Antibodies to melanocytes. Occurrence in patients with vitiligo and chronic mucocutaneous candidiasis

Abstract

The prevalence of antibodies to melanocytes was determined by an immunofluorescence complement fixation technique in 294 patients with vitiligo, other pigmentary disorders, and unrelated dermatoses. Antimelanocyte antibodies were present in the sera of five (29%) of 17 patients with chronic mucocutaneous candidiasis. Only two of the five patients with antibodies had vitiligo. No antibodies to melanocytes were found in the sera of 31 patients with common vitiligo or of 38 patients with vitiligo associated with autoimmune diseases or melanoma. Nor were antibodies to melanocytes found in 129 patients with other diseases of pigment-producing cells or in a control group of 79 patients with nonpigmentary dermatoses. These results suggest that complement fixing antibodies to melanocytes are associated wih chronic mucocutaneous candidiasis but are not involved in the pathogenesis of common vitiligo.

Melanocyte Destruction and Repopulation in Vitiligo

“…Antibodies to melanocytes in vitiligo were first found in mucocutaneous candidiasis (MCC) but were felt to be limited to this subset of vitiligo patients (Howanitz et al, 1981). Naughton et al (1983) were the first to convincingly document the presence of antimelanocyte antibodies in vitiligo vulgaris patients in general.…”

Vitiligo Coexistent with Nevus Depigmentosus

“…The disorder has been reported in association with several endocrinopathies of autoimmune nature, including thyroid diseases, adrenal insufficiency, diabetes mellitus, and autoimmune type chronic active hepatitis (5-7). In addition, vitiligo has been described in association with alopecia areata, lupus erythematosus, scleroderma, myasthenia gravis, chronic subcutaneous candidiasis, pernicious anemia, atopic dermatitis, and psoriasis (8)(9)(10)(11). Scattered reports exist on vitiligo in association with various disorders, such as derrnatitis herpetifonnis, acromegaly, parapsoriasis, erythema dyschromicum perstans, porphyria cutanea tarda, and lichen sclerosis et atrophicus (12)(13)(14)(15).…”

The Significance of Vitiligo Antibodies

“…Thus, complement-fixing antibodies to cytoplasmic antigens of melanocytes have been reported in a few patients with vitiligo and chronic mucocutaneous candidiasis (MCC) (9,10,13). However, a subsequent much larger study in 294 patients showed these to be associated with chronic MCC and not with vitiligo (12). This finding has been confirmed in another large study (14).…”

“…Bursectomy delays the ap-.pearance of vitiligo in DAM chickens, suggesting antibodies may be involved in the pathogenesis (7). However, reports of antibodies to melanocytes in human vitiligo (8-10) have either not been confirmed by other investigators using the same technique (11) or result from other diseases concurrently afflicting the patients (12). Thus, complement-fixing antibodies to cytoplasmic antigens of melanocytes have been reported in a few patients with vitiligo and chronic mucocutaneous candidiasis (MCC) (9,10,13).…”