Vitiligo - Part 1

Abstract

Vitiligo is a chronic stigmatizing disease, already known for millennia, which mainly affects melanocytes from epidermis basal layer, leading to the development of hypochromic and achromic patches. Its estimated prevalence is 0.5% worldwide. The involvement of genetic factors controlling susceptibility to vitiligo has been studied over the last decades, and results of previous studies present vitiligo as a complex, multifactorial and polygenic disease. In this context, a few genes, including DDR1, XBP1 and NLRP1 have been consistently and functionally associated with the disease. Notwithstanding, environmental factors that precipitate or maintain the disease are yet to be described. The pathogenesis of vitiligo has not been totally clarified until now and many theories have been proposed. Of these, the autoimmune hypothesis is now the most cited and studied among experts. Dysfunction in metabolic pathways, which could lead to production of toxic metabolites causing damage to melanocytes, has also been investigated. Melanocytes adhesion deficit in patients with vitiligo is mainly speculated by the appearance of Köebner phenomenon, recently, new genes and proteins involved in this deficit have been found.

Prevalence of vitiligo in Brazil—A population survey

“…It has its onset mostly during the 2nd and 3rd decade of life and affects females with a slight predilection over males. Although found globally, vitiligo tends to be more frequent among Asians and Africans (Tarle, Nascimento, Mira, & Castro, 2014;Zhang et al, 2016). In Mexico, a multicentre survey with 50,000 individuals estimated the prevalence to be 0.21% (Estrada Castañón et al, 1992), but data for South America are relatively sparse.…”

A Practical Approach to the Diagnosis and Treatment of Vitiligo in Children

“…31,32 The leading theory is that generalized vitiligo is a multifactorial, polygenic autoimmune disorder that occurs in only a minority of genetically susceptible individuals and is therefore believed to have a strong component of environmental triggering. Other theories of vitiligo development include biochemical defects in the tetrahydrobiopterin pathway/oxidative damage, adhesion defects, and neural induction 33 ; however, generalized disease at this point in time is usually presumed autoimmune in nature, with demonstrable autoantibodies against pigment cells in patients with vitiligo. 34 In a survey of 2624 primarily White probands, frequency was 6.1% in siblings, and concordance only 23% in identical twins.…”

Knowledge, beliefs, and perceptions of Turkish vitiligo patients regarding their condition

“…Vitiligo is a social stigma and is associated with a decreased quality of life, especially when lesions are located over the face; thus, it may affect the quality of social and personal life depending on the patient's perception. 2 …”