Vitiligo

Description:

Vitiligo (from the Latin word vitium – defect + a suffix – igo = "a vicious disease") – the acquired chronically proceeding skin disease from group of dyschromias which is characterized by emergence on skin of the depigmented spots of white color inclined to the peripheral growth, merge owing to absence or decrease in content of melanin in skin.

Vitiligo reasons:

At the heart of vitiligo, as well as the majority of disturbances of a xanthopathy, according to many researchers, disturbance of formation of normal melanin in skin melanocytes lies. It, in turn, can be caused by a number of the reasons.

Earlier and conventional the infectious theory of an origin of disturbances of pigmental exchange was considered as the most widespread. It was supposed that some type of the known or unknown viruses, getting into skin, promotes further emergence of sites on it excessive or, on the contrary, understaining. Defeat of integuments could result also from any bacterial infection, under the influence of the harmful substances emitted by disease-producing bacteria. Now the given hypothesis is rejected as did not find due proofs. Today it is considered to be that the greatest value in development of a disease is played by the following factors: psychological experiences and stresses, some diseases of an infectious origin, a myelosyringosis (a special hereditary disease of a spinal cord as a result of which the skin innervation is broken), back tabes, the postponed syphilis, diseases of the helminthic nature, disturbance from functioning of hemadens (major importance disorders of functions of such glands as a hypophysis, a thyroid gland, gonads have). Vitiligo can develop also in those places where skin is constantly subject to mechanical irritations, for example, during carrying bandages, corsets, bandages, gypsum. At all not on the last place there are various disturbances of exchange processes in an organism, for example, deficit of such elements as iron and copper which are of rather great importance in the mechanism of development of a disease.

Pathogeny:

The disease has the acquired character therefore it is not connected with genetic disorders in any way and practically never affects children of early age. Most often pathology occurs at adult persons, is slightly more rare at teenagers and children of the senior age groups. Vitiligo is especially severe. Now the quantity of cases of pathology decreased a little, however in connection with action of a large number of adverse environmental factors, and also a constant stressogenny situation in society it is nevertheless quite widespread.

Normal natural skin color is provided at the expense of the special cells entering into its structure - the melanocytes containing a pigment melanin. Normal melanocytes always have to contain a special set of enzymes by means of which other substances, for example, amino acid tyrosine, turn into the specified pigment. Melanocytes in large numbers are located in deep layers of skin, in trunks of hair. At the same time it is interesting to note that people with different intensity have colourings of integuments, for example at the European and the Black, the quantity of melanocytes which is contained in skin does not differ at all. Perfectly only the quantity of a pigment made by them. In normal conditions intensity of coloring of skin and hair is influenced by many various factors: heredity, belonging to this or that race and the nation, stay duration in the sun during the day, features of a metabolism of an organism, its food, age.

Vitiligo symptoms:

Vitiligo is shown by the fact that on skin of the patient appear a rounded or oval shape of a spot, deprived of a melanin pigment which first, as a rule, the small size - 0,2-0,3 cm in the diameter. Initially they can be more, further their sizes grow. Externally spots look white, milk color or color of ivory that is characteristic.

Border between the centers of defeat and healthy skin accurate. Characteristic signs is that on a surface of spots scales are never formed, and spots never tower over the surface of healthy skin which in the field of spots is deprived of a pigment. However if to look narrowly, then can seem that the pigment is as if moved to edges of the centers as skin is painted intensively here.

Sometimes some patients in spots of vitiligo have smaller spots of the strengthened xanthopathy. As it was already told above, at the very beginning of the development spots at vitiligo have the small sizes. Then at the edges they begin to grow, become larger, sometimes as a result of growth connect to nearby spots, forming larger centers of the wrong outlines. At the same time at the edges of the center the same characteristic sign - strengthening of coloring of skin remains. Often the center of defeat accepts just huge sizes over time: it can occupy all area of a buttock, all stomach, all back. Sometimes defeat takes all skin of a body, but it happens extremely seldom.

Defeat at a disease does not differ in any favourite localization, it can be located in any place including on eyebrows, on generative organs, on a pilar part of the head. Most often the centers come to light on external genitals that quite often mistakenly take for displays of infections, sexually transmitted, on a dorsum of brushes, pleated between buttocks. At some patients skin displays of vitiligo look peculiar: small sites of a depigmentation alternate with sites of normal skin that in general gives it a motley look.

Hair in a zone of damage of skin become decoloured. At the same time the patient does not feel any subjective feelings, does not show complaints, in medical institutions does not ask for the help. Some researchers revealed in recent years that skin in a zone of spots of vitiligo is very sensitive to action of sunshine, especially ultra-violet range.

In a zone of defeat function of sweat glands is considerably broken that leads to disturbance of release of sweat. At uviolizing skin in the field of vitiligo spots never gains suntan while the sites of a hyperpegmentation surrounding a spot even more darken. There are such places on which vitiligo never develops - it is mucous membranes, palms and soles. At some patients development of a disease happens peculiar: at first in the field of future center the erubescence spot appears, then on this place integuments lose the coloring. Often vitiligo affects the patient's skin not separately, and is combined with such diseases as a scleroderma, a porphyrinic disease, gnezdny baldness, a nevus of Satte-na, a white atrophy of skin etc. Specific characters are lack of a peeling and atrophy of skin in the field of the defeat centers at any form of a disease.

Vitiligo always proceeds chronically, rather difficult gives in to the carried-out therapy. As it was already specified, process begins with small and in most cases a speck, imperceptible on skin. Further this speck grows in the sizes. There are new centers of defeat on other areas of a body, and this process happens slowly, gradually, can continue long months and even years. Sometimes the disease does not cease to develop till the end of life of the patient. In literature cases when the disease passed independently, without the corresponding therapy are described, but it happens extremely seldom, most often vitiligo persistently does not give in to any methods of treatment.

If to consider the scrapings taken from the place of the centers of defeat a microscope, then it turns out that in such skin completely there is no pigment melanin. At the same time in the material taken from regions of the center, the maintenance of melanocytes and a pigment in them is found in very large, excessive numbers. At the same time in all layers of skin in the field of the center it is possible to reveal the inflammatory phenomena which, probably, are caused mostly by allergic reactions.

Treatment of vitiligo:

The vitiligo disease will respond to treatment badly, and therefore demands special patience, both from the doctor, and from the patient.
Recommend to sick vitiligos reception of vitamins - ascorbic acid, thiamin (B1), Riboflavinum (B2), pantothenic and para-aminobenzoic acids. Purpose of high doses of the ascorbic acid exerting the regulating impact on chromogenesis is shown. Use of salts of copper and iron is unconditional, reasonable. Copper sulfate can be appointed in the form of 1% of solution in drops after food. In some cases successful was a method of an electrophoresis of 0,5% of solution of sulfate copper for the depigmented sites of skin.
Also use the drugs increasing light sensitivity in combination with PUVA-therapy (radiation by ultra-violet light). The drugs increasing light sensitivity: бероксан, Puvalenum, Methoxalenum, Oxsoralenum, ламадин, аммифурин, Meladininum, Psoralenum, Psoberanum. Drugs are produced in the form of tablets, spirit solutions for external use, ointments. Existence of contraindications for PUVA-therapy: pregnancy, malignant tumors, hypersensitivity to radiation, diseases of a stomach, a liver, kidneys, cardiovascular system, blood, age up to 5 years is also more senior than 60 years.