T cell subpopulations in vitiligo: A chronobiologic study

Mozzanica, N.; Frigerio, U; Finzi, A. F.; Cattaneo, Angelo; Negri, Marco; Scaglione, F; Fraschini, F.; Foppa, Sergio

doi:10.1016/0190-9622(90)70029-h

Cited by 33 publications

(21 citation statements)

References 16 publications

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“…Provavelmente, são vários fatores combinados de modo peculiar para cada paciente, os quais agem sobre uma base e determinismo genéticos. 1,2,3,4,5 Ao avaliarmos alguns fatores desencadeantes da doença, novamente percebemos o quanto o fator emocional é importante no surgimento do vitiligo. Traumas e queimaduras (incluindo a solar) têm um papel importante na origem do problema para muitos pacientes, mas, em estudos variados, até 7,2% dos afetados relatam que a alteração se inicia com algum estresse emocional.…”

Section: Introductionunclassified

“…Isso poderia responder pelo início do vitiligo em algumas pessoas. 4,5,6 Em relação à influência do estresse na dermatose, é bem possível que esta dependa do conjunto de crenças colecionado pelos indivíduos ao longo da vida, gravado em sua vivência de maneira inconsciente. As crenças representam a verdade para cada pessoa, de forma que diferentes fatores trarão diferentes vivências para cada pessoa.…”

Section: Introductionunclassified

“…É assim que a qualidade de pensamentos influencia a pele, inclusive a unidade melânica. 4,5,6,7,8 Está comprovado, por exemplo, que o peptídio relacionado ao gene da calcitonina (CGRP) tem efeito modulador sobre as células de Langerhans, as quais estão em constante contato com nervos epidérmicos que segregam o peptídio. Também o alfa-MSH é potente imunomodulador, inibidor da produção de IL1 e 2 e IFN gama.…”

Section: Introductionunclassified

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Vitiligo e emoções

Nogueira

Zancanaro

Azambuja

2009

An. Bras. Dermatol.

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INVESTIGAÇÃOResumo: FUNDAMENTOS: O vitiligo acomete, em média, 1% da população mundial. Mais de 75% dos pacientes têm autoimagem depreciativa em relação à doença. Seu impacto emocional é muitas vezes negligenciado pelo cuidador, influenciando negativamente o prognóstico. OBJETIVO -Verificar o efeito do vitiligo sobre as emoções e discutir as últimas descobertas sobre a interação mente? corpo e seu desdobramento sobre a doença. MÉTODOS -Cem pacientes com diversas formas de vitiligo responderam, na primeira consulta, a uma pergunta sobre as emoções que a presença das manchas lhes provocava. RESULTADOS -Entre os que apresentavam manchas em áreas expostas, 80% queixaram-se de emoções desagradáveis, em contraposição a 37% dos que tinham manchas em áreas não expostas. As emoções mais referidas foram medo (71%), vergonha (57%), insegurança (55%), tristeza (55%) e inibição (53%). CONCLUSÃO -Qualquer doença crônica produz nos seres humanos uma vivência negativa propiciada pela expectativa de sofrimento. O vitiligo é um desafio à autoestima. Além de uma orientação científica adequada, o paciente de vitiligo carece de conforto emocional. A resposta e a adesão ao tratamento e até mesmo a resiliência diante de eventuais falhas terapêuticas dependem da boa relação médico-paciente. Numa época em que dispomos de respeitável terapêutica, torna-se indispensável que o dermatologista se mostre apto a avaliar seu paciente holisticamente. Palavras-chave: Emoções; Relações médico-paciente; Vitiligo.Abstract: BACKGROUND: On average, vitiligo affects one percent of the world population. More than 75% of the patients have negative self-image on account of the disease. The emotional impact of the dermatosis is frequently neglected by the caretaker, which has negative influence on therapy and prognosis. OBJECTIVE -To check the effect of vitiligo on patients' emotions and discuss the mind-body interaction and its impact on the disease. METHODS -In their first medical visit, one hundred patients with various forms of vitiligo answered a question about which emotions were elicited by the presence of the spots. RESULTS -Eighty-eight percent of the patients with spots in exposed areas complained of unpleasant emotions versus twenty-seven percent of those with spots in unexposed areas. The most frequently referred emotions were fear, specifically of expansion of the spots (71%), shame (57%), insecurity (55%), sadness (55%) and inhibition (53%). CONCLUSION -Chronic illnesses generate in human beings a negative experience propitiated by the expectation of suffering. Besides appropriate scientific guidance, vitiligo patients need emotional comfort. Treatment outcomes and patients' compliance to it, and even their resilience to face occasional therapeutic failures, rely on good physician-patient relationship. At a time when doctors make use of reputable therapeutic resources, it is indispensable that dermatologists become able to evaluate the patient in an integrative fashion.

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Section: Introductionunclassified

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Vitiligo e emoções

Nogueira

Zancanaro

Azambuja

2009

An. Bras. Dermatol.

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“…The significance of these findings must be interpreted with caution, as many different factors are known to influence these parameters. Furthermore, they show nyctemeral variations and this parameter has obviously not been considered in most available studies (Mozzanica et al, 1989(Mozzanica et al, , 1990.…”

Section: Is Vitiligo An Autoimmune Disease?mentioning

confidence: 99%

Vitiligo: Where Do We Stand?

Ortonne

Bose

1993

Pigment Cell Research

140

107

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Vitiligo is a puzzling disorder characterized by a disappearance of epidermal and/or follicular melanocytes by unknown mechanisms. This very common disorder involving 1-4% of the world population is thus of great importance for the practicing dermatologist. The cellular and molecular mechanisms leading to the destruction of melanocytes in this disorder have not yet been elucidated, making it of major interest for the cell biologist involved in melanocyte research.Recent advances in this field, due largely to the availability of techniques for culturing normal human melanocytes, opened new perspectives in the underitanding of vitiligo. Although vitiligo has long been considered a disorder confined to the skin, there is now good evidence that it also inwlves the extracutaneous compartment of the "melanocyte organ." It is also clear that vitiligo is not only a melanocyte disorder, but that it also involves cells, such as keratinocytes and Langerhans cells, found in the epidermis and follicular epithelium.The three prevailing theories of the pathogenesis of vitiligo are the immune hypothesis, the neural hypothesis, and the self-destruct hypothesis. New hypotheses suggest that vitiligo may be due to (1) a deficiency in an unidentified melanocyte growth factor, (2) an intrinsic defect of the structure and function of the rough endoplasmic reticulum in vitiligo melanocytes, (3) abnormalities in a putative melatonin receptor on melanocytes and (4) a breakdown in free radical defense in the epidermis. None of these hypotheses has been demonstrated, and according to the available data, it is likely that the loss of epidermal and follicular melanocytes in vitiligo may be the result of several different pathogenetic mechanisms.

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“…T-cell profiles have been shown to be abnormal in patients with vitiligo. There are increased TNF-alpha and IFN-gamma levels, with a reduction in T-helper cells [28][29][30] . More recently, the promising response to the macrolide immunosuppressant tacrolimus, has given support to the immune theory 31 .…”

Section: The Autoimmune Hypothesismentioning

confidence: 99%

Disorders of Pigmentation of the Skin - Hypotheses Underlying Interventions by Multiple Systems of Medicine:Is there a Role for Integrated Medicine?

Arianayagam

Ryan

2016

Current Science

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Biomedicine has not provided a complete explanation with fully effective therapies for disorders of pigmentation. Biomedicine emphasizes the role of melanocyte for protection from UV rays and as a determinant of skin colour. These important properties acquired a genetic basis much later than other functions, many relating to cell contact as in the keratinocyte -melanocyte unit, or as with the synapses of the neurological system. There are other roles, biochemical and mechanical, of melanocyte. Management that is inclusive of a maximally holistic approach justifies the use of diverse herbals, yoga and concern for cultural awareness provided by integrated medicine. Vitiligo provides a model which demonstrates that Ayurveda has a richer view of its presentations, possibly a stronger line on its pathogenesis, and a huge range of herbals, many now backed by studies from ethnobotanical laboratories, awaiting research into the many possible mechanisms by which they may act in the wide and complex field of melanocyte biochemistry.

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T cell subpopulations in vitiligo: A chronobiologic study

Cited by 33 publications

References 16 publications

Vitiligo e emoções

Vitiligo e emoções

Vitiligo: Where Do We Stand?

Disorders of Pigmentation of the Skin - Hypotheses Underlying Interventions by Multiple Systems of Medicine:Is there a Role for Integrated Medicine?

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