Vitiligo: A Review

Abstract

Vitiligo, a common depigmenting skin disorder, has an estimated prevalence of 0.5-2% of the population worldwide. The disease is characterized by the selective loss of melanocytes which results in typical nonscaly, chalky-white macules. In recent years, considerable progress has been made in our understanding of the pathogenesis of vitiligo which is now clearly classified as an autoimmune disease. Vitiligo is often dismissed as a cosmetic problem, although its effects can be psychologically devastating, often with a considerable burden on daily life. In 2011, an international consensus classified segmental vitiligo separately from all other forms of vitiligo, and the term vitiligo was defined to designate all forms of nonsegmental vitiligo. This review summarizes the current knowledge on vitiligo and attempts to give an overview of the future in vitiligo treatment.

Dermoscopic and Clinical Response Predictor Factors in Nonsegmental Vitiligo Treated with Narrowband Ultraviolet B Phototherapy: A Prospective Observational Study

“…This is in contrast with the general opinion that vitiligous patches featuring leukotrichia on clinical ground are associated with a lack of therapeutic response due to a possible reduction/absence of follicle-associated melanocytes in white hairs [1][2][3][4][5][6][7][8]. However, the speculated association between leukotrichia and poor therapeutic response is mainly based on studies on segmental vitiligo [27,28], which is notoriously more resistant to treatments compared with NSV [1][2][3][4][5][6][7][8]. Additionally, some studies showed that it is still possible to find follicleassociated melanocytic precursors in white hairs, which if stimulated, might migrate and differentiate, thereby giving rise to pigment production [29,30].…”

“…Narrowband ultraviolet B (Nb-UVB) therapy (wavelength ranging from 311 to 313 nm) is one of the most prescribed treatments for NSV, with variable therapeutic results being reported in daily clinical practice [7]. According to literature data, several factors may negatively affect the outcome of Nb-UVB therapy in NSV, including disease activity, associated autoimmune diseases, extensive involvement, family history of vitiligo, long duration of disease, mucosal involvement, presence of koebnerization and leukotrichia [1][2][3][4][5][6][7][8]. However, darker phototypes, early therapeutic response, and facial involvement are associated with a good treatment outcome [9].…”

Decreased suppression of CD8+ and CD4+ T cells by peripheral regulatory T cells in generalized vitiligo due to reduced NFATC1 and FOXP3 proteins

“…Generalized vitiligo was diagnosed by dermatologists at General hospital, using Wood's lamp as bilateral, symmetrical, depigmented macules or patches occurring in a random distribution over the entire body surface. [1] The extent of vitiligo depigmentation was measured by vitiligo area severity index (VASI) score. [19] As described by Bhor and Pande, [19] the total body VASI score for GV patients was calculated as the product of the vitiligo area and the degree of the depigmentation within each patch determined by the hand units and a hand unit is approximately 1% of the total body surface area.…”

“…Generalized vitiligo (GV) is an acquired and polygenic skin depigmenting disease characterized by bilateral, symmetrical depigmented patches over the entire body. [1] GV has been suggested to be caused due to autoimmune-mediated loss of functional melanocytes. [2] About 0.5%-2% population worldwide is affected with vitiligo.…”

Vitiligo Treated by Soaking in an Earth Pond Containing KELEA Activated Water

“…Vitiligo is a disease characterized by the loss of melanin pigment in one or more circumscribed areas of the skin [1] . The term is derived from the Latin word "vitellus" meaning veal, in reference to the paleness of the skin.…”