Vitiligo disease has been known since ancient times, receiving its current name from Latin writer and physician Aurelius Cornelius Celsius (45 a. C.-25 d. C.). Its exact description would not be carried out until many centuries later, in the 19th century, constituting each of the scientific contributions made over later centuries an advance in the knowledge of the disease. Despite this, today it continues to be a pathology without a truly effective pharmacological treatment and alternative care to improve its physical effects.
A disease that still stigmatizes those who suffer it both from the series of physical sequelae that involve skin depigmentation and from the rejection and harassment of those who are often subjected. After declaring some celebrities suffering from vitiligo, more visibility has been given to the disease, popularizing in the media what is the viligus, its causes, symptoms, and treatments.
What is Vitiligo?
Vitilcle is a skin disease resulting from the loss of pigmentation when the functioning of the cells that generate melanin is altered. The lack of melanin leads to the appearance of white spots on the skin, acquiring the appearance of patches or irregular and white spots.
The degree of melanin loss is identical and may be different in each vitiligo plate, it is normal to alternate more active cycles with stable ones. It is considered a benign disease because it does not lead to serious health consequences, with the psychological and aesthetic effects being more harmful by generating great physical and emotional stress in patients.
Vitiligo lesions are bilateral and usually particularly affect those areas most exposed to the sun such as the face, hands, arms, or feet, but also in fold areas such as armpits and knees. The extent of the stains is variable and usually affects people between 20 and 50 years of age.
Causes
There is no concrete cause for developing this pathology. In the 20th century, vitiligo was attributed to damage to peripheral nerves, although other possible causes are also established:
- The destruction of melanocytes is due to the accumulation of metabolic toxic products derived from the synthesis of melanin.
- A defective gene generates a lack of the enzyme that is needed to eliminate these metabolites.
- Overproduction of an electronic transport coenzyme, 6-tetrahydrobiopterin (6BH4), an essential component of the pigment system.
- A problem with the body’s immune system is that it reacts against the body’s pigment cells.
- Associated with other autoimmune diseases such as insulin-dependent diabetes mellitus, anemia, autoimmune thyroiditis, alopecia areata, Addison’s disease, and autoimmune polyendocrine syndromes.
- Stress and sun exposure are considered trigger factors in people predisposed to the vine.
- If any parent suffers from vitiligo.
Symptoms of Vitiligo:
The symptoms of vitiligo begin with spots appearing on the skin. These spots are usually irregular and bleached, although sometimes there are darker dots, especially around those areas where hair grows. The amount and dimensions of the spots are irregular, depending on the lack of melanin in them.
Each patient shows a different evolution in this process of pigmentation loss, being very visible in those with the darkest skin. Cases of total depigmentation may occur. The areas of the body in which the stains usually appear are the navel, the armpits, the groin, the face, the hands, the genital area, and the rectal. It doesn’t usually affect the scalp.
Being a cure-free disease that affects patients very much emotionally and aesthetically, vitiligo usually involves psychological diseases such as depression and stress.
Prevention
As a disease whose origin is unknown, vitiligo cannot be prevented. Only their effects can be alleviated or prevented not by exposing them to the sun to the effect that the difference between pigmented and depigmented areas are not so noticeable.
Types of Vitiligo
According to specialists, vitiligo can be classified into two different types according to the mechanisms that act as pathogens:
- Non-se segmental or Type A Vitiligo
This is the most common type of vitiligo and is given at any age. Those affected by this variant usually have a history of vitiligo in the family and are associated with pathologies such as halo nevus. It is characterized by the symmetry of the distribution of skin spots and presents a phenomenon known as Koebner and consists of the transformation of lesions into new spots. This variety is associated with immune system disorders. This type of vitiligo is classified into four groups, depending on where it is located.:
Acrofacial
The stains are located on the fingers and face.
Acral
The stains appear only on feet and hands.
Located
The stain or stains are located in a single spot.
Generalized
It is usually the most common, spreading the injuries throughout the body.
- Segmental or type B Vitiligo
This variety of vitiligo usually appears throughout childhood or adolescence and youth, spreading rapidly in the first moments, and then stabilizing. It’s not the most common kind of vitiligus.
Treatments for Vitiligo
Diagnosis usually has no complications and in most cases only requires a physical skin examination to locate all stains. If they have any doubts, medical specialists also tend to resort to other tests such as targeting ultraviolet light on the skin to discover areas with fewer pigmentary cells, skin biopsies, and hormonal and vitamin B12 analytics.
In the absence of effective pharmacological treatment, doctors often use conservative treatments such as:
- Powerful corticosteroids in small areas and eventually.
- Oral photochemotherapy: a combination of an oral drug such as psoralen with exposure to UVA rays to repigment more extensive vitiligo.
- Kellina via topical and combined with sun exposure.
- Calcipotriol via topical means and calcineurin inhibitors.
Surgical treatments are also applied through autologous skin grafts selective leukocyte cultures or the patient’s own epidermal cell transplantation. This technique is usually very effective in the face, not being so successful in the case of hands.
One of the most innovative treatments is cell therapy. A procedure that consists of the cultivation of epidermal cells, a mixture of keratinocytes and melanocytes, on an amniotic membrane and obtaining epidermal cell plates to apply to the affected areas. The membranes are implanted in the operating room and then covered with an occlusive dressing for 3 or 4 days. Once the dressing is removed, the patient must be exposed to sun ultraviolet radiation or UVA rays.
Finally, it is highly recommended to take care of the skin every day, avoid stress, protect all affected areas with a high-protection sun filter, work on the acceptance of the disease by the patient and its environment, and improve the patient’s self-esteem.