/ˌvɪtContents[hide] |
[edit]Signs and symptoms
The most notable symptom of vitiligo is depigmentation of patches of skin that occurs on the extremities.[3][4] Although patches are initially small, they often enlarge and change shape.[1][3] When skin lesions occur, they are most prominent on the face, hands and wrists.[3][4] Depigmentation is particularly noticeable around body orifices, such as the mouth, eyes, nostrils, genitalia and umbilicus.[3][4] Some lesions have hyperpigmentation around the edges.[5] Patients who are stigmatised for their condition may experience depression and similar mood disorders.[6]
[edit]Non-segmental
In non-segmental vitiligo (NSV), there is usually some form of symmetry in the location of the patches of depigmentation. New patches also appear over time and can be generalized over large portions of the body or localized to a particular area. Vitiligo where little pigmented skin remains is referred to as vitiligo universalis. NSV can come about at any age, unlike segmental vitiligo,which is far more prevalent in teenage years.[5]
Classes of non-segmental Vitiligo include:
- Generalized Vitiligo: the most common pattern, wide and randomly distributed areas of depigmentation[7]
- Universal Vitiligo: depigmentation encompasses most of the body[7]
- Focal Vitiligo: one or a few scattered macules in one area, most common in children[7]
- Acrofacial Vitiligo: fingers and periorificial areas[7]
- Mucosal Vitiligo: depigmentation of only the mucous membranes[7]
[edit]Segmental
Segmental vitiligo (SV) differs in appearance, etiology and prevalence from associated illnesses. Its treatment is different from that of NSV. It tends to affect areas of skin that are associated with dorsal roots from the spine. It spreads much more rapidly than NSV and, without treatment, it is much more stable/ static in course and not associated with auto-immune diseases and a very treatable condition that responds to topical treatment.[5]
[edit]Differential diagnosis
Conditions with similar symptoms include:
- Pityriasis alba
- Tuberceloid Leprosy
- Post inflammatory hypopigmentation
- Tinea versicolor[7]
- Albinism
- piebaldism[7]
- idiopathic guttate hypomelanosis[7]
- progressive macular hypomelanosis[7]
[edit]Pathogenesis
Vitiligo is a disorder characterized by patchy loss of skin pigmentation due to immune attacks on melanocytes, while, there is no significant proof or evidence for this, many doctors believe that[8] it can be caused by defects in many genes. Variations in genes that are part of the immune system or part of melanocytes have both been associated with vitiligo. The immune system genes are associated with other autoimmune disorders.
In one case, the gene TYR, which makes the melanocyte more susceptible to the immune system in vitiligo, also makes the melanocyte more susceptible to the immune system in the skin cancer malignant melanoma. So people with vitiligo caused by the TYR gene are less likely to have malignant melanoma.
A genomewide association study found 10 independent susceptibility loci for generalized vitiligo, responsible for 7.4% of the genetic risk. Some patients had vitiligo alone; others had generalized vitiligo with other autoimmune diseases. Most loci were associated with both forms. (The exception was PTPN22, which was only associated with generalized vitiligo.) In the MHC region, which controls the immune system, major association signals were identified in the class I gene region (between HLA-A and HLA-HGC9) and class II gene region (between HLA-DRB1 and HLA-DQA1). Outside the MHC region, association signals were identified near RERE, PTPN22, LPP, IL2RA, GZMB, UBASH3A and C1QTNF6 genes, which are associated with other autoimmune diseases. TYR encodes tyrosinase, which is not a component of the immune system, but is an enzyme of the melanocyte that catalyzes melanin biosynthesis, and a major autoantigen in generalized vitiligo. The major alleles of TYR are associated with vitiligo, and the minor alleles are associated with malignant melanoma. Vitiligo-associated 402R tyrosinase may be more efficiently presented to the immune system. Melanoma-associated 402Q may fail to be identified by the immune system.[9]
The transcriptional profile of melanocytes from vitiligo patients have been studied. Oligonucleotide microarrays containing approximately 16,000 unique genes were used to analyse mRNA expression in melanocytes from vitiligo patients and age-matched healthy controls. In total, 859 genes were identified as differentially expressed.[10]
Vitiligo is sometimes associated with autoimmune and inflammatory diseases,[11] commonly thyroid overexpression and underexpression. A study comparing 656 people with and without vitiligo in 114 families found several mutations (single-nucleotide polymorphisms) in the NALP1 gene.The NALP1 gene, which is on chromosome 17 located at 17p13, is on a cascade that regulates inflammation and cell death, including myeloid and lymphoid cells, which are white cells that are part of the immune response. NALP1 is expressed at high levels inT cells and Langerhan cells, white blood cells that are involved in skin autoimmunity. Polymorphisms of CD4 were shown to be associated with the vitiligo and other autoimmune diseases like type I Diabetes Mellitus.[12]
Among the inflammatory products of NALP1 are caspase 1 and caspase 5, which activate the inflammatory cytokine interleukin-1β. Interleukin-1β is expressed at high levels in patients with vitiligo. There are compounds which inhibit caspase and interleukin-1β, and so might be useful drugs for vitiligo and associated autoimmune diseases. In one of the mutations, the amino acid leucine in the NALP1 protein was replaced by histidine (Leu155->His). The original protein and sequence is highly conserved in evolution, and found in humans, chimpanzee, rhesus monkey, and bush baby, which means that it is an important protein and an alteration is likely to be harmful. Addison's disease (typically an autoimmune destruction of the adrenal glands) may cause vitiligo.[13][14]
[edit]Treatment
There is no cure for vitiligo, but there are a number of treatments that improve the condition. In fair-skinned people, avoiding tanning of normal skin can make patches of vitiligo much less noticeable. Treatment options generally fall into four groups:[15]
[edit]Sunblock
A high protection sun-block (factor 20 or above) is applied to areas of vitiligo to prevent sunburn. Affected areas of skin are protected when the sun is strong, especially in the middle of the day by wearing, for example, a wide brimmed hat and long sleeved clothing.[15]
[edit]Skin camouflage
In mild cases, vitiligo patches can be hidden with makeup or other cosmetic camouflage solutions. If the affected person is pale-skinned, the patches can be made less visible by avoidingsunlight and sun tanning of unaffected skin.[7]
[edit]Reversal
The traditional treatment used by dermatologists is the application of corticosteroid cream.[16]
Studies have shown that immunomodulator creams such as Protopic and Elidel also cause repigmentation in some cases, when used with UVB narrowband treatments.[17][18]
A 1997 report[19] suggests that combining Vitamin B12 and folic acid supplements with sun exposure caused repigmentation in 52% of cases.
In October 1993, a scientific report was published of successfully transplanting melanocytes to vitiligo affected areas, effectively repigmenting the region.[20] The procedure involved taking a thin layer of pigmented skin from the patient's gluteal region. Melanocytes were then separated out to a cellular suspension that was expanded in culture. The area to be treated was then denuded with a dermabrader and the melanocytes graft applied. Between 70 and 85 percent of patients experienced nearly complete repigmentation of their skin. The longevity of the repigmentation differed from person to person.[21]
Ultraviolet light (UVA) treatments are normally carried out in a hospital clinic. Psoralen and Ultraviolet A light (PUVA) treatment involves taking a drug which makes the skin very sensitive to light. The skin is then exposed to ultraviolet A light (UVA). Treatment is required twice a week for 6–12 months or longer. PUVA may cause side effects such as 'sunburn' type reactions or skin freckling.[15] Narrowband ultraviolet B (UVB) phototherapy is now used more commonly than PUVA as it is less damaging to the skin. As with PUVA, treatment is carried out twice weekly but there is no requirement to pre-sensitise the skin and the treatment sessions are much shorter.[15]
A few preliminary trials have been carried out using the herb gingko biloba. A small scale open label pilot clinical trial found the progression of vitiligo stopped in all participants; the total VASI (Vitiligo Area Scoring Index) indicated an average repigmentation of vitiligo lesions of 15%. The authors conclude "Larger, randomized double-blind clinical studies are warranted and appear feasible." [22]
[edit]De-pigmenting
In cases of extensive vitiligo the option to de-pigment the unaffected skin with topical drugs like monobenzone, mequinol or hydroquinone may be considered to render the skin an even colour. The removal of all the skin pigment with monobenzone is permanent and vigorous sun-safety must be adhered to for life to avoid severe sun burn and melanomas. Depigmentation takes about a year to complete.[15]
2. http://www.medicinenet.com/vitiligo/article.htm
3. 모 회사에서 효과가 있다고 입증되는 약을 내놓았드라...
DON'T LIVE UNAWARE...VITILIGO CURE IS AVAILABLE NOW
By Kumail @ 5th Apr 2011 15:46:00
Health Feeds
Are you in search of Vitiligo cure or a treatment for Vitiligo that can get you re-pigmented? http://www.naturalvitiligotreatment.com/vitiligo-cure.html has all what you required to know about vitiligo cure. What is the most common answer when you seek for cure of Vitiligo? It is NO most of the time, and the people that claims YES are promising so much that it is hard to believe.
Vitiligo is one of the painful diseases which a person has to suffer, though it is not dangerous to human life. This skin condition is one of the oldest diseases known in human history, but than also no assured way has been produced yet to cure Vitiligo entirely and get one re-pigmented.
But this does not mean that there is no way to get rid of Vitiligo, Natural Vitiligo treatment is one that claims re-pigmentation and Vitiligo cure. But wait Don't jump to any conclusions. I'm not denying to the fact that has been told by almost all the sites that since the causes of Vitiligo are not confirmed so no sure cure for Vitiligo is sustained. Well, that's true. But as a matter of fact nothing is impossible in this modern era and science has given the answer for many unsolved mysteries. This science has also proved the fact that nature is the best supplement for medication and healing process.
Thus it is the best treatment ever known to cure Vitiligo or any other skin condition. I can admit that doubtlessly as I have experienced it myself. Yes... I'm a sufferer of Vitiligo or at least I was. Natural Vitiligo treatment is the only product that did what it claims and provided me with my desired results. It is purely a natural product as it does not have any side effects or harmful after affects. It is a trusted formula that has made for re-pigmentation of skin. After gaining a good success rate locally it has been launched world widely and it is satisfying people all over the world which is depicted by their views (testimonials). It is effective in both the cases of onset may it be long established or recent onset of the disease? If used exactly like directed undertaking the precautions there is no way that it won't work as required and if this is the case you can claim your money back!!
For more details please visit: http://www.naturalvitiligotreatment.com
http://www.prfire.co.uk/press-release/dont-live-unaware...vitiligo-cure-is-available-now-50380.html
그래서 한 번 뭐가 들어있나 그 회사 사이트에 들어가 보았다.
This Remedy of Vitiligo contains the following herbal substances:
- Mustard Oil
- Turmeric powder
- Coconut Oil
그 다음으론?? Turmeric powder => 얘는 '강황'이란 아이군요..
얘들이 어떻게 연관이 될 지 이제 막 생각해보려는 중입니다 -ㅇ-;;
참고로 사이트 밑에 있는 말은
Disclaimer:
The information provided should be examined in the light of individual case evaluation by local doctors. The website developers and the team of Natural Vitiligo Treatment take no responsibility whatsoever. The Natural Vitiligo Treatment team assures you of the best possible efforts for those who apply for online treatment. However, please note that we do not claim to cure each and every case, nor do we guarantee any magical cure.
일단 여기까지 ... 나중에 더 생각해보도록하겠으...
+@ : 최근 백반증 치료 관련 논문 하나.
Treatment of vitiligo.pdf아 그리고 이 논문에 나온 (Tacrolimus ointment)
Pharmacology
Tacrolimus is chemically known as a macrolide. In T-cells, activation of the T-cell receptor normally increases intracellular calcium, which acts via calmodulin to activate calcineurin. Calcineurin then dephosphorylates the transcription factor NF-AT (nuclear factor of activated T-cells), which moves to the nucleus of the T-cell and increases the activity of genes coding for IL-2 and related cytokines. Tacrolimus prevents the dephosphorylation of NF-AT.[5] In detail, Tacrolimus reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP12 (FK506 binding protein) creating a new complex. This FKBP12-FK506 complex interacts with and inhibits calcineurin thus inhibiting both T-lymphocyte signal transduction and IL-2 transcription.[6] Although this activity is similar to ciclosporin, studies have shown that the incidence of acute rejection is reduced by tacrolimus use over ciclosporin.[7] Although short-term immunosuppression concerning patient and graft survival is found to be similar between the two drugs, tacrolimus results in a more favorable lipid profile, and this may have important long-term implications given the prognostic influence of rejection on graft survival.[8]
- 면역억제제군요.. from wikipedia http://en.wikipedia.org/wiki/Tacrolimus
http://www.jwatch.org/na31644/2013/07/26/melanocytes-march?query=etoc_jwderm
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