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 little tolerant society. Violation of melanin synthesis is rare. Many simply do not know that the disease is not contagious, so they avoid and infringe in every way a person with white spots on the skin.
General information
Vitiligo (other names: dog, piebald skin, white spot disease, leukopathy) is an acquired dermatological disease. Science has established that in a third of cases the disease is transmitted genetically. The name comes from the Latin word vitium, which means "lack" or "defect". Pathology refers to a group of skin dyschromias - various pigmentation disorders (chroma - "color" from Latin, and the prefix dys- means "deviation from the norm" or "impaired function").
In the normal state, skin tone is determined by pigmentsmelanin, carotene, reduced and oxygenated hemoglobin. Reduced hemoglobin is blue and found in venules, while oxygenated hemoglobin in capillaries is red. Melanin provides the brown color and carotene provides the 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? Pigmented dermatosis can appear at any age, but most often symptoms occur in people under 20 years of age, with half of the cases of the disease developing in the range from 10 to 30 years. On average, the prevalence of pathology is about 1%, while women are more likely to suffer from vitiligo. The disease is not contagious, does not increase the likelihood of skin cancer, and is relatively safe for he alth.
Causes of occurrence
The physiological causes of vitiligo and the mechanisms behind the development of the disease are still unknown to medical science, but there are a number of studies suggesting treatments. It cannot be excluded 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 there is still a very high probability of error in this matter.
All assumptions regarding the causes of vitiligo in children and adults are rather vague from the point of view of evidence-based medicine, but they have a right to exist. The following hypotheses are currently the main ones: various endocrine disorders, mental trauma, disorders of the autonomic nervous system, autoimmune causes, family history, enzyme deficiency of tyrosinase, which is responsible for the synthesis of melanin in humans.
The cause of vitiligo (treatment in this case is quite specific) may be a chemical effect, but in this case, dermatological diseases are classified as secondary and treatable. Tret-butylphenol, polyacrylate, butylpyroxatechin and some other chemicals can cause white spots on the skin.
Provoking factors
Some experts argue that the manifestations of a dermatological disease are only indicative, that is, they indicate more serious internal disorders. For example, diseases of the thyroid gland can affect the occurrence of vitiligo. According to statistics, 10% of patients diagnosed with vitiligo also have thyroid dysfunction. Dysfunction of the sex glands, adrenal glands, pituitary gland negatively affects the predisposition to dermatological disorders.
Dyschromia can be caused by trophic disorders associated with burns (including sunburns) 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. Skin cells that produce melanin are gradually damaged, which eventually leads to a violationskin pigmentation.
Vitiligo often develops against the background of dysbacteriosis, 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, certain enzymes and B vitamins), which are important for maintaining the normal condition of the skin. 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. Genetic predisposition is also a common causative factor. Vitiligo is not a congenital disease, but develops under the influence of several factors. But scientists managed to prove that dyschromia is related to genetics. There is a group of genes that makes a person more vulnerable. In addition, it has been found that people with brown eyes are more likely to develop white spots on their skin, while those with blue or green eyes are much less likely to develop the disease.
The autoimmune nature of pigmentation disorders is considered today as the main one. Malfunctions of the immune system lead to the emergence of antibodies that affect not only foreign bacteria, viruses and fungi, but also the body's own cells. This theory is supported by the fact that lupus erythematosus is often found in patients diagnosed with vitiligo,rheumatoid arthritis, autoimmune thyroid disease and other diseases associated with malfunctioning of the immune system.
Psychosomatics of disease
In addition to physiological causes, the development of skin dyschromia is affected by the emotional component, that is, the disease can be psychosomatic. Vitiligo is a specific disease and not fully understood, so there are many theories about it. One of them is psychosomatics. The disease of vitiligo, according to psychologists, can manifest itself in people who feel a sense of shame or blame themselves too much for something, objectively not 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 in humans. For example, a small child feels unwanted after the appearance of a brother or sister in the family, when parents devote all their attention and free time to the baby. At such moments, the child suffers from a forced separation from his parents and wants to stand out in order to attract attention. The body can respond to strong experiences through vitiligo.
Psychosomatics highlights other possible causes of the disease. Therefore, patients are advised 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, a cosmetic defect helpsget rid of work with qualified psychologists or a psychotherapist.
Disease classification
Doctors distinguish between a generalized form of the disease, localized and universal. The most common is generalization, when the spots are located throughout the body, with localized - in separate places. The universal form of the disease occurs in a small percentage of cases and is characterized by an almost complete loss of pigment (more than 80% of the body surface is covered with spots).
The main types of skin dyschromia are divided into subgroups. In vitiligo vulgaris, spots are symmetrically distributed over the body, acrofacial affects only the limbs and face, and mixed is a combination of two types. All these subgroups are characteristic only for the generalized form of the disease. With a localized form, focal vitiligo (spots in one or two areas), mucous (spots are located only on the mucous membranes), segmental (spots on one side of the body) can be diagnosed.
There is a division according to the color of the spots. Between he althy skin and a vitiligo spot, there may be a moderately pigmented zone, in addition to the three colors, a zone of strong pigmentation around can be added. In some cases, the patches are bluish or inflamed - the border of the patch is raised and inflamed.
The course of the disease can be progressive, that is, the process of depigmentation is observed constantly, but it can be fast or slow. With stable vitiligo, the spots do not change for a long time.period of time. The unstable form of the disease is characterized by the fact that some spots disappear from time to time, while others, on the contrary, increase.
Vitiligo symptoms
How does vitiligo start? Spots of different sizes and shapes appear on the skin, which can increase and merge. The hair on the affected areas becomes discolored. In this case, the patient does not experience any subjective sensations: there is no pain, itching, irritation, peeling or dryness. Some spots may spontaneously disappear over time. As a rule, vitiligo affects the limbs, groin and anus, hands. In most cases, this is only a cosmetic defect. The psychosomatics of vitiligo gives the right to assume that the pathology begins with a strong emotional experience.
Sometimes the disease may be accompanied by some accompanying symptoms. Psychosomatics of vitiligo usually does not explain this phenomenon in any way, but doctors, as a rule, quickly find physiological causes. The disease may be accompanied by baldness, choreoretinitis (inflammation of the retina and back of the eye), gray hair and lightening of hair in those areas that are prone to vitiligo, psoriasis, scleroderma, lichen planus, impaired sweating in the affected areas, dermatitis and various diseases of the gastrointestinal tract.
Disease diagnosis
Vitiligo is easy to diagnose. Diagnosis is based on visual examination, examination under a special Wood's lamp, differentiation from true, post-inflammatory and chemical leukoderma, pityriasis versicolor, idiopathic guttate hypomelanosis, partialalbinism, tuberous sclerosis and some other dermatological diseases.
Vitiligo treatment
Vitiligo causes and treatment may be related if the disease is caused by exposure to chemicals. But, as a rule, specific provoking factors cannot be identified. There is no specific cure for vitiligo today, but hardware and laboratory diagnostics and medicine do not stand still, but are intensively developing, so the following possible methods of therapy should be taken into account:
- Helium-neon laser.
- Vitamin therapy. Vitamins for vitiligo are prescribed to all patients. Usually a dermatologist recommends taking (including chipping the affected lesions) group B drugs, vitamin A.
- Macro and microtherapy. Recommended copper sulfate 0.5-1%, electrophoresis with sulfur, zinc, iron. The last recommendation comes from the fact that vitiligo patients are traditionally deficient in copper.
- Glucocorticosteroid therapy. Applied externally and internally: chipping lesions, applications, creams for external use, taking drugs inside.
- PUVA therapy. Irradiation of body parts with ultraviolet light of a certain wavelength and controlled intensity. The method of therapy involves taking orally or externally means that improve the perception of ultraviolet radiation, after which local or general irradiation is carried out using special equipment. After a few sessions, pigmentation on the affected areas of the skin mayrecover.
- 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 excluded, the dermatologist may recommend that the patient consult a psychologist.
- Phytotherapy. Reasonable use is recommended inside, as well as externally, marsh duckweed, echinacea (increases the number of T-lymphocytes, which are usually lacking in skin dyschromia), St. John's wort.
Prognosis for vitiligo is unlikely to be good because the spots can continue to spread throughout the body even during treatment. In some cases, even skin grafting operations do not help. At the same time, those areas that are often subjected to injury and friction (vitiligo on the arms, legs), or those on which there was damage to the skin, change most quickly, both negatively and positively.
Folk methods
Is it possible to treat vitiligo at home with folk methods? Self-medication is not worth it, because only a qualified dermatologist can draw up and justify an adequate strategy for managing a particular patient, but after consultation, you can use an unconventional remedy described below.
10 aspirin tablets to be crushed andmix with half a tube of fat cream. You need to 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 the pathology is characterized by relative stability. During the period of active development, vitiligo can capture large areas of the skin. The only proven complication of the disease to date can be called the psychological discomfort experienced by patients diagnosed with vitiligo. The psychology of illness in this case is indeed a serious problem.
Advice to the patient
With vitiligo, it is definitely recommended to take vitamins, a rational diet that includes foods high in copper - 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 feeling of discomfort. To get rid of these manifestations, it is recommended to visit a psychologist.
Prevention measures
There are no specific measures to prevent the disease. At risk may be patients with any disorders of the endocrine system, autoimmune diseases, helminthiasis and some disorders of the gastrointestinal tract. Vitiligo may be the result of diseases of internal organs and systems not recognized in time, so time is importantfrom time to time undergo medical examinations and treat the identified violations.
