Miscellaneous

Vitiligo: photo initial stage, Causes and Treatment

Vitiligo - a pigmentary anomaly. The disease contributes to the destruction of colored skin cells - melanocytes, which are in place in the affected location of the skin appear white spots. The disease is characterized by the appearance of depigmented patches of small size, which tend to increase in size and merge.

The number of such spots in some cases as high as several tens. Also lends itself to discoloration and hair on the affected skin. The disease is able to manifest itself at any age, regardless of the gender of the person. This disease is characterized by various localization and quite long, usually progressive course. Often the process is exacerbated after trips to sunny resorts.

What it is?

Vitiligo - a pigmentation disorders, manifested in the disappearance of the pigment melanin in certain areas of the skin. The disease occurs on the skin, presumably as a result of certain drugs and chemicals, neuro-trophic, neuroendocrine and autoimmune factors melanogenesis and after inflammatory and necrotic processes in the skin.

Susceptibility to vitiligo can be inherited. The nature of the disease is not fully understood.

Statistics

This is common skin disorders. The number of patients reach 0.5-8% of the population of the planet, which is about 40 million people. Vitiligo often appears at a young age: 50% of patients - people 10-30 years. Start of the disease in people over 40 years - a rarity. Rise in incidence noted in the spring and summer months, when the skin is exposed to sunlight.

Causes of

Interesting may be considered the fact that this disease is not congenital, treat the white spots is necessary after exposure, not only external but also internal factors. Race does not matter, however, the disease is diagnosed more often in dark-skinned patients.

May provoke the development of disease following reasons:

  1. Heredity.
  2. Endocrine and hormonal disorders.
  3. Exposure to chemical substances that can be used in the production of poor-quality cosmetics.
  4. Prolonged exposure to the sun.
  5. The use of certain pharmaceuticals.
  6. Pathologies of the digestive system.
  7. The presence in the body of autoimmune processes in which antibodies tend to hit healthy cells instead of the pathological.
  8. Various skin injuries, burns - in the affected areas inflammatory reactions triggered with an autoimmune component, often react in this way it is-producing cells pigment.

The development of vitiligo can begin completely invisible to humans. Sometimes it is preceded by a slight itching, increased sensitivity of the skin, tingling, "pins and needles." Each spot is appearing clean-cut, more such spots with smooth or scalloped edges are rounded. In addition to the white color is not observed any changes in the skin, there is no peeling or atrophy.

With further development of the pathology spots begin to coalesce, grow in size, occur on any part of the body. Lack of pigmentation - is not the only sign of the disease, it is sometimes observed skin irritation.

Classification

Vitiligo, depending on the location of the spots are divided into three main types:

  • localized form: spots are located in certain places;
  • generalized form (most common form) spots are located throughout the body;
  • Universal Form (least common): almost complete pigment loss (more than 80% body surface area).

In turn, the main types is subdivided into subgroups. Generalized form of Vitiligo includes akrofatsialnoe (only the face and extremities), vulgar vitiligo (spots scattered over the body symmetrically), mixed vitiligo (a combination of different types). By localized form include focal vitiligo (patches have 1-2 stations), segmental vitiligo (Spots are located on one side of the body), mucous vitiligo (patches only on the mucous shells).

There is also a division of the type of stain:

  • blue stain - stains have a bluish tint;
  • sore spot - the border spots is inflamed and elevated;
  • three-color stain - between healthy skin and have moderately pigmented spot area;
  • Four-spot - in addition to the three colors appear around the area of ​​strong pigmentation spots.

During the disease process in vitiligo is divided into types:

  • stable form white spot appears and remains unchanged for a long time;
  • progressive form observed steady progress depigmentation process, sometimes it happens quickly, sometimes - slowly;
  • unstable form some stains disappear, while other entities are increasing.

What are the symptoms of the disease?

The main manifestation of the disease are white spots on the body. Foci of the disease can occur at any age, often during childhood and adolescence may be formed in all areas of the skin. The greatest risk of the appearance of depigmented areas prone to those places where the skin is most injured - there are spots on the feet, knees, hands, elbows.

  1. The foci of vitiligo broken sweating, the skin becomes unable to normally respond to cold and heat. Bleached hair on parts of the body, many patients also discolored. Individual spots can disappear spontaneously even without treatment, but the disease progresses depigmentation pockets can be formed in the field recently injuries, friction or pressure skin.
  2. The initial stage of Vitiligo is expressed very weakly. It is characterized by small foci of depigmentation - small spots that appear to be a significant, but not particularly eye-catching cosmetic defect that is easy to camouflage clothing. Gradually, the bright spots on the skin increases, and combined to form a large area of ​​milky-white color.

Any disturbing symptoms of the disease Vitiligo does not cause, it is not contagious, but it is difficult to cure. Vitiligo patients perceived as a serious aesthetic defect, so the disease can cause severe psychological distress. After tanning, colorless areas are becoming very visible, the affected area of ​​the skin very sensitive to UV light and fast "burn."

What is vitiligo: photo

The photo shows how the disease is manifested in humans and other initial stages.

Diagnostics

Vitiligo spots at the first sight might be confused with spots appearing with herpes or syphilis. However, the latter two diseases are characterized by expression of other symptoms besides skin discoloration. So, in syphilis observed specific mucosal lesions, while herpes surface scaly spots.

Most accurately we can determine vitiligo spots shine on Wood's lamp. Underneath the affected areas are highlighted blue and white, as well as become visible area where the pigment began to fade only. When you visit a dermatologist is better to insist on this diagnostic method.

How to treat vitiligo?

If vitiligo lesion area is not more than 20% of the body, primarily for the treatment of topical glucocorticosteroid appointed means in the form of creams and ointments.

  • methylprednisolone aceponate (advantan and analogues);
  • alklometezona dipropionate (Afloderm and analogues);
  • betamethasone dipropionate (aktiderm and analogues).

There are several schemes for the application of these preparations, the physician selects an optimal scheme based on the analysis results, the area affected, the patient's age and other factors. If the visible effect is observed within 4-6 months, prescribers second line - topical calcineurin inhibitors:

  • tacrolimus ointment varying concentration level;
  • pimecrolimus cream.

It's worth noting that despite the success of the study (2013.), The diagnosis of vitiligo is still not officially part of the indications for use.

How can I get rid of vitiligo?

New methods in the treatment of this disease:

  1. skin whitening. This is an attempt to equalize the tone of the affected areas, and healthy skin. At present, the most popular means for this procedure - elokvina injection, hydroquinone (2-4%) and its monobenzyl ether (Monobenzon) externally. All preparations are aggressive enough and have a lot of side effects, and therefore can not be considered a panacea in solving the problem of depigmentation. In addition, the price tags on them rather bite (elokvina injection costs about 50 thousand rubles), and the lighting sections occurs, requiring almost constant use of drugs.
  2. Laser therapy. This removal of portions depigmentation highly directional radiation with a wavelength of 308 nm. The mechanism of action is almost similar to phototherapy. The highest efficiency is achieved in patients with localized forms of the disease and the duration of the pathological process is not more than five years. Duration of radiation per session is seconds. Other names for this method - an excimer laser or Ratokderm. For more information about contraindications and indications of laser therapy.
  3. Melagenin plus. This is an alcohol extract from the human placenta, produced by Cuba. Entitled Melagenin drug appears on the market since 1998, characterized by an average efficiency in relation to the localized form of the disease.
  4. Transplantation of melanocytes. This introduction of pigment cells retrieved from the patient's own healthy skin sites in its problematic skin.
  5. Creating a vaccine. In 2013, scientists from the Medical School at the University of Chikagkskom in a series of experiments on mice the tested vaccine protein that suppresses the autoimmune reaction leading to vitiligo. However, until today the completion of the information is not received the vaccine.

Australian drug Sceness, registered in Europe for the treatment of erythropoietic protoporphyria, also represents a perspective view to eliminate depigmentation in vitiligo.

phototherapy

Phototherapy - treatment with light of a particular wavelength - when used in the form of vitiligo selective phototherapy, PUVA therapy, uzkovolnofoy UVB phototherapy at the wavelength of 311 nm. Selective phototherapy least effective therapy PUVA (psoralens reception photosensitisers followed by irradiation into skin UVA rays) is considerably more efficient in comparison with selective phototherapy, however, toxic effects, manifested by nausea, vomiting, headache, dizziness, as well as the risk of skin cancer with prolonged use limit the use of PUVA therapy in the treatment of vitiligo.

Uzkovolnovaya 311 nm UVB phototherapy performance comparable with PUVA therapy (recovery of pigmentation over 75% of the area of ​​lesions vitiligo in 70% of patients), but it is devoid of toxic side effects and, moreover, is approved for use in the treatment of children. The most significant therapeutic effect was observed in the presence of lesions in the face, neck, trunk and proximal extremities. the effect is less pronounced in the localization of the fingers and toes. In addition, it is better to respond to treatment lesions caused by no more than 2-5 years ago.

Phototherapy namely uzkovolnovaya 311 nm UV-B phototherapy, considered at the moment one of the most affordable and effective methods of treatment of vitiligo. The method is quite safe, but it is important for long-term use. To achieve a good effect requires between 30 and 100 procedures, with a periodicity of 2-3 times a week.

Surgical intervention

In 20% of cases, conservative treatment of vitiligo does not give the desired result, then discusses the operation. Surgical treatment is a transplant of their own pockets to normal melanocytes lacking pigment. After the operation, the formation of new melanocytes in the deeper layers of the epidermis. The process of restoring pigmentation takes several months.

Indications for surgical treatment of vitiligo

  1. Foci are located in open areas of the body (face, neck, décolleté, hands). They are a significant cosmetic defect and violate the psychological status of the patient.
  2. The lack of results from local and systemic therapy for 12 months.
  3. The disease is in remission. New spots do not appear within 1-2 years, and the current does not increase.

There are several methods of surgical treatment of vitiligo

  1. Transplantation of epidermis. Affected skin is excised. In their place put PUVA prepared by graft (graft epidermis with a healthy part of the body).
  2. Minitransplanty. The depigmented lesions transplanted areas of healthy skin of less than 1 mm.
  3. Transplantation cultivated or uncultivated melanocytes. The skin implanting certain cells that produce the pigment.

Adverse surgical actions may include:

  1. The appearance of scars;
  2. Uneven pigmentation;
  3. Rejection of transplanted epidermis sites;

Contraindications:

  1. Tendency to scarring;
  2. Intolerance UFO and laser therapy.

How to disguise spots of vitiligo?

The desire to hide the white spots on the face and body - it is quite natural desire of people suffering from vitiligo. Because as long as the treatment is carried out, you can use the following ways:

  • Vitiligo can help mask a method such as dermabrasion. When this skin is processed in layers, and the penetration depth depends on the form of the disease, age spots and so forth.
  • Using tanning. If you perform this procedure in the cabin environment, the color will be more smooth and it will keep longer. Besides their own it is difficult to pick up a shade and apply on the body. Unlike cosmetics, tanning is convenient to use the hands and feet, as it does not stain clothes.
  • The use of green walnut peel. For this purpose it is necessary to grind with a blender and leave for 2 hours. After that, the mixture should buy brown color. The juice from the skin to press and with a cotton pad put on the spot, which will contribute to their coloring. One of the advantages of this tool - it does not leave marks on clothing.
  • The use of cosmetics. This is the most affordable and easy way to make patches less noticeable. In this case, apply concealer and other matting agents need to correct. First, the skin needs to be aligned to its natural color, and after starting to mat. Furthermore, you can use permanent tattoo to be more stable and does not rub off on contact with water or clothes.

However, the use of these funds is important not to forget about the rules of care for the affected skin. We should not once again to hurt her or exposed to allergens. It is important not to wear too tight clothing and footwear, avoid rubbing the stains, if necessary use a razor, you should be as careful. Jewelry should not leave visible marks on his neck and fingers. It is necessary to limit the pastime of both the sun and the cold. After tanning often triggers the formation of new spots.

Latest news

Scientists have created a genetically engineered protein that treats vitiligo in mice. Previous studies have shown that a key role in the disease vitiligo plays HSP70i - stress-inducible heat shock protein (activation of its synthesis occurs at higher temperature).

  • HSP70i consists of 641 amino acids. Researchers from Loyola University in New Orleans to replace one of these amino acids, having genetically modified version HSP70i. New modified protein displaces its normal precursor and stops the development of autoimmunity.
  • Scientists have entered modified HSP70i experimental mice suffering from vitiligo and having color "salt and pepper". After some time, the mice gained normal hair black. Similar effects were obtained in experiments in cell culture of human skin.

Experimenters hope that human studies have confirmed the effectiveness of the new method and finally allow to find a cure for vitiligo. However, the experiments were conducted as far back as 2013, and more of them could not hear. Perhaps experiments stopped due to insecurity of genetically modified designs.

prevention

Because the cause of vitiligo is not installed, the prevention of this disease is insufficiently substantiated. But it is noted that the beneficial effect on patients with vitiligo has a regular stay at seaside resorts, so if a family vacation in the family, there are cases of vitiligo, should organize an annual (and, if possible and more) on sea. To consolidate preventive effect can sunbathe at 10 minutes a day all the warm season.

Avoid overloading the body substances metabolic disorders: to treat a chronic disease of the digestive system, a balanced feed.

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