Vitiligo overview

1. VITILIGO
April 26th, 1999
Chemistry 412
Rick Helgemo

2. What is vitiligo?
Autoimmune disorder
Genetic link
Affects 1-2% of population
Difficult to cure
Harmful effects

4. “Untreated” Vitiligo

5. 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?

6. 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

7. Curing Vitiligo Effects
Long and difficult process, rarely 100% effective on individual
Always involves sunlight or ultraviolet light
Physical and chemical methods
Cosmetics
Depigmentation
Psychological counseling

8. Chemical Treatment Options for
Vitiligo
Corticoids
Psoralens (PUVA)
Phenylalanine
P-aminobenzoic acid (PABA)
Cantharidin, a blister beetle secretion

9. Physical Treatment Options for
Vitiligo
Tattooing (micropigmentation)
Autologous skin grafts
Skin grafting using blisters
Autologous melanocyte transplantation
Combination of Sun and Sunscreen

10. 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.

11. 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.