Description of vitiligo

Vitiligo is a relatively common acquired depigmentation (loss of pigment) skin. In 30-40% are familial (family) occurrence. It occurs in 1-2% of the population in the dark races more often. It affects both sexes equally often, usually occurs between 20 to 30 years of age. The name comes from the Latin word from vitium, which is a defect and vitelis, meaning white.

The disease arises as a result of termination of skin cells (melanocytes) that produce the skin pigment – melanin that gives our skin a tone. Consequently occur anywhere on the skin of the bodyenclosed by the bearing of white color. They can also occur in the scalp, the hair growing from that precinct are usually too pale to white.

In connection with this disease are found a number of autoimmune diseases, which supports the theory that it is also an autoimmune disease. Important is that the disease is not contagious.

The exact cause of the disease is unknown. In connection with this illness we speak and discusses three theories of onset. Probably the most recognized theory is the autoimmune destruction pigmentotvorných cells (melanocytes), which means that our immune system after a particular insult recognizes melanocyte cells as a foreign body and tries to eliminate it.

What is causing such a cause is not clear, probably emotional stress (accident, death in the family, serious illness) or infection, but their significance is difficult verified.

Another theory is based on self-destruct enzymes melanocytes while the lack of protection of cells.

The latest theory is Neuromediating hypothesis which states that melanocytes are destroyed substances (neurotransmitters) that are used for signal transmission between nerve cells.

Probably, however, when the disease interacts more agents and factors and no theory is not entirely satisfactory explanation for the disease.


Risk factors of vitiligo

Risk factor number one is the presence in the family, but even here you can not determine precisely whether and how likely the disease in the offspring occurs or not.

The disease is the interplay of us more or less unknown factors, among which is likely to include genetic predisposition, experiencing stress, reaction to infection, the condition of your immune system and the skin condition. Any injury can trigger a cascade of events that can lead to depigmentation. Disorders of pigmentation at the site of injury has been described as the so called. Koebnerův phenomenon.

Considerable risk factor is the occurrence of autoimmune disease, with which the vitiligo often species. Such diseases include thyroid disorders, in which the coincidence with vitiligo and 30% (increased and decreased thyroid function, for example. Graves’ disease, Hashimoto’s thyroiditis),diabetes (diabetes mellitus), pernicious anemia (anemia), rheumatoid arthritis , Crohn’s disease (inflammatory bowel disease), Addison’s disease, systemic lupus erythematosus, myasthenia gravis and others.


prevention of vitiligo

Adequate disease prevention is to maintain the condition of your immune system and proper skin care.

Take care because of their lifestyle, regularly play sports, Eat to adequately and appropriately (varied and balanced diet). Wear comfortable, non-irritating, preferably cotton clothing.

Linger in the sun sensibly and if you already have problems with your skin, try to reduce the effect of ultraviolet radiation on your skin. Wear protective clothing, any injury can be a causative factor for vitiligo.


Signs and symptoms of vitiligo

Vitiligo occurs at any age, but usually between 10 to 30 years. In 50% of patients depigmentation occurs about 20 years. It begins as a white circular bearing that can grow and take on different shapes, while its margins are increasingly often pigmented (hyper). Bearing gradually increasing and may coalesce to affect the entire body.

Predilection areas are increasingly bearing the occurrence of pigmented body parts – head, neck, armpits, nipples, back of the hands, abdomen and genital area. Vitiligo may also occur in the scalp, where hair usually growing from it are also white.

According to the appearance and quantity depigmentovaných bearings (lacking pigment) distinguish localized vitiligo, generalized, universal, and mixed type.

Localized vitiligo occurs independently or polysubstituted, nevertheless affects a relatively small district of skin, which is supplied from a nerve spinal cord (from one dermatome).

Generalized Vitiligo affects a large part of the body, especially the face and extremities.

Universal type affects the skin of the entire body, may be present few deposits increased pigmentation.

Since albinism handicap differs by the absence of the eyes (here pigment is therefore present and the patient has a normal color irises). Mixed type is a variant of the previous.

The process is different in every individual, the worse it is assumed in allergic patients (patients with atopic eczema, allergies). Perhaps even regression, i.e. retreat disease, especially in the summer months, but without treatment are not widespread.


treatment of vitiligo

Neither is currently not satisfactorily treated. There is both supportive therapy – administration of antioxidants, which inhibit cell damage arising Mediators in melanocytes and administration of beta-carotene that stimulate pigmentation.

The most effective treatment is considered by using ointments containing corticosteroids(medicines dampening immune process, including depigmentation of the skin), then called.Phototherapy – treatment with ultraviolet light when the patient is at the site where the irradiated UV lamp.
Modification PUVA phototherapy is a method where the skin before irradiation applied psoralens,substances potentiating effects of UV radiation or balneotherapy, when the treatment with UV light promoted medicinal baths. Usually the patient to phototherapy occurs after at least 3-12 months. If this treatment without result, it makes no sense to continue.

Very little used method is autotransplantation – the delegation’s own pigment cells (melanocytes) from healthy skin into the affected areas.

In the case of extensive involvement in some states carried irreversible (irreversible) normally pigmented depigmentation of the remaining parts of the body using chemical substances (hydroquinone). Irreversible depigmentation is permanent skinning pigment using a cream with an active ingredient which destroy melanocytes. whitening takes 8-12 months. It is important to note that this step is irreversible and that the patient must be very effectively protected from sunlight through clothing and sunscreen with a high protection factor.

All treatment of vitiligo is very time consuming and long term.


How can I help myself

Vitiligo is not one disease, which would be primarily dying. However, it can be very uncomfortable, not only for aesthetic reasons.

The pharmacy can buy special creams and gels, which act as skin protection and are specifically designed for this purpose. The products contain substances absorbing depigmentation (loss of pigment).

Taking vitamins (especially A, C, E – called. Antioxidants), minerals and trace elements(recommended as selenium and zinc) is more or less supportive.

White bearings can be masked with a suitably chosen makeup or self-tanning creams. Perhaps even tattooing vitiligo (i.e. incorporation of pigments using a tattoo needle), but usually not recommended for potential activation disorders.


complications of vitiligo

Complications is not only the presence of other autoimmune diseases, but also mental problemspatient. Each individual suffering from this disease should not be afraid to visit a psychologist or a psychiatrist who specializes in the field of dermatology (skin medicine) that can help him cope with the disease.

Other complications are based on actual treatment, especially corticosteroids. Corticosteroids are drugs that are very efficient and are able to induce regression of the disease. However, they also have side effects. Although they applied to the skin, and can absorb a certain amount into the blood (in particular if the treated area large) and act on the body generally.
Among the effects are mainly depression of the immune system, incidence of infection (eg. Fungi-mycosis) have an influence on the metabolism of fats, sugars, can cause the development of diabetes, weight gain, gastric and duodenal ulcers, osteoporosis and cataracts (cataract) and others.

Other names: Disease white spots speckled depigmantace

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