Autoimmune and cytotoxic hypotheses: Aberration of immune surveillance results in melanocyte dysfunction or destruction. The autoimmune theory proposes alteration in humoral and cellular immunity in the destruction of melanocytes of vitiligo. [9, 10, 11] This theory is of particular relevance given the fact that nonsegmental vitiligo is more frequently associated with autoimmune conditions than is segmental vitiligo. [12] Hence, making a diagnosis of nonsegmental vitiligo in a person with a family history of autoimmune disease may warrant a more thorough workup. For these reasons, certain disorders have been linked to vitiligo, such as: Hashimoto thyroiditis, Graves disease, Addison disease and diabetes mellitus, alopecia areata, pernicious anemia, inflammatory bowel disease, psoriasis, and autoimmune polyglandular syndrome. The most convincing evidence of an autoimmune pathogenesis is the presence of circulating antibodies against melanocyte proteins in patients with vitiligo. [13] In addition to humoral immune mechanisms, strong evidence indicates involvement of cellular immunity. Destruction of melanocytes may be directly mediated by autoreactive CD8 + T cells. Activated CD8 + T cells have been demonstrated in perilesional vitiligo skin. [10, 11] Follow us on social media Gauthier, Y. et al. in Vitiligo. Ch.1.1 (eds Picardo, M. & Taïeb, A.) 3–10 (Springer, 2010). Shop Shin, S., Shin, Y., Lee, H. & Oh, S. H. Spreading of pre-existing segmental vitiligo after immunotherapy with house dust mite in a patient with atopic dermatitits. Clin. Exp. Dermatol. (2014). Unfortunately, the spots grew more noticeable over the years. After further research and personal analysis, I learned that the disorder did have one consistent trait: symmetry. The imperfections mimicked one another on each half of my body. Elbows, knees, underarms, feet, inner thighs, wrists were now invaded with the abnormality. My olive skin was tarnished. The splotches were pure white and resembled kaleidoscopic images. They were delicate in appearance, popping up without warning or consent, choosing the specific place in which they would like to exist. Every night, I searched online for an explanation. I became a victim to the columns of questions with response boxes left unanswered. There wasn’t an explanation for my condition; there were suggested treatments — treatments like topical creams and PUVA laser. Medical sources encouraged me to stay out of the sun completely, ironic because I lived in the sunniest state in the country. As the blemishes grew more noticeable, I was more susceptible to telling white lies. People would ask constantly, “What is that on your elbow?” “You have something on your arm.” I would reply with “birthmark,” which made much more sense to me then than it does now. With every new confrontation, I crawled sheepishly back inside myself, losing a bit of my identity each time. Spritz, R. A. Modern vitiligo genetics sheds new light on an ancient disease. J. Dermatol. 40, 310–318 (2013). Depression 3.1 Classification Drugs & Supplements Vitiligo: Signs and symptoms Pediatric Dermatology Activate Subscription ADD/ADHD Rokos, H., Beazley, W. D. & Schallreuter, K. U. Oxidative stress in vitiligo: photo-oxidation of pterins produces H(2)O(2) and pterin-6-carboxylic acid. Biochem. Biophys. Res. Commun. 4, 805–811 (2002). Vitiligo is a skin condition that has been around for centuries and has been documented in various historical accounts A treatment that uses medicine plus ultraviolet A (UVA) light (PUVA) Midpotency topical corticosteroids may be used for the rest of the body on a daily basis and in a sequential discontinuous scheme (eg, 1 week treatment and 1 week off for 6 months) to prevent local side effects (ie, skin atrophy, telangiectasia, hypertrichosis, acneiform eruptions, and striae). The use of topical vitamin D derivatives should be in combination with topical steroids. Staying Healthy Tuelings, H.-E. et al. The antibody response against MART-1 differs in patients with melanoma-associated leucoderma and vitiligo. Pigment Cell Melanoma Res. 27, 1086–1096 (2014). 59. Copyright © 2010–2018, The Conversation US, Inc. Mohs AUC TTY: 301-565-2966 Epidemiology Reviewed by Cynthia Cobb, APRN Fat and Fats - What do you know about fat? WebMD Magazine Hair loss: Scientists test wearable regrowth device segmental vitiligo Credit: American Academy of Dermatology Rent or Buy Pay a Bill Learn about skin cancer Member directory Get newsletter Newsletter Vitiligo (Medical Encyclopedia) Also in Spanish Family history. Individuals with a family history of vitiligo are more likely to inherit the genetic factors that affect melanocyte function. Autoimmune disease. Autoimmune diseases occur when the body mistakenly attacks and destroys its own cells. Hyperthyroidism is one such condition that may launch an immune response against melanocytes. Drug Interaction Checker Access to compounded medications Vitiligo can be treated with topical creams, UV light treatment, or, in serious cases, surgery. Jump up ^ Don, Philip; Iuga, Aurel; Dacko, Anne; Hardick, Kathleen (2006). "Treatment of vitiligo with broadband ultraviolet B and vitamins". International Journal of Dermatology. 45 (1): 63–5. doi:10.1111/j.1365-4632.2005.02447.x. PMID 16426381. About the Journal Dry pomegranate leaves in shade and grind into fine powder. Sieve it and take 8 gms of it every morning and evening with fresh water. Existing treatments such as topical steroids and light therapy, which are used “off-label” because they have not been FDA-approved to treat vitiligo, can be effective for patients. These treatments reverse the disease by stimulating brown spots to appear around hair follicles within the affected white patches of skin. As these brown spots increase in number and size they merge until the white patch is replaced with normal skin color. Workup Have a mural you want to show off? Send your photo to, and we’ll add it to the gallery. MACRA Lose weight without dieting! Live better and be healthier with these quick nutritional tips from the experts. for Educators . Treatment of vitiligo with a topical application of pseudocatalase and calcium in combination with short-term UVB exposure: a case study on 33 patients. Dermatology. 1995;190(3):223–229pmid:7599386 Surgical Care Harris, J. E. et al. A mouse model of vitiligo with focused epidermal depigmentation requires IFN-gamma for autoreactive CD8(+) T-cell accumulation in the skin. J. Invest. Dermatol. 132, 1869–1876 (2012). Edit Your Comment (2000 Characters only) 110. After three months, Akter's face was almost completely free of white patches. About 75 percent of her neck, chest, forearms and shins were re-pigmented with color. Her hands had only minimal freckling. Mind The Foundation The Facts About Bunions Akdeniz N, Yavuz IH, Gunes Bilgili S, Ozaydın Yavuz G, Calka O. Comparison of efficacy of narrow band UVB therapies with UVB alone, in combination with calcipotriol, and with betamethasone and calcipotriol in vitiligo. J Dermatolog Treat. 2014 Jun. 25 (3):196-9. [Medline]. Psoralens Pregnancy 159. Vitiligo can be focal and localized to one area, or it may affect several different areas on the body. Linthorst Homan MW, Spuls PI, de Korte J et al. “The burden of vitiligo: patient characteristics associated with quality of life.” J Am Acad Dermatol 2009; 61: 411-20. The No-Diet Approach Although any part of your body may be affected by vitiligo, depigmentation usually first develops on sun-exposed areas of your skin, such as your hands, feet, arms, face and lips. Vitiligo generally appears in one of three patterns: 128. Ermis O, Alpsoy E, Cetin L, Yilmaz E. Is the efficacy of psoralen plus ultraviolet A therapy for vitiligo enhanced by concurrent topical calcipotriol? A placebo-controlled double-blind study. Br J Dermatol. 2001 Sep. 145 (3):472-5. [Medline]. Cochrane Scholarship Interaction Surgical Treatments Nature Reviews Disease Primers volume 1, Article number: 15011 (2015) | Download Citation Melanin is the pigment that gives the skin its characteristic color. Vitiligo is caused by a loss of pigment in the skin, due to destruction of pigment-forming cells known as melanocytes. Although vitiligo affects all races equally, it is more noticeable in dark-skinned people. Vitiligo can cause cosmetic problems. Health Conditions LIVE Prevention & Wellness Vitiligo can be treated with topical creams, UV light treatment, or, in serious cases, surgery. WebMD Harris, J. E. et al. A mouse model of vitiligo with focused epidermal depigmentation requires IFN-gamma for autoreactive CD8(+) T-cell accumulation in the skin. J. Invest. Dermatol. 132, 1869–1876 (2012). Advanced Search 150. This page was printed from: Tinea versicolor responds to either topical or oral forms of treatment. Topical antifungal creams, ointments, or shampoos - containing selenium sulfide, keteconazole, zinc-pyrithrone, imidazole, or other medications - applied directly to affected areas once or twice daily have proven effective. Thyroid profile: especially TSH (radioimmunoassay) Lipper GM. A Promising New Treatment for Vitiligo?. Medscape News & Perspective. Available at July 12, 2017; Accessed: July 25, 2017. 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