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Vitiligo

Vitiligo is an autoimmune skin disorder where melanocytes, the cells responsible for skin pigmentation, are destroyed. This results in patches of unpigmented skin. It affects 1-2% of the population and has a genetic link. There is no single cure and treatments can be long and difficult, rarely resulting in 100% repigmentation. Vitiligo occurs when the immune system attacks and destroys melanocytes due to cellular proteins unique to melanocytes. Some potential causes include other autoimmune diseases and genetic factors. Treatments include corticosteroids, ultraviolet light, and skin grafting, but results are often incomplete with pigmentation returning only in some areas.

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VITILIGO April 26th, 1999 Chemistry 412 Rick Helgemo
What is vitiligo? Autoimmune disorder Genetic link Affects 1-2% of population Difficult to cure Harmful effects
“Untreated” Vitiligo
Autoimmune disorder Melanocytes destroyed *Melanocyte-specific differentiation antigens *Tyrosinase, Dopachrome isomerase (TRP-2), gp100, MART-1 Immunoglobulin G recognizes TRP-2, causing immune response Possible link to curing melanoma?
Genetic Links Two types-Segmental and nonsegmental Polygenic nature, multifactorial inheritance Autosomal and not linked to race or sex Linked to other autoimmune diseases Weakly heritable
Curing Vitiligo Effects Long and difficult process, rarely 100% effective on individual Always involves sunlight or ultraviolet light Physical and chemical methods Cosmetics Depigmentation Psychological counseling
Chemical Treatment Options for Vitiligo Corticoids Psoralens (PUVA) Phenylalanine P-aminobenzoic acid (PABA) Cantharidin, a blister beetle secretion
Physical Treatment Options for Vitiligo Tattooing (micropigmentation) Autologous skin grafts Skin grafting using blisters Autologous melanocyte transplantation Combination of Sun and Sunscreen
References: §“Anti-tyrosinase-related protein-2 immune response in vitiligo patients…;” Okamoto T, Irie RF, Fujii S, etal.; The Journal of Investigative Dermatology; Dec 1998; 111:1034-1039. §“Autoantibodies to Tyrosinase-related protein-1 detected in the sera… ;” Kemp EH, Waterman EA, Gawkrodger DJ, et al.; British Journal of Dermatology 1998; 139:798-805. §“A systematic review of autologous transplantation methods in vitiligo;” Njoo MD,Westerhof W, Bos JD, Bossuyt PMM; Archives of Dermatology, Dec 1998 134:1543-1549. §“The genetics of vitiligo in Korean patients;” Kim SM, Chung HS, Hann SK; International Journal of Dermatology 1998; 38:908-910. §“On the association between vitiligo and malignant melanoma;” Lindelof B, Hedblad MA, Sigurgeirsson B; Acta Dermatologica Venereologica; 1998 78:483-484. §“Tyrosinase as an autoantigen in patients with vitiligo;” Baharav E, Merimsky O, Shoenfeld Y, et al.; Clinical Experimental Immunology; 1996 105:84-88. §“Nonsurgical repigmentation therapies in vitiligo;” Njoo MD,Westerhof W, Bos JD, Bossuyt PMM; Archives of Dermatology; Dec 1998 134:1532-1540. §“Spontaneous repigmentation of vitiligo patches distant from the autologous skin…;” Malakar S, Dhar S; Dermatology; 1998 197:274.
More References §“Treatment of vitiligo with oral and topical phenylalanine: 6 years of experience;” Camacho F, Mazuecos J; Archives of Dermatology; Feb 1999 135:216-217. §“UV-dependent melanocyte plasticity-The structure-function relationship;” Iyengar B; Indian Journal of Pathological Microbiology; 1996 39(2):105-109. §“Topical application of a melanotropin analogue to vulgar vitiligo dermo-epidermal minigrafts;” Schwartzmann-Solon AM, Visconti MA, Castrucci AML; Brazilian Journal of Medical and Biological Research; 1998 31:1557-1564. §“Repigmentation of vitiligo lesion after beetle dermatitis;” Parsad D, Saini R, Nagpal R; Dermatology; 1998 197:398.