VITILIGO

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VITILIGO

• April 26th, 1999
• Chemistry 412
• Rick Helgemo

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What is vitiligo?

• Autoimmune disorder
• Genetic link
• Affects 1-2 of population
• Difficult to cure
• Harmful effects

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Untreated Vitiligo
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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?

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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

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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

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Chemical Treatment Options for Vitiligo

• Corticoids
• Psoralens (PUVA)

• Phenylalanine

• P-aminobenzoic acid (PABA)
• Cantharidin, a blister beetle secretion

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Physical Treatment Options for Vitiligo

• Tattooing (micropigmentation)

• Autologous skin grafts

• Skin grafting using blisters

• Autologous melanocyte transplantation

• Combination of Sun and Sunscreen

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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
  1111034-1039.
• Autoantibodies to Tyrosinase-related protein-1
  detected in the sera Kemp EH, Waterman EA,
  Gawkrodger DJ, et al. British Journal of
  Dermatology 1998 139798-805.
• A systematic review of autologous
  transplantation methods in vitiligo Njoo
  MD,Westerhof W, Bos JD, Bossuyt PMM Archives
  of Dermatology, Dec 1998 1341543-1549.
• The genetics of vitiligo in Korean patients
  Kim SM, Chung HS, Hann SK International Journal
  of Dermatology 1998 38908-910.
• On the association between vitiligo and
  malignant melanoma Lindelof B, Hedblad MA,
  Sigurgeirsson B Acta Dermatologica
  Venereologica 1998 78483-484.
• Tyrosinase as an autoantigen in patients with
  vitiligo Baharav E, Merimsky O, Shoenfeld Y,
  et al. Clinical Experimental Immunology 1996
  10584-88.
• Nonsurgical repigmentation therapies in
  vitiligo Njoo MD,Westerhof W, Bos JD, Bossuyt
  PMM Archives of Dermatology Dec 1998
  1341532-1540.
• Spontaneous repigmentation of vitiligo patches
  distant from the autologous skin Malakar S,
  Dhar S Dermatology 1998 197274.

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More References

• Treatment of vitiligo with oral and topical
  phenylalanine 6 years of experience Camacho
  F, Mazuecos J Archives of Dermatology Feb
  1999 135216-217.
• 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 311557-1564.
• Repigmentation of vitiligo lesion after beetle
  dermatitis Parsad D, Saini R, Nagpal R
  Dermatology 1998 197398.