Symptoms of vitiligo
Vitiligo is a disease of the skin which is characterized by white spots that appear and spread on the skin. It affects 0.5% of the world population, with no predominance of sex or ethnic origin. Its manifestation and development can occur at any age although most people develop vitiligo before the age of 20 years.
This disease can be genetic or related to a violent stress. Vitiligo is not infectious or contagious but can be transmitted by heredity, and an estimated this risk at 30%. A mutation in the gene NALP1 (NACHT leucine-rich-repeat protein) has been identified as correlated with the risk of developing vitiligo.
Depigmentation that causes the disease results from loss of melanocytes (cells producing melanin).
The affected areas were more pigment, they are particularly sensitive to ultraviolet radiation (the melanin typically has the role of protection from the sun by tanning). In some cases, you can also find a concentration of melanin (darker area) in the vicinity of the damaged area. This lack pigment is mainly on the face, extremities, joints and friction areas (Koebner phenomenon).
It is mainly on the finding of characteristic lesions on the skin. There are two main forms: the form of "generalized" is characterized by plaques roughly symmetrical to the centerline of the body and represents nearly nine tenths of the cases. The segmental form is somewhat more common in children, especially in the face, with more rapid progress.
In late stages, a depigmentation of hair or hair can be seen. This disease does not cause physical pain but can cause aesthetic contradictions.
Vitiligo is often misspelled as:
bitiligo, viteligo, vitilgo, vitilago, vitiligo
The treatments of vitiligo are many, but with imperfect success rates were low and sometimes for the most significant side effects. It includes in all cases protect against sunburn, which has a beneficial role, however, about the disease and depigmented plaques in people with dark skin, seem to retain its properties of resistance to sunburn.
Irradiation with ultraviolet B, mainly for generalized forms;
Psoralen combined with ultraviolet A, however, less effective than treatment with ultraviolet B.
The corticosteroid ointment or cream is a good and rapid efficacy, but results are inconsistent over time.
Inhibitors of calcineurin (tacrolimus, ointment may be used, preferably in a dressing.
Treatment with exciter laser (results on stable vitiligo).
If the plates are of moderate size, they can be artificially masked by makeup.
Surgical treatment of Vitiligo
It is recommended when medical treatment is ineffective and involves transplantation of melanocytes. Vitiligo should be clinically stable for at least a year to consider what type of treatment (if there is high risk of recidivism). The transplant can be done in several ways:
Registry of ultra-thin skin. A surface identical to the area to be treated must be taken from a body part not affected by the disease. Several meetings are planned with a risk of scarring.
Culture of melanocytes, previously collected from a sample of skin and then cultured in the laboratory. This technique is not widespread as delicate and expensive.
Fresh suspension of epidermal cells (keratinocytes and melanocytes) prepared from a sample of thin skin. The treated surface can be several dozen times the size of the sample. This technique requires traditionally a laboratory but a medical device has recently been on the market and avoids the use of laboratory (receiving company Clinical Cell Culture).
In all cases the procedure is similar:
1. sample on a healthy area.
2. withdrawal of the top layer of skin on the treatment area (mechanical dermabrasion or laser) under local anesthesia in general.
3. application of the graft or suspension
4. bandage for a week
The skin is rebuilt in a week but melanocytes require 4 to 6 weeks to produce melanin which restores pigmentation. Ultraviolet sessions may be required, especially on the skin to stimulate melanocytes newly grafted.
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