Vitiligo Classification and external resources
Young woman with Vitiligo
ICD-10	L80.
ICD-9	709.01
OMIM	193200
DiseasesDB	13965
MedlinePlus	000831
eMedicine	derm/453

Vitiligo (pronounced /ˈvɪdlˈaɪgoʊ/) or leukoderma is a chronic skin condition that causes loss of pigment, resulting in irregular pale patches of skin. The precise cause of vitiligo is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic, and environmental factors. The population incidence worldwide is considered to be between 1% and 2% (0.74% in the United States).^[1] Alphos is a form of non-contagious leprosy, formerly described by the physician Celsus under the name of vitiligo, a term now used for another skin disease. ... Image File history File links Download high-resolution version (856x1000, 584 KB) Beschreibung: Vitiligo Source: PflegeWiki. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // L00-L99 - Diseases of the skin and subcutaneous tissue (L00-L08) Infections of the skin and subcutaneous tissue (L00) Staphylococcal scalded skin syndrome (L01) Impetigo (L02) Cutaneous abscess, furuncle and carbuncle (L03) Cellulitis (L04) Acute lymphadenitis (L05) Pilonidal cyst (L08) Other local infections of skin and subcutaneous tissue (L081) Erythrasma... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... The Blue Morpho butterfly, native to Central America, derives its distinctive blue coloring from iridescence rather than from pigmentation. ... For other uses, see Skin (disambiguation). ... Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ... This article is about the general scientific term. ...

According to Diseases Database: "A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached." The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... In cell biology, quiescence is the state of cell when it is not dividing. ...

Signs

Half of people with vitiligo develop patches of de-pigmented skin appearing on extremities before their 20s. The patches may grow, shrink, or remain constant in size. Patches often occur symmetrically across both sides on the body. Occasionally small areas may repigment as they are recolonised by melanocytes. The location of vitiligo affected skin changes over time, with some patches re-pigmenting and others becoming affected. A limb (from the Old English lim) is a jointed, or prehensile (as octopus tentacles or new world monkey tails), appendage of the human or animal body; a large or main branch of a tree; a representative, branch or member of a group or organization. ... Sphere symmetry group o. ...

In some cases, mild trauma to an area of skin seems to cause new patches - for example around the ankles (caused by friction with shoes or sneakers). Doctors also say that cuts that turn into scabs will heal and the new skin will be depigmented, if the person already has vitiligo. Vitiligo may also be caused by stress that affects the immune system, leading the body to react and start eliminating skin pigment. In medicine, a trauma patient has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death. ... For a review of anatomical terms, see Anatomical position and Anatomical terms of location. ... For other uses, see Friction (disambiguation). ... ‹ The template below is being considered for deletion. ... In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ...

Vitiligo on the scalp may affect the color of the hair (though not always), leaving white patches or streaks. It will similarly affect facial and body hair. The scalp is the anatomical area bordered by the face anteriorly and the neck to the sides and posteriorly. ... For the 1968 stage production, see Hair (musical), for the 1979 film, see Hair (film). ...

Symptoms

Some symptoms are:

• white patches on the skin, including the face, limbs, torso, and groin
• white patches on mucous membranes and around the eyes, nostrils, and mouth
• uveitis
• premature graying of hair
• sun sensitivity

The mucous membranes (or mucosae; singular: mucosa) are linings of mostly endodermal origin, covered in epithelium, and are involved in absorption and secretion. ... Uveitis specifically refers to inflammation of the middle layer of the eye, termed the uvea but in common usage may refer to any inflammatory process involving the interior of the eye. ... Photodermatitis is a reaction of the skin to UV rays of the sun. ...

Disease mechanism

Vitiligo is associated with autoimmune and inflammatory diseases, commonly thyroid overexpression and underexpression. Jin in the New England Journal of Medicine reported a study comparing 656 people with and without vitiligo in 114 families, which found several mutations (single-nucleotide polymorphisms) in the NALP1 gene.^[2][3] The NALP1 gene, which is on chromosome 17 located at 17p13, is on a cascade that regulates inflammation and cell death, including myeloid and lymphoid cells, which are white cells that are part of the immune response. NALP1 is expressed at high levels in T cells and Langerhan's cells, white cells that are involved in skin autoimmunity. DNA strand 1 differs from DNA strand 2 at a single base-pair location (a C/T polymorphism). ... Pattern recognition receptors, or PRRs, are a class of cell surface receptors which are employed by the cells of the immune system to identify foreign (disease-associated) biomolecules in the body. ...

Among the inflammatory products of NALP1 are caspase 1 and caspase 5, which activate the inflammatory cytokine interleukin-1β. Interleukin-1β is expressed at high levels in patients with vitiligo. There are compounds which inhibit caspase and interleukin-1β, and so might be useful drugs for vitiligo and associated autoimmune diseases.

Of the 656 people, 219 had vitiligo only, 70 had vitiligo with autoimmune thyroid disease, and 60 had vitiligo and other autoimmune diseases. Addison's disease (typically an autoimmune destruction of the adrenal glands) may cause vitiligo.

In one of the mutations, the amino acid leucine in the NALP1 protein was replaced by histidine (Leu155->His). The original protein and sequence is highly conserved in evolution, and found in humans, chimpanzee, rhesus monkey, and bush baby, which means that it's an important protein and an alteration is likely to be harmful.^[3] Type species Simia troglodytes Blumenbach, 1775 distribution of Species Pan troglodytes Pan paniscus Chimpanzee, often shortened to chimp, is the common name for the two extant species of apes in the genus Pan. ... Binomial name Macaca mulatta (Zimmermann, 1780) The Rhesus Macaque (Macaca mulatta), often called the Rhesus Monkey, is one of the best known species of Old World monkeys. ... Genera  Otolemur  Euoticus  Galago For the desktop presence framework, see Galago (software). ...

The following is the normal DNA and protein sequence in the NALP1 gene:

In some cases of vitiligo the first leucine is altered to histidine, by a Leu155→His mutation:

(Leucine is nonpolar and hydrophobic; histidine is positively charged and hydrophilic, so it is unlikely to serve the same function.^{[4] [5]})

The normal sequence of the DNA code for NALP1 of TCACTCCTCTACCAA is replaced in some of these vitiligo families by the sequence TCACACCTCTACCAA,^[6] which respectively code for the amino acid sequence of the normal NALP1 protein SLLYQ being replaced by SHLYQ.^[7]

Psychological effects

Vitiligo can have a significant effect on the psychological well being of the patient.^[8] This is especially true for darker skinned patients as the contrast between pigmented and depigmented skin can be quite drastic. Mental health is a term used to describe either a level of cognitive or emotional wellbeing or an absence of a mental disorder. ... A patient having his blood pressure taken by a doctor. ... Left side of the image has low contrast, the right has higher contrast. ...

In some cultures there is a stigma attached to having vitiligo. Those affected with the condition are sometimes thought to be evil or diseased and are sometimes shunned by others in the community. People with vitiligo may feel depressed because of this stigma or because their appearance has changed dramatically. Other people with vitiligo experience no negative psychological effects at all. For other uses, see Culture (disambiguation). ... Social stigma is severe social disapproval of personal characteristics or beliefs that are against cultural norms. ... For other uses, see Evil (disambiguation). ... Shunning is the act of deliberately avoiding association with, and habitually keeping away from an individual or group. ... For other uses, see Depression. ...

Treatment

There are a number of ways to alter the appearance of vitiligo without addressing its underlying cause. In mild cases, vitiligo patches can be hidden with makeup or other cosmetic camouflage solutions. If the affected person is pale-skinned, the patches can be made less visible by avoiding sunlight and the sun tanning of unaffected skin. However, exposure to sunlight may also cause the melanocytes to regenerate to allow the pigmentation to come back to its original color. Make-up redirects here. ... This article is about protective camouflage used to disguise people, animals, or military targets. ... Prism splitting light High Resolution Solar Spectrum Sunlight in the broad sense is the total spectrum of the electromagnetic radiation given off by the Sun. ... A suntanned arm showing browner skin where it has been exposed. ...

The traditional treatment given by most dermatologists is corticosteroid cream.^[9] In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ...

Phototherapy may also beneficial using exposure to long-wave ultraviolet (UVA) light from the sun or from UVA, together with Psoralen, called "PUVA", Or with UVB Narrowband lamps (without Psoralen), can help in many cases. Psoralen can be taken in a pill 1-2 hours before the exposure or as a Psoralen soaking of the area 1/2 hour before the exposure. Lately, PUVA is being more and more replaced with exposure UVB Narrowband light at a wavelength of 311-313 nanometers. This treatment does not involve Psoralen since the effect of the lamp is strong enough. The source for the UVB Narrowband UVB light can be special fluorecent lamps that treat large area in few minutes, or high power fiber-optic devices in a fraction of a second. Light therapy or phototherapy consists of exposure to specific ranges of light wavelengths (using lasers or LEDs), or very bright, full-spectrum light, for a prescribed amount of time. ... For other uses, see Ultraviolet (disambiguation). ... Psoralen (also called psoralene) is the parent compound in a family of natural products known as furocoumarins. ... PUVA is a Psoralen + UVA treatment. ...

Studies have also shown that immunomodulator creams such as Protopic and Elidel also cause repigmentation in some cases, when used with UVB Narrowband treatments.^[10][11] An immunomodulator is a drug used for its effect on the immune system: drugs may be immunosuppressants or immunostimulators. ... Tacrolimus (also FK-506 or Fujimycin) is a 23-membered macrolide lactone discovered in 1984 from the fermentation broth of a Japanese soil sample that contained the bacteria Streptomyces tsukubaensis. ... Pimecrolimus is an immunomodulating agent used in the treatment of atopic dermatitis. ...

Alternatively, some people with vitiligo opt for chemical depigmentation, which uses 20% Monobenzone (monobenzylether of hydroquinone). This process is irreversible and generally ends up with complete or mostly complete depigmentation. Monobenzone is the monobenzyl ether of hydroquinone used medically for depigmentation. ...

In late October of 2004, doctors successfully transplanted melanocytes to vitiligo affected areas, effectively repigmenting the region. The procedure involved taking a thin layer of pigmented skin from the patient's gluteal region. Melanocytes were then separated out and used to make a cellular suspension. The area to be treated was then ablated with a medical laser, and the melanocyte graft applied. Three weeks later, the area was exposed to UV light repeatedly for two months. Between 73 and 84 percent of patients experienced nearly complete repigmentation of their skin. The longevity of the repigmentation differed from person to person.^[12] This article or section does not cite its references or sources. ... Gluteus maximus The gluteal muscles are the three muscles that make up the human buttocks. ... Drawing of the structure of cork as it appeared under the microscope to Robert Hooke from Micrographia which is the origin of the word cell being used to describe the smallest unit of a living organism Cells in culture, stained for keratin (red) and DNA (green) The cell is the... Ablation is defined as the removal of material from the surface of an object by vaporization, chipping, or other erosive processes. ... For other uses, see Laser (disambiguation). ... Skin grafting is a type of organ transplant involving the transplantation of skin. ...

In early 2008 scientists at King's College London discovered that piperine, a chemical derived from black pepper can aid repigmentaion in skin, especially when combined with pUVA therapy produces a longer lasting and more even pigmentation than previous treatments [2].

Support organizations

Support groups and organizations are available to help people learn more about vitiligo, understand treatment options, and find support from other people with vitiligo. ‹ The template below (Mind-body interventions) is being considered for deletion. ...

Vitiligo Support International is the largest vitiligo organization in the world. The nonprofit organization provides free access to online message boards, chat rooms, frequently asked questions, information and articles, as well as a patient-referred doctor search. The group advocates on behalf of patients, conducts patient conferences and has local support groups. A non-profit organization (abbreviated NPO, or non-profit or not-for-profit) is an organization whose primary objective is to support an issue or matter of private interest or public concern for non-commercial purposes, without concern for monetary profit. ... A typical Internet forum discussion, with common elements such as quotes and spoiler brackets A page from a forum showcasing emoticons and Internet slang An Internet forum is a web application for holding discussions and posting user generated content. ... A chat room or chatroom is a term used primarily by mass media to describe any form of synchronous conferencing, occasionally even asynchronous conferencing. ... FAQ is an abbreviation for Frequently Asked Question(s). The term refers to listed questions and answers, all supposed to be frequently asked in some context, and pertaining to a particular topic. ... An advocate is one who speaks on behalf of another, especially in a legal context. ...

The National Vitiligo Foundation (NVF) is a 501(c)(3) nonprofit organization that provides access to online resources, physician listings, frequently asked questions (etc); funds research through grants and sponsors local support groups and workshop style conferences. A non-profit organization (abbreviated NPO, or non-profit or not-for-profit) is an organization whose primary objective is to support an issue or matter of private interest or public concern for non-commercial purposes, without concern for monetary profit. ... FAQ is an abbreviation for Frequently Asked Question(s). The term refers to listed questions and answers, all supposed to be frequently asked in some context, and pertaining to a particular topic. ...

The American Vitiligo Research Foundation Inc. (AVRF) is a non-profit, tax-exempt charity that aims to increase public awareness about vitiligo and to help those affected by vitiligo, focusing specifically on children and their families. It supports finding a cure through alternatives to animal torturer. A tax exemption is an exemption to the tax law of a state or nation in which part of the taxes that would normally be collected from an individual or an organization are instead foregone. ... This article is about charitable organizations. ...

Famous people with vitiligo

• Michael Jackson, pop star, has claimed he is a vitiligo sufferer during his interview with Oprah in 1993. He is perhaps the most well-known celebrity to be possibly associated with the disease.
• Graham Norton, who has white patches in his hair as a result of vitiligo.^[13]
• Leigh Thomas, a news anchor and entertainment reporter for WJBK (Fox) Detroit.^[14][15][16]
• Bryan Danielson, professional wrestler, revealed on May 19, 2007 in an interview for F4W.^{[citation needed]}
• Doc Hammer, artist and co-creator of The Venture Bros. has vitiligo on his scalp, causing his hair to grow two different colors.^{[citation needed]}
• John Henson, comedian and co-host of Watch This!^{[citation needed]}
• Kara-Louise Horne from Big Brother 8 suffers a mild case of vitiligo visible on her forehead. It also runs into her hairline resulting in a blonde patch of hair.^{[citation needed]}
• Big Krizz Kaliko, singer/rapper of the Strange Music record label. He has even named his debut album after the condition (with slightly altered spelling), Vitaligo (The Funkra).^[17]
• Thomas Lennon, of Reno 911!, as evidenced by close-ups of his hands during the bike lock scene of episode "The Investigation Continues."^{[citation needed]}
• Hedvig Lindahl, Swedish football player.^{[citation needed]}
• Joe Rogan, actor/comedian/host.^{[citation needed]}
• Liam J. Holland, British Director/Producer/Editor.
• J.D. Runnels, of the Chicago Bears.^{[citation needed]}
• Sisqo, solo and lead singer of Dru Hill reports having vitiligo.^{[citation needed]}
• Rasheed Wallace of the Detroit Pistons has it on his scalp.^{[citation needed]}
• Fez Whatley, of the Ron and Fez show has vitiligo patches on his face.^{[citation needed]}
• Tempestt Bledsoe
• Merritt Chappie, famous stylist in the Dallas- Fort Worth area.
• Yvette Fielding

Michael Joseph Jackson (August 29, 1958), commonly known as MJ as well as the King of Pop, is an American musician, entertainer, and pop icon whose successful career and controversial personal life have been a part of pop culture for the last three decades. ... Graham Norton, born Graham William Walker on 4 April 1963 in Bandon, County Cork, Ireland, is an Irish actor, comedian and television presenter. ... WJBK (FOX2) is the Fox-owned and operated television station in Detroit, Michigan. ... FOX redirects here. ... Motto: Speramus Meliora; Resurget Cineribus (We Hope For Better Things; It Shall Rise From the Ashes - this motto was adopted after the disastrous 1805 fire that devastated the city) Nickname: The Motor City and Motown Location in Wayne County, Michigan Founded Incorporated July 24, 1701 1815  County Wayne County Mayor... Bryan Danielson (born May 22, 1981 in Aberdeen, Washington)[1] is an American independent professional wrestler, known as the American Dragon. ... This article contains a trivia section. ... The Venture Bros. ... This article does not cite any references or sources. ... There are 24 housemates in total in the eighth series of Big Brother in the UK where they are observed by television viewers 24 hours a day and each week, a housemate will be voted to be evicted by the general public until the winner is left. ... Big Brother 2007 was the eighth series of the United Kingdom reality television programme Big Brother,[1] airing on Channel 4, with a number of closely associated programmes also airing on E4. ... Strange Music is a record label created by Travis OGuin and Tech N9ne. ... This article is about the comic actor and writer. ... For the 2007 film, see Reno 911!: Miami. ... Hedvig Lindahl, born (29 April 1983) in Katrineholm , Sweden is a football (soccer) goalkeeper who currently is playing for Linköpings FC in the Swedish womans 1st division Damallsvenskan. ... Joe Rogan performing at a comedy club after UFC 70. ... J.D. Runnels (born June 19, 1984 in Midwest City, Oklahoma) is an American football fullback for the Chicago Bears of the NFL. He was selected in the sixth round of the 2006 NFL Draft out of the University of Oklahoma. ... City Chicago, Illinois Other nicknames Da Bears, The Monsters of the Midway Team colors Navy Blue and Orange Head Coach Lovie Smith Owner Virginia Halas McCaskey Chairman Michael McCaskey General manager Jerry Angelo Fight song Bear Down, Chicago Bears Mascot Staley Da Bear League/Conference affiliations Independent (1919) National Football... Sisqo on the cover of his 1999 LP Unleash the Dragon. ... For other uses, see Singer (disambiguation). ... Dru Hill is an American singing group, most popular during the late 1990s, whose repertoire included R&B, soul, and gospel music. ... Rasheed Abdul Wallace (born September 17, 1974, Philadelphia, Pennsylvania) is an American professional basketball player in the National Basketball Association. ... The Detroit Pistons are a team in the National Basketball Association based in the Detroit metropolitan area. ... Fez Whatley during the 2006 Opie and Anthony Homeless Shopping Spree. ... The Ron and Fez Show is a radio talk show hosted by Ron Bennington and Fez Marie Whatley. ... Tempestt Bledsoe (born August 1, 1973 in Chicago, Illinois) is an American actress best known for her role as Bill Cosbys daughter and fourth child, Vanessa Huxtable, in the popular 1980s sitcom The Cosby Show. ... Dallas redirects here. ... Fort Worth is the sixth-largest city in the state of Texas, located about 30 miles west of Dallas on the West Fork Trinity River and forming part of the Dallas/Fort Worth Metroplex. ...

Vitiligo in domestic animals

Vitiligo is sometimes considered a cosmetic defect in the Rottweiler

Vitiligo along with poliosis is seen as a familial trait in domestic animals. It is especially common in Arabian horses (called Arabian Pinky Syndrome) and in Rottweiler dogs. It may also cause constant itching in very rare cases. Image File history File links Vitiligo_in_a_rottweiler. ... Image File history File links Vitiligo_in_a_rottweiler. ... This is a list of animals that have been domesticated by humans. ... The Arabian horse is a breed of horse with a reputation for intelligence, high spirit, and outstanding stamina. ... This article is about the dog breed. ...

See also

• Alphos
• Albinism
• Leucism
• Melanism
• Pityriasis alba - the most common and benign cause of pale patches on children's faces.

Alphos is a form of non-contagious leprosy, formerly described by the physician Celsus under the name of vitiligo, a term now used for another skin disease. ... Albino redirects here. ... Leucism is characterized by reduced pigmentation, resulting in an individual with white or brighter patches of fur, plumage or skin than in the typical representative of the species. ... The Black Panther is the prototypical example of melanism. ... Pityriasis alba is a common skin condition mostly occurring in children and usually seen as dry, fine scaled, pale patches on their faces. ...

References

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 298th day of the year (299th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 35th day of the year in the Gregorian calendar. ...

External links

• Vitiligo Support International
• American Vitiligo Research Foundation
• National Vitiligo Foundation
• Overview at Davidson College
• Articles on Vitiligo in the Indian Journal of Dermatology and Venerology
• Article on UVB Narrow Band Treatment
• DermAtlas 45
• Narrow Band UVB Treatment Photo's, Vitiligo Treatment Articles