Melanocyte Reservoir in Vitiligo

Arrunátegui, Adriana; Arroyo, C. E.; García, Lucy; Covelli, Claudia; Escobar, Carlos; Carrascal, Edwin; Falabella, Rafael

doi:10.1111/j.1365-4362.1994.tb02860.x

Cited by 69 publications

(52 citation statements)

References 19 publications

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“…The main reservoir of melanocytes is the hair follicle, in particular the external root sheath. 2,3 This is supported by the clinical observation that the face and neck have the maximum response rate to medical therapies, followed by proximal extremities and trunk. Acral parts of extremities and nonhairy areas such as the wrist, feet and male genitals respond poorly.…”

Section: What Does This Study Add?mentioning

confidence: 66%

Surgical interventions for vitiligo: an evidence-based review

Mulekar¹,

Isedeh

2013

Br J Dermatol

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SummaryBackground Vitiligo is a disfiguring disease, characterized frequently by the presence of de-pigmented macules and/or patches. Traditional therapies are essentially medical and are most preferred by dermatologists. Surgical therapies, however, are amongst the most effective interventions for vitiligo but are limited by their invasive nature, as well as the training and expertise needed to perform specific procedures. Objectives To assess the evidence for the effectiveness, safety and applicability of the various surgical methods in the treatment of vitiligo. Methods For this systematic review of vitiligo surgical therapies, our searches included: PubMed, MEDLINE and Cochrane databases. Results We reviewed research studies reporting on split thickness skin grafts (STSG), punch/mini-graft, blister roof grafting, cultured and non-cultured cellular transplantation (MKTP). While all methods vary in their repigmentation outcomes, STSG is found to have the highest repigmentation success rate. Overall, post-operative complications included milia, scarring, cobblestone appearance or hyperpigmentation of treated areas. Conclusion This review highlights the need for more randomized controlled trials in this field, underpinned by a more standardized objective approach to the assessment of repigmentation following surgical interventions.

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Section: What Does This Study Add?mentioning

confidence: 66%

Surgical interventions for vitiligo: an evidence-based review

Mulekar¹,

Isedeh

2013

Br J Dermatol

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“…Various studies have established the presence of a melanocyte reservoir in the lower third of the hair follicle [20,22]. Recently, melanoctyte stem cells have been demonstrated in the bulge area near the insertion of the hair follicle muscle [23].…”

Section: Medical Therapiesmentioning

confidence: 99%

Surgical management of vitiligo

Mulekar¹

2010

Expert Review of Dermatology

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Vitiligo is a common condition characterized by hypopigmented and/or depigmented spots on the skin, affecting approximately 1-2% of the world population. Until approximately 30 years ago, it was exclusively treated by medical therapies. The most commonly used medical therapies include topical steroids, calcineurin inhibitors and phototherapy. Lesions on the face and neck respond the best to medical therapies, followed by lesions on the proximal extremities and trunk, while those distributed over acral parts of extremities and nonhairy areas, such as the wrist, feet and male genitals, respond poorly. Surgical methods complement medical therapies by providing melanocytes to these refractory lesions, and are indicated for unilateral segmental and clinically stable bilateral vitiligo, refractory to medical treatment. Tissue-grafting methods include minigrafting or punch grafting, epidermal grafting and split thickness grafting. These methods use full-thickness punch grafts, roof of epidermal blisters and shave biopsy samples, respectively, as the source of melanocytes. Cellular grafting includes noncultured and cultured melanocytes/keratinocytes suspensions obtained from trypsinizing the shaved skin biopsy sample as a source of melanocytes. Recent advances over the years have enabled dermatologists to treat extensive areas located on any anatomic site in a single operative session by surgical intervention. The purpose of this review is to describe the selection criteria for the surgical treatment, their utility and limitations in the various types of vitiligo.

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“…1 It affects about 1% of the world's population 2 and has significant impact on both the physical and mental health of patients. Following melanocyte loss, the skin is deprived of pigment protection, leaving it more susceptible to solar damage, and occasionally, compromised immunity may result.…”

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confidence: 99%

A Role for Tyrosinase-Related Protein 1 in 4-tert-Butylphenol-Induced Toxicity in Melanocytes

Manga

Sheyn

Yang

et al. 2006

The American Journal of Pathology

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Vitiligo presents with depigmented cutaneous lesions following localized melanocyte death. Multiple factors contribute to cell death, including genetically determined susceptibility to trauma, and environmental factors, such as exposure to 4-tert-butylphenol (4-TBP). We demonstrate that 4-TBP induces oxidative stress that is more readily overcome by melanocytes from normally pigmented individuals than from two individuals with vitiligo. The antioxidant catalase selectively and significantly reduced death of melanocytes derived from two individuals with vitiligo, indicating a role for oxidative stress in vitiligo pathogenesis. In normal melanocytes, oxidative stress results in reduced expression of microphthalmia-associated transcription factor (MITF). Melanocyte-stimulating hormone-induced expression of MITF protein caused increased sensitivity to 4-TBP, whereas sensitivity of melanomas correlated with MITF expression. MITF stimulates melanin synthesis by up-regulating expression of melanogenic enzymes such as tyrosinase-related protein-1 (Tyrp1). Although melanin content per se did not affect sensitivity to 4-TBP, expression of Tyrp1 significantly increased sensitivity. Melanocytes and melanomas that express functional Tyrp1 were significantly more sensitive to 4-TBP than Tyrp1-null cells. Thus, normal melanocytes respond to 4-TBP by reducing expression of MITF and Tyrp1. We hypothesize that melanocytes in vitiligo demonstrate reduced ability to withstand oxidative stress due, partly, to a disruption in

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Melanocyte Reservoir in Vitiligo

Abstract: Although these findings were observed only in a few patients, they suggest that melanocytes from the implanted lower third portion of the hair follicle (hair bulb) act as a reservoir in this anatomic location and are able to migrate and repigment achromic areas in vitiligo.

Cited by 69 publications

References 19 publications

Surgical interventions for vitiligo: an evidence-based review

Surgical interventions for vitiligo: an evidence-based review

Surgical management of vitiligo

A Role for Tyrosinase-Related Protein 1 in 4-tert-Butylphenol-Induced Toxicity in Melanocytes

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