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VITILIGO

April 26th, 1999

Chemistry 412Rick Helgemo

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What is vitiligo?

Autoimmune disorder

Genetic link

Affects 1-2% of population

Difficult to cure

Harmful effects

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http://localhost/var/www/apps/conversion/tmp/scratch_2//SGS1/helgemrj$/Documents/moocow.au

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Untreated Vitiligo

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Autoimmune disorder

Melanocytes destroyed

*Melanocyte-specific differentiation

antigens

*Tyrosinase, Dopachrome isomerase

(TRP-2), gp100, MART-1

Immunoglobulin G recognizes TRP-2, causing

immune response

Possible link to curing melanoma?

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Genetic Links

Two types-Segmental and nonsegmental

Polygenic nature, multifactorial inheritance

Autosomal and not linked to race or sex

Linked to other autoimmune diseases

Weakly heritable

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Curing Vitiligo Effects

Long and difficult process, rarely 100% effective on individual

Always involves sunlight or ultraviolet light

Physical and chemical methodsCosmetics

Depigmentation

Psychological counseling

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Chemical Treatment Options for

VitiligoCorticoids

Psoralens (PUVA)

Phenylalanine

P-aminobenzoic acid (PABA)

Cantharidin, a blister beetle secretion

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Physical Treatment Options for

VitiligoTattooing (micropigmentation)

Autologous skin grafts

Skin grafting using blisters

Autologous melanocyte transplantation

Combination of Sun and Sunscreen

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References:Anti-tyrosinase-related protein-2 immune response in vitiligo patients;

Okamoto T, Irie RF, Fujii S, etal.; The Journal of Investigative Dermatology; Dec 1998;

111:1034-1039.

Autoantibodies to Tyrosinase-related protein-1 detected in the sera ; Kemp EH, Waterman EA,

Gawkrodger DJ, et al.;British Journal of Dermatology 1998; 139:798-805.

A systematic review of autologous transplantation methods in vitiligo; Njoo MD,Westerhof W, Bos JD,

Bossuyt PMM; Archives of Dermatology, Dec 1998 134:1543-1549.

The genetics of vitiligo in Korean patients; Kim SM, Chung HS, Hann SK;International Journal of

Dermatology 1998; 38:908-910.

On the association between vitiligo and malignant melanoma; Lindelof B, Hedblad MA, Sigurgeirsson

B; Acta Dermatologica Venereologica; 1998 78:483-484.

Tyrosinase as an autoantigen in patients with vitiligo; Baharav E, Merimsky O, Shoenfeld Y, et al.;

Clinical Experimental Immunology; 1996 105:84-88.

Nonsurgical repigmentation therapies in vitiligo; Njoo MD,Westerhof W, Bos JD, Bossuyt PMM;

Archives of Dermatology; Dec 1998 134:1532-1540.

Spontaneous repigmentation of vitiligo patches distant from the autologous skin; Malakar S, Dhar S;

Dermatology; 1998 197:274.

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More References

Treatment of vitiligo with oral and topical phenylalanine: 6 years of experience; Camacho F,

Mazuecos J; Archives of Dermatology; Feb 1999 135:216-217.

UV-dependent melanocyte plasticity-The structure-function relationship; Iyengar B; Indian Journal of

Pathological Microbiology; 1996 39(2):105-109.

Topical application of a melanotropin analogue to vulgar vitiligo dermo-epidermal minigrafts;Schwartzmann-Solon AM, Visconti MA, Castrucci AML; Brazilian Journal of Medical and

Biological Research; 1998 31:1557-1564.

Repigmentation of vitiligo lesion after beetle dermatitis; Parsad D, Saini R, Nagpal R; Dermatology;

1998 197:398.