ohio-based National Vitiligo Foundation.
Vitiligo attacks the soul and psyche, foundation executive director Robert Haas says.
"When was the last time you saw someone with vitiligo handling your food? It is the public's image that it is some leprosy-type of disease," he says. "A lot of folks feel this disease has trapped them and kept them away from their life goals."
That was Thomas' fear.
He uses a combination of creams and makeup to cover the growing patches of skin — which he calls devoid of color — on his face, hands and arms. Viewers, co-workers and, for years, his basketball buddies, were none the wiser.
Only family members and those closest to him knew the secret he had kept since age 25.
Thomas first noticed a change after getting a haircut while working in Louisville, Ky. He looked in a mirror and thought the barber had nicked him. A closer look revealed a pale spot, about the size of a quarter.
"I got two more on the other side of my scalp, on my hand and one in the corner of my mouth," he recalls in an interview from the station's studio. "That's when I went to the doctor and got diagnosed."
He didn't let it slow down his blossoming career. From Louisville, he soon landed at WABC in New York for three years beginning in 1994. After a short freelancing stint in Los Angeles, Thomas found his way to WJBK in Detroit in 1997. He has carved a niche in the Motor City market with his quirky, upbeat and humorous reporting style; his confidence, constant smile and positive air on the set mirrors his demeanor off the set as well.
Even though Thomas uses makeup to conceal his skin discoloration, he realized the vitiligo was becoming more obvious when he couldn't hide it from a preschooler during a story about a playground. His two-toned hands frightened the girl, who began to cry.
"I thought my career was over," says the Emmy award winner who routinely travels to Hollywood for one-on-one interviews with celebrities including Will Smith, Tom Cruise and Halle Berry.
So he gathered himself one day and approached the station's news director, prepared to walk away from television.
"She said, 'Let's just see what happens,'" Thomas recalls. "As it got worse, she kept encouraging me to tell my story."
Dana Hahn, WJBK's vice president of news, says the station was concerned about Thomas possibly leaving because of the condition.
"Lee is also a friend and we wanted to help," she says. "He had covered it up so well, we really didn't realize the impact it was having or how far it had spread."
Thomas finally agreed to tell his story on television in November 2005.
After the first segment on Thomas' vitiligo aired, Hahn says he took a leave of absence and missed the initial response from viewers.
"I received 40 to 50 e-mails a day the entire time he was gone," Hahn says. "So many people found support and encouragement in his story. I've never seen the kind of response to any story in my 12 years at Fox 2."
At the time, Thomas was already writing his book.
"As all those things happened, the tone of the book changed," he says. "I was writing for all those people who were afraid to come outside."
Dr. Sancy Leachman, associate professor of dermatology at the University of Utah, calls vitiligo stigmatizing, driving some to even consider suicide.
"They feel people are looking at them all of the time," she says. "They are very self-conscious about people staring at them in the grocery line. It can be a very demoralizing condition."
Thomas acknowledges he even preferred the security of solitude to the awkward stares of strangers when not wearing his makeup.
"There were times when I would not come out of the house," he says. "I call it a mental war. It was me saying, 'I don't want to deal with it today.' I never stayed in for very long. I know people who stay in now for months at a time."
When he's out socially now, Thomas forgoes the makeup he wears on camera.
He met his girlfriend of seven months, Karen Tate, at a vegetarian restaurant they both enjoy. She said when they're out together, she notices some people staring and making muffled comments about his appearance.
"He doesn't say anything," Tate, 28, says. "It doesn't really bother me. Some people are just rude."
She says she sees past what some people can't. "He just has a very free spirit. He is just a very nice guy. He opens up completely in his book. It is something he really wanted to do."
Surprisingly, Thomas gives vitiligo some credit.
"Having this disease forces me to focus on what I am: kind, caring, honest," he says. "There are people who have diseases that will kill them."
The Michael Jackson Syndrome: Vitiligo -1993