Vitiligo and autoimmune diseases

Abstract

Przegląd Dermatologiczny 2016/5 400 StreSzczenie Bielactwo nabyte (vitiligo) jest stosunkowo często występującą chorobą skóry. Chociaż nie powoduje żadnych dolegliwości podmiotowych, stanowi istotny problem natury kosmetycznej mający znaczny wpływ na obniżenie jakości życia. W patogenezie choroby rozpatruje się szereg czynników, między innymi podłoże genetyczne, czynniki środo-wiskowe i stres. Wyniki badań ostatnich lat wskazują na udział zjawisk immunologicznych w rozwoju choroby, o czym może świadczyć współwystępowanie vitiligo z chorobami tarczycy, reumatoidalnym zapaleniem stawów, łuszczycą i cukrzycą oraz autoimmunologicznymi zespołami wielogruczołowymi. W pracy przedstawiono także obraz kliniczny, przebieg i czynniki rokownicze choroby. Poznanie przyczyn depigmentacji skóry może się przyczynić do opracowania skutecznych metod leczniczych, a wiedza dotycząca współistnienia z innymi chorobami pozwoli na ich wcześniejszą diagnozę. AbStrActVitiligo is a quite frequently occurring skin disease. Although it does not cause any pain or internal organ damage, it constitutes a significant cosmetic problem having a significant impact on quality of life. A number of factors can influence the disease pathogenesis, including the genetic background, environmental factors and stress. Studies performed in recent years indicate the role of immunological phenomena in the development of vitiligo, as is confirmed by co-occurrence with other autoimmune diseases such as thyroid disease, rheumatoid arthritis, psoriasis, diabetes and many autoimmune polyendocrine syndromes. In the manuscript the clinical presentation, course of the disease and prognostic symptoms are also presented. Understanding the causes of skin depigmentation may allow for the development of effective therapeutic methods, and the knowledge of coexistence with other autoimmune diseases will help with the early diagnostic process. Bielactwo nabyte (vitiligo) jest powszechnie wystę-pującą chorobą skóry oraz błon śluzowych spowodowaną niszczeniem melanocytów w obrębie błony podstawnej zajętych obszarów. Objawia się dobrze odgraniczonymi, zazwyczaj licznymi, odbarwionymi plamami różnych kształtów i wielkości. Zmiany najczęściej lokalizują się na kończynach górnych (zwłaszcza grzbietach rąk) oraz twarzy, ale często

The Role of TRM Cells in the Pathogenesis of Vitiligo—A Review of the Current State-Of-The-Art

“…Additionally, they probably affect the regeneration of melanocytes by blocking local regulatory T cells (Tregs), which play a vital role for hair follicles stem cells in this process [94]. Latest findings confirm the existence of autoreactive CD8 + cells with CD103 + CD69 + CD49a + T RM phenotype in the skin of vitiligo patients [4,28,40,84]. Furthermore, melanocyte-specific CD8 + T RM cells were highly present in lesional skin as compared to blood regardless of whether the actual disease status was active or stable [86].…”

“…Vitiligo is probably the result of an interaction between genetic, environmental, and biochemical factors supporting autoimmune processes, in which melanocytes are destroyed on the body areas affected by the disease. Considering the high incidence (11-31%) of developing this skin disorder in the family, as well as the early age when the first symptoms are observed (usually in patients aged 10-30; over half of the cases are patients below 20), it has been suggested that genetic predispositions contribute to the development of vitiligo [4,[26][27][28]. In addition, a study conducted by Alkhateeb et al demonstrated that the outbreak age of the disease is lower in family cases [3].…”

“…The lesions often appear on elbows, knees, wrists, or the back of hands, i.e., in places most exposed to sunlight. They also show up around natural body orifices, such as the mouth, nose, eyes, and genitourinary organs [3,4]. Although vitiligo was described thousands of years ago (some records come from ancient Egypt and India), there is still a negative social stigma connected with this disease [5].…”

Association Between Foxp3 (Rs3761548) Promoter Polymorphism With Vitiligo Patients, Their Clinical Data and Response to Phototherapy: A Study From Egypt

“…The skin, hair, and nails are covered by white patches of different sizes and shapes 2 . It usually affects areas exposed to the sun like elbows, the back of the hands, and wrists and it affects the areas around the body orifices 3 . The depigmentation occurs due to the destruction of melanocytes responsible for melanin production 4 .…”