And whether you know...
November 20, 2011
Vitiligo is a chronic illness of the acquired type which belongs to group of dyschromias. Our natural color of integuments is provided by special cells which are called melanocytes. They also contain a pigment melanin. If cells work normally, then in them there is a special set of enzymes which influence other substances and those turn into melanin. Vitiligo arises owing to disturbance in the course of formation of melanin in skin melanocytes.
Formation of the depigmented spots on integuments is characteristic of this illness. Spots have white color, they are inclined to peripheral growth, and there is a merge because of total absence or reduced content of melanin in skin of the person later.
Vitiligo – an ancient illness. During the period B.C. people had similar white spots. But as a separate illness of vitiligo began to be considered in 1842: then appeared scientific proofs of difference of leprosy and vitiligo. As the World Health Organization, the number of people for which vitiligo is diagnosed reports, makes about 30 million people.
This illness can be shown during any period of human life, however is the most frequent, approximately in 70% of cases, vitiligo arises till 25 flyings. About 25% of all sick vitiligos are children of different age including babies, newborns. Recently specialists note increases in number of the people who got sick with this illness. As a rule, the first symptoms of an illness arise during the spring and summer period. Vitiligo, having shown once, the long period, even until the end of human life can proceed. Without treatment symptoms of an illness disappear seldom or never. At the same time the illness affects both women, and men though some researchers of vitiligo claim that they of the two third patients are women. But in Central Asia concerning vitiligo men address specialists already much more often.
The most problematic moment for sick vitiligos is its influence on psychosocial positioning of the person. The illness conducts to rather notable psychoemotional problems over time.
Though the vitiligo reasons till today accurately are not defined, it is for certain known that vitiligo is not an infectious disease.
Today there are no certain concepts about what specifically can be the vitiligo reasons. The major factors capable to provoke emergence of an illness, the stress, frequent injuries, the increased friction, influence of sunshine and chemicals is considered. As internal factors of the reason of vitiligo is an influence of infections and toxins. Still it is not proved that vitiligo is interconnected with problems of internals. Also there are no data that vitiligo is the illness which is descended however it is quite possible that there are some factors which are descended and promote emergence of this disease.
The illness begins imperceptibly for the person. Seldom or never before external manifestations of the patient feels an itch and a pricking, crawling of goosebumps or there is primary erythema (so-called "pink vitiligo").
Spots which appear on skin at vitiligo have very accurate outlines, their edges smooth or scalloped edges, most often spots have the round form. Color of such educations can vary from white color to milky-white. Except discoloration external changes of skin are not noted – neither the atrophy, nor a peeling is observed. However in those spots which are located on open skin sites and, respectively they are influenced by ultra-violet radiation, also the skin peeling is sometimes shown, integuments can be thickened. At all patients of a spot are located individually, their form, the sizes, quantity also differs. Hair around spots also become colourless. Vitiligo is shown sometimes and in places where integuments constantly are exposed to friction owing to, for example, carrying gypsum, a corset.
Sometimes, that the depigmentation at vitiligo remains invariable for several years, however progress of pathological process on an integument is even more often observed, spots become more, the old centers merge in a uniform spot, and in other places new spots appear. Spontaneous disappearance of the centers of vitiligo is seldom observed. As a rule, spots are painted in usual color after impact on sun skin.
Pathological process at vitiligo is divided into the following types:
- stable: the white spot appears and remains invariable a long time;
- progressing: progress of process of a depigmentation is constantly observed, sometimes it occurs quickly, sometimes – slowly;
- unstable: some spots disappear, at the same time other educations increase.
Diagnosis of vitiligo
Such diagnosis is made on the basis of clinical examination, and also the analysis of anamnestic data. Also in the course of diagnosis the doctor examines the patient's skin in beams of a cold light lamp of Wood. Such lighting allocates the vitiligo centers with bluish-white coloring. Thus, lighting helps to allocate those centers which are imperceptible at usual superficial survey.
Also the specialist at statement of the diagnosis studies the data obtained from the patient from which it is possible to learn about time of emergence of spots on skin, a tendency to increase in their sizes, the presumable reason of emergence of spots. The doctor learns also about existence of vitiligo at close relatives of the patient.
At once after emergence of spots histologically it is possible to define inflammatory reaction. Later so define accumulation of melanin on extreme sites of the depigmented zone.
Examination of such patients from neuroendocrinal system is conducted, and also work of a digestive tract is checked to exclude a helminthic invasion. If in the mentioned systems disturbances are shown, then the corresponding therapy is appointed.
Treatment of vitiligo
The main goal of treatment of vitiligo is a fight against cosmetic defect and the subsequent recovery of pigmentation of these sites of skin. All methods of treatment are defined in an individual order. Complex treatment which includes therapy by medicines, and also recreational and preventive measures is appointed generally sick.
It should be noted at once that this illness will rather hard respond to treatment therefore both the patient, and specialists have to stock up with patience.
Treatment of vitiligo includes reception of a complex of vitamins: ascorbic acid, thiamin (B1), Riboflavinum (B2), pantothenic and para-aminobenzoic acid. In the course of therapy to the patient high doses of ascorbic acid which regulates chromogenesis in an organism are appointed. Also reception of salts of copper and iron is appointed. In many cases good results were yielded by an electrophoresis on the depigmented sites (0,5% of solution of sulfate copper).
Treatment of vitiligo assumes use of means which increase light sensitivity, PUVA-therapy is in parallel carried out (radiation by ultra-violet light). Today there is a number of medicines which raise a photosensitivity. They are let out in different dosage forms. However it is necessary to consider accurately a number of contraindications for carrying out PUVA-therapy. It is pregnancy, existence of malignancies, hypersensitivity to radiation, a stomach disease, blood, kidneys, a liver, cardiovascular system. It will not be carried out to children under 5 years and people 60 years are more senior. Also vitiligos in certain cases treat by a surgical method: replace epidermis, place microtransplants in the depigmentation centers, will transplant the cultivated epidermis, and also not cultivated and cultivated melanocytes.
The special masking cosmetics helps to reduce expressiveness of vitiligo for a while. Feature of treatment of vitiligo should consider and catering services of the patient. So, the food has to contain a large amount of ascorbic acid, vitamins of group B. It is necessary to use often those products which contain many photodynamic substances. It is buckwheat, a fig, greens, hips. Use of phytodrugs which contain copper is recommended: train, arnica mountain.
Complications of vitiligo
In certain cases vitiligo is combined with other diseases. In parallel at the patient focal baldness, a scleroderma, psoriasis can be observed, red flat deprive. Besides at patients with vitiligo low indicators of anti-toxic function of a liver are noted, chronic illnesses of a stomach and intestines are observed.
One more essential complication of this illness – burns which arise after stay on the sun in view of lack of melantotsit integuments have no protective functions from radiation.
Prevention of vitiligo
It is important to lead a healthy lifestyle and to watch carefully a condition of own health. For prevention of vitiligo it is necessary to hold fortifying events, to become tempered and accept vitamin complexes. It is very important to approach a question of contact with the various chemicals capable to provoke skin diseases carefully.
Section: Dermatology (Skin diseases)