15Mar

Vitiligo - symptoms, causes, treatment, diagnosis, types of disease

This disease is characterized by the appearance of limited white spots on unchanged skin. Vitiligo can occur in all age groups, however, it can not be congenital. The prevalence of this disease among the entire population does not exceed 1%, in the southern regions this figure can increase to 3-4%.

Normally, the color of the skin is caused by the pigment melanin, which is contained in the melanocytes of the epithelium. This pigment is formed from the amino acid L-tyrosine during a multi-stage chemical reaction involving copper and zinc. Formed melanin accumulates in granules - melanosomes. In the case of inadequate production of pigment, hypopigmentation occurs.

Causes of Vitiligo

Vitiligo is a polyetiological disease, however, the pathogenesis of its development has not been studied well enough. According to studies( Halder RM, Chappell JL, 2009), the causes of vitiligo development can be:

  • Disruption of cell enzyme systems;
  • Disturbance of oxidation-reduction processes( oxidative stress);
  • Genetic predisposition;
  • Autoimmune lesion of melanocytes;
  • Insufficiency of microelements and vitamins.

By the nature of the development of vitiligo can be:

  1. Primary. Develops as an independent disease in relatively healthy people with a genetic predisposition.
  2. Secondary. In this case, the formation of white spots on the skin is associated with the development of a primary disease, and can be caused by:
  • Skin diseases.
  • Endocrine disorders.
  • Chronic diseases of the digestive tract.
  • Systemic autoimmune diseases.

An important role in the development of the disease is played by disorders of the nervous system. Vitiligo can occur on a background of stress, psychological trauma or neuropsychic stress. This is due to the inadequate response of melanocytes to the release of neuropeptides, such as catecholamines.(Picardi A, Pasquini P, 2003).

Clinical picture

Vitiligo is an exclusively cosmetic defect. This disease is characterized by the appearance of white spots on the skin, depending on the nature of the location of which the following forms are distinguished:

  1. Localized vitiligo:
  • Segmental vitiligo. Depigmentation sites are located on a specific segment on one side of the body. This form rarely progresses and is not inclined to spread.
  • Focal( focal) vitiligo. White spots are located in small groups in one area. This form is most often detected in children.
  • Vitiligo mucous. The centers of depigmentation are located on the mucous membranes of the mouth, the red border of the lips or genitals.
  1. Generalized vitiligo:
  • Acrofacial form. Depigmentation sites are located on the distal parts of the limbs( wrists, fingers) or face skin.
  • Universal shape. A rare form of vitiligo. Depigmentation is subject to an extensive( up to 80%) surface of the skin.

The disease is characterized by a prolonged chronic course. Appearance of the areas of depigmentation is preceded by the appearance of pink spots, which eventually acquire a milky-white color. Gradually, these pockets increase in size, acquiring different outlines. As a rule, patches of regular shape, round or oval, tend to merge. They can be located singly or in small groups on any part of the skin.

If the centers of depigmentation are located in the open parts of the body, then, under the influence of sunlight, skin peeling, hyperemia( reddening) and compaction of white spots can be noted.

Vetilingo treatment

Vitiligo treatment is aimed at correction of metabolic disorders and restoration of normal skin pigmentation. There are many methods of treatment, but persistent positive dynamics can be achieved only through a complex effect.

Photosensitizing therapy is aimed at protecting affected areas of the skin from exposure to sunlight. To this end, sunscreens are used that can significantly reduce the risk of sunburn on the altered skin.

The recovery of pigmentation of in vitiligo is the most justified symptomatic treatment. Currently, the following methods of restorative therapy are used:

  • Corticosteroids. Assign locally. Application for longer than two months is not practical.
  • Combined phototherapy. is the irradiation of affected areas with ultraviolet light of the medium-wave range( 280-420 nm).
  • Local photochemotherapy( PUVA-therapy). It is used for the restoration of pigmentation in small areas. The method consists in the local use of methoxylene, which causes photochemical reactions in the skin. The average duration of the course of treatment is more than one hundred procedures.
  • General photochemotherapy. It is used to treat generalized forms of vitiligo. This method consists in the appointment of trioxisalene or bergapten followed by insolation( sun baths) or irradiation with ultraviolet light. The effectiveness of the method reaches 70-80%.
  • Phytotherapy. Is the application of photosensitizing preparations on a plant basis( Beroxane, ammifurin, psoralen).The basis for the development of phytotherapy was some folk methods of treatment.

Skin whitening is used to correct a cosmetic defect by reducing the contrast between healthy skin and the centers of depigmentation. This method of treatment is indicated for common generalized forms of vitiligo. For bleaching apply monobenzone, which is applied to the whole body 2 times a day. The course of treatment is 9-12 months. In limited areas, the drug is not used, as it provokes the development of new spots.

Therapeutic methods of treatment of vitiligo are aimed at correction of metabolic processes of the body and elimination of concomitant pathologies. Drug treatment is usually performed in conjunction with photochemotherapy. The following drugs are used:

  • Vitamins and microelements. In case of a lack of copper, which is necessary for the formation of melanin, electrophoresis with copper sulfate is applied in places of localization of white spots.
  • Preparations of hormones. Applied in the case when vitiligo developed against a background of endocrine disorders.
  • Immunomodulators. Assigned to normalize the ratio of T-helpers and T-suppressors in the blood.
  • Antioxidants. With the intravenous introduction of ozone, a cascade of reactions is triggered, which promote the restoration of the body's antioxidant defense and activate the reparative processes.

Conclusion

There is no clear treatment regimen for the treatment of vitiligo. Despite this, the prognosis for recovery remains favorable. Positive dynamics can be achieved only due to complex effects on the sites of depigmentation for a long time. Be patient and keep hope for the best!

Video

How to get rid of white spots. Recipes from Malysheva.