Vitiligo today is a little-studied dermatological disease. Pathology delivers a lot of psychological and aesthetic problems to a patient living in a modern, fearful and intolerant society. Violation of melanin synthesis is rare. Many simply do not know that the disease is not contagious, therefore they avoid and in every possible way infringe a person with white spots on the skin.
General information
Vitiligo (other names: dog, pied skin, white spot disease, leukopathy) refers to acquired dermatological diseases. Science has established that in a third of cases, the disease is transmitted genetically. The name comes from the Latin word vitium, which means “deficiency” or “vice”. Pathology belongs to the group of skin dyschromia - various pigmentation disorders (chroma - “color” from Latin, and the prefix dys- means “abnormality” or “impaired function”).
In a normal state, the skin tone is determined by the pigments melanin, carotene, reduced and oxygenated hemoglobin. Reconstituted hemoglobin is blue and contained in the venules, and hemoglobin, oxygenated, in the capillaries, is red. Melanin provides brown and carotene yellow. Most often, skin pigmentation disorders are associated with an excess or lack of melanin.
What kind of disease is vitiligo, is it contagious, who is most often faced with pathology? Dermatosis with the formation of age spots can occur at any age, but most often symptoms occur in people under 20 years of age, in the range from 10 to 30 years, half the cases of the development of the disease. On average, the prevalence of pathology is about 1%, while women are more often sick with vitiligo. The disease is not contagious, does not increase the likelihood of skin cancer and is relatively safe for health.
Causes of occurrence
The physiological causes of vitiligo and the mechanisms of the development of the disease are still unknown to medical science, but there are a number of studies that offer methods of treatment. It cannot be ruled out that some of them will be successful, but this will be confirmed only after numerous clinical trials. Today, one can only list a number of scientific hypotheses, but one must take into account that the error probability is still very high on this issue.
All assumptions regarding the causes of vitiligo in children and adults are rather vague in terms of evidence-based medicine, but have a right to exist. The main hypotheses at present are: various endocrine disorders, mental trauma, disorders of the autonomic nervous system, autoimmune causes, family history, and tyrosinase enzyme deficiency, which is responsible for the synthesis of melanin in humans.
The cause of vitiligo (treatment in this case prescribes a rather specific one) may be a chemical effect, but in this case, dermatological diseases are classified as secondary and treatable. White spots on the skin can cause tert-butylphenol, polyacrylate, butylpyroxatechin, and some other chemicals.
Provocative factors
Some experts argue that the manifestations of dermatological disease are only indicative, that is, they indicate more serious internal disorders. For example, thyroid disease can affect the occurrence of vitiligo. According to statistics, in 10% of patients diagnosed with vitiligo, thyroid dysfunctions are also detected. Negatively affects the predisposition to dermatological dysfunction of the sex glands, adrenal glands, and pituitary gland.
Dyschromia can cause trophic disorders associated with burns (including sunburn) or skin injuries. How does vitiligo start? The first manifestations are often observed in previously damaged areas, because they have an autoimmune component due to the inflammatory process. The skin cells that produce melanin are gradually disrupted, which ultimately leads to a violation of the pigmentation of the skin.
Vitiligo often develops against the background of dysbiosis, irritable bowel syndrome, malabsorption, impaired motor and acid-forming functions of the gastrointestinal tract. These pathologies lead to disruption of the absorption of vitamins and other biologically active substances (for example, some enzymes and B vitamins), which are important for maintaining normal skin condition. Stagnation of bile can lead to deterioration of the skin and aggravation of the symptoms of vitiligo.
Some drugs contribute to the development of the pathological process, cosmetic substances containing harmful components or aggressive chemicals. A common provocative factor is a genetic predisposition. Vitiligo is not a congenital disease, but develops under the influence of several factors. But scientists were able to prove that dyschromia is related to genetics. There is a group of genes that makes a person more vulnerable. In addition, it was found that the probability of white spots on the skin is higher in people with brown eyes, and those with blue or green eyes have a much lower risk of developing the disease.
The autoimmune nature of pigmentation disorders is today regarded as the main one. Malfunctions of the immune system lead to the appearance of antibodies, which affect not only foreign bacteria, viruses and fungi, but also the body's own cells. In favor of this theory is the fact that often patients with a diagnosis of vitiligo have lupus erythematosus, rheumatoid arthritis, autoimmune thyroid lesions and other diseases associated with malfunctions of the immune system.
Psychosomatics of the disease
In addition to physiological reasons, the development of dyschromia of the skin is affected by the emotional component, that is, the disease can be psychosomatic. Vitiligo is a specific and incompletely studied disease, so there are many theories about it. One of them is psychosomatics. According to psychologists, the disease of vitiligo can occur in people who feel shame or blame themselves too much for something, without objectively being guilty. Then the brain “decides to help” by “cleansing”, and the skin becomes covered with white spots.
Under natural conditions, albino animals stand out sharply against the general background. The same "program" can work for a person. For example, a small child feels unwanted after the appearance of a brother or sister in the family, when the parents devote all their attention and free time to the baby. At such moments, the child suffers from forced separation from his parents and wants to stand out in order to attract attention. The body can respond to strong feelings through vitiligo.
Psychosomatics highlights other possible causes of the disease. Therefore, patients are recommended to pay attention to their experiences during the development of the disease - the appearance of the first white spots on the skin, as a rule, falls on the active phase of the conflict. In some cases, working with qualified psychologists or a psychotherapist helps to get rid of a cosmetic defect.
Disease classification
Doctors distinguish between a generalized form of the disease, localized and universal. The most common is generalized, when spots are located throughout the body, while localized - in separate places. The universal form of the disease occurs in a small percentage of cases and is characterized by almost complete loss of pigment (spots cover more than 80% of the body surface).
The main types of skin dyschromia are divided into subgroups. In case of vulgar vitiligo, spots are located symmetrically in the body, acrofacial affects only the limbs and face, and mixed - this is a combination of two types. All these subgroups are characteristic only of the generalized form of the disease. With a localized form, focal vitiligo (spots on one or two sites), mucosa (spots are located only on the mucous membranes), and segmental (spots on one side of the body) can be diagnosed.
There is a color separation of spots. Between healthy skin and a vitiligo stain there may be a medium-pigmented area, in addition to the three colors a strong pigmentation area can be added around. In some cases, the spots have a bluish tint or become inflamed - while the border of the spot rises and becomes inflamed.
The course of the disease can be progressive, that is, the process of depigmentation is observed constantly, but can be fast or occur at a slow pace. With stable vitiligo, the spots do not change over a long period of time. An unstable form of the disease is characterized by the fact that some spots disappear from time to time, while others, on the contrary, increase.
Symptoms of Vitiligo
How does vitiligo start? Spots of different sizes and shapes appear on the skin, which can grow and merge. The hair in the affected areas is discolored. In this case, the patient does not experience any subjective sensations: there is no pain, itching, irritation, peeling or dryness. Some spots may fade spontaneously over time. Typically, vitiligo is susceptible to limbs, groin and anus, arms. In most cases, this is only a cosmetic defect. The psychosomatics of vitiligo gives the right to suggest that pathology begins with a strong emotional experience.
Sometimes the disease may be accompanied by some concomitant symptoms. The psychosomatics of vitiligo usually does not explain this phenomenon, but doctors, as a rule, quickly find physiological causes. Diseases can be accompanied by baldness, choreoretinitis (inflammation of the retina and the posterior part of the eye), gray hair and lightening of hair in those areas that are prone to vitiligo, psoriasis, scleroderma, lichen planus, disturbed sweating in the affected areas, dermatitis and various gastrointestinal diseases.
Diagnosis of the disease
Diagnosis of vitiligo is not difficult. The diagnosis is made on the basis of visual inspection, examination under a special Wood lamp, differentiation with true, post-inflammatory and chemical leukoderma, pityriasis versicolor, idiopathic drop-shaped hypomelanosis, partial albinism, tuberous sclerosis and some other dermatological diseases.
Vitiligo Treatment
The causes of vitiligo and treatment may be related if the disease is caused by exposure to chemicals. But, as a rule, specific provocative factors cannot be identified. There is no specific medicine for vitiligo today, but hardware and laboratory diagnostics and medicine do not stand still, but are developing intensively, so the following possible treatment methods should be taken into account:
- Helium Neon Laser.
- Vitamin Therapy. Vitamins for vitiligo are prescribed to all patients. Typically, a dermatologist recommends taking (including chipping of the affected lesions) group B drugs, vitamin A.
- Macro and microtherapy. Recommended copper sulfate 0.5-1%, electrophoresis of sulfur, zinc, iron. The last recommendation is that patients with vitiligo traditionally have copper deficiency.
- Glucocorticosteroid therapy. It is applied externally and inward: chipping of foci, applications, creams for external use, taking medications inside.
- PUVA therapy. Ultraviolet irradiation of body parts of a certain wavelength and controlled intensity. The method of therapy involves the adoption of internal or external means that improve the perception of ultraviolet radiation, after which local or general irradiation is carried out using special equipment. After several sessions, pigmentation in the affected areas of the skin can recover.
- Diet therapy. It is recommended to include seafood, lamb, apples, oats, rice, corn, cod liver, cabbage, tomatoes in the diet.
- Cosmetology. Be sure to use UV products with a degree of protection of more than 30, you can use special masking compounds.
- Consultations of a psychotherapist or psychologist (depending on the need for psychological correction). If the psychosomatics of vitiligo is not ruled out, a dermatologist may recommend that the patient consult a psychologist.
- Phytotherapy. Reasonable use of the inside and outside of the marsh duckweed, echinacea (increases the number of T-lymphocytes, which are usually not enough for skin dyschromia), St. John's wort.
The prognosis for vitiligo is unlikely to be positive, because spots can continue to spread throughout the body even during treatment. In some cases, even skin grafting surgery does not help. At the same time, those areas that are often injured and rubbed (vitiligo on the arms, legs), or those on which there was damage to the skin, change both negatively and positively.
Folk methods
Is it possible to treat vitiligo at home with alternative methods? Self-medication is not worth it, because only a qualified dermatologist can compile and substantiate an adequate management strategy for a particular patient, but after consultation you can use an unconventional remedy, described below.
10 tablets of aspirin need to be crushed and mixed with half a tube of fat cream. Lubricate the affected areas two to three times a day, store the medicine in the refrigerator. According to reviews, patients with minor skin lesions got rid of vitiligo in just 10-20 days of such treatment.
Possible complications
Skin dyschromia has a chronic course, while pathology is characterized by relative stability. During the period of active development, vitiligo can capture significant areas of the skin. The only proven complication of the disease to date is the psychological discomfort experienced by patients diagnosed with vitiligo. The psychology of the disease in this case is indeed a serious problem.
Recommendations to the patient
With vitiligo, vitamin intake is recommended, a rational diet that includes foods with a high copper content - tomatoes, seafood, lamb, cod liver, the use of products with a high level of UV protection. The lifestyle is determined by the disease itself, because such a pathology causes emotional experiences and a sense of discomfort. To get rid of these manifestations, it is recommended to visit a psychologist.
Preventive measures
There are no specific measures for the prevention of the disease. At risk may be patients with any disorders of the endocrine system, autoimmune diseases, helminth infections and some gastrointestinal disorders. Vitiligo may be the result of diseases of internal organs and systems that were not recognized in time, therefore it is important to undergo a medical examination from time to time and treat the revealed violations.