What is Vitiligo?:
Vitiligo is an acquired, depigmentary disorder characterized by the patchy loss of skin color. It affects any part of the body. It may remain static for years and progress gradually or some times extend rapidly with in a period few months. Usually both sides of the body are similarly affected but some times only one side of the body may be affected. The later condition is called segmental vitiligo. In either case, it is a disfiguring pigmentary disorder. The affected patches are normal in all respects, except that due to the lack of pigment, these areas can be more conspicuous and are more vulnerable to sunburn.
What determines Skin Color?
Melanin that is produced by cells called melanocytes determines the color of skin, hair and eyes. Melanocytes are present in the skin, mucous membranes, eyes, and inner ear. The loss of melanocytes alters both the structure and function of these organs and results in the loss of color.
While it was traditionally thought that vitiligo-affected areas lacked melanocytes, the pigment-producing cells, recent studies have demonstrated that such areas do contain these cells though they are non-functional.
Vitiligo affects both men and women and can progressively develop over time.
Causes of the disease:
The etiology of vitiligo is far from clear. A few of the main hypotheses of the cause(s) of this disease are presented below:
Genetics: There is scientific evidence suggesting that vitiligo may be inherited in humans. This, however, is not according to the Mendelian genetic basis but possibly due to the simultaneous involvement of two or more genes.
Autoimmunity: The literature also suggests that vitiligo may be an autoimmune disorder. In a recent study, mice vaccinated with a recombinant vaccine virus encoding a protein that resides in a pigment producing part of melanocytes developed skin depigmentation resembling human vitiligo three weeks after the second immunization.
Growth Factor Deprivation: It was postulated that bFGF deprived in the skin could be the cause of vitiligo. It is this hypothesis upon which a new method of treatment was developed and tried successfully.
Implications of the disease:
The patchy depigmentation of skin is disfiguring and can often produce psychological trauma leading to depression or social withdrawal of affected individuals. The risk of sunburn of the affected skin also increases due to the lack of protective pigments
Vitiligo generally affects about 1% of the world population without racial, sexual or regional differences. Some reports do, however, suggest that incidence in India, Egypt and Japan is higher, ranging from 1.25% to 6% of the population.
Traditional ways of treatment:
Traditional therapies for vitiligo, based on ancient Atharva Veda observations, include photo chemotherapy with topical/oral psoralens, followed by exposure to ultraviolet light Sunlight). This combined treatment is known as PUVA and is based on the observation in Atherva Veda more than 3000 years ago. It is reported that these treatments result in limited success. Even in patients who have good response to medical treatment methods, the hands, fingers, feet, ankles and lips frequently do not repigment.
In the fast spreading cases of vitiligo, skin creams and / or ointments with corticosteroids are prescribed. This is to limit the spread of the pigment loss by reducing the loss of melanocytes by autoimmune antibodies to melanocytes. Vitiligo can also be treated through homeopathic medicine.
The success rate of these traditional methods of treatment is, however, not satisfactory. These methods are not completely effective, and they produce undesirable side effects.
There is indeed a need to develop a new method of treatment for this disorder.