Medicine for vitiligo_Medicine for the treatment of vitiligo

Vitiligo is a relatively common acquired skin depigmentation disease in clinical practice. The common clinical manifestation is the appearance of white spots on the skin surface. Young women are generally the main patient population. There is no specific medicine for the treatment of vitiligo, but there are external medicines and internal medicines. If you want to know which medicine is suitable for you, you still need to decide based on the type of illness you have.

Vitiligo is a common acquired localized or generalized skin depigmentation disease. It is caused by the disappearance of melanocyte function in the skin, but the mechanism is still unclear. It can occur in any part of the body, most commonly on the back of the fingers, wrists, forearms, face, neck, and around the genitals. It can also occur in the female vulva, mostly in young women.

Causes

The cause of this disease is still unclear. Recent studies have shown that this is related to the following factors:

1. Genetic theory

Vitiligo can occur in twins and families, indicating that heredity plays an important role in the onset of vitiligo. Studies have shown that vitiligo has incomplete penetrance and there are multiple pathogenic sites on the gene.

2. Autoimmunity theory

Vitiligo can be combined with autoimmune diseases such as thyroid disease, diabetes, chronic adrenal insufficiency, pernicious anemia, rheumatoid arthritis, malignant melanoma, etc. Specific antibodies to various organs can also be detected in the serum, such as anti-thyroid antibodies, anti-gastric parietal cell antibodies, anti-adrenal gland antibodies, anti-parathyroid antibodies, anti-smooth muscle antibodies, anti-melanocyte antibodies, etc.

3. Psychological and neurochemical theory

Mental factors are closely related to the onset of vitiligo. Most patients suffer from mental trauma, excessive tension, depression or frustration during the onset or development of skin lesions. The degeneration of nerve endings in the white spots also supports the neurochemical theory.

4. Melanocyte self-destruction theory

Vitiligo patients can produce antibodies and T lymphocytes in their bodies, indicating that the immune response may lead to the destruction of melanocytes. Toxic melanin precursors synthesized by the cells themselves and certain chemicals that cause skin depigmentation may also have a selective destructive effect on melanocytes.

5. Trace element deficiency theory

The levels of copper or ceruloplasmin in the blood and skin of vitiligo patients are reduced, resulting in reduced tyrosinase activity, thus affecting the metabolism of melanin.

6. Other factors

Trauma, sun exposure and some photosensitive drugs can also induce vitiligo.

Clinical manifestations

There is no significant difference in gender, and the disease can occur in all age groups, but it is more common in adolescents. The skin lesions are depigmented spots, which are often milky white but can also be light pink, with a smooth surface and no rash. The boundaries of the white spots are clear, the pigmentation of the edges is increased compared to normal skin, and the hair inside the white spots is normal or whitened. The lesions often occur in areas exposed to sunlight and damaged by friction, and are often distributed symmetrically. White spots are often distributed according to nerve segments and arranged in bands. In addition to skin lesions, the mucous membranes of the lips, labia, glans penis and inner foreskin are also often affected.

Most patients have no subjective symptoms, and a small number of patients experience local itching in the affected area before or during the onset of the disease. Vitiligo is often accompanied by other autoimmune diseases, such as diabetes, thyroid disease, adrenal insufficiency, scleroderma, atopic dermatitis, alopecia areata, etc. The specific classification is as follows:

1. Limited type

(1) Focal type: one or more white spots are confined to one area but not distributed segmentally;

(2) Unilateral type (segmental type): one or more white spots are distributed segmentally and disappear suddenly at the midline;

(3) Mucosal type only affects the mucosa.

2. Scattered

(1) Common type with widespread and scattered white spots;

(2) Facial acrofacial type is distributed on the face and limbs;

(3) Mixed distribution of segmental, facial acral, and/or vulgaris types.

3. Generalized

Complete or almost complete loss of pigmentation.

More than 90% of vitiligo is of the scattered type, and among the remaining vitiligo, localized vitiligo is more common than generalized vitiligo.

According to the degree of pigment loss in the lesions, the disease can be divided into complete and incomplete types. The former has a negative reaction to dihydroxyphenylalanine (DOPA), melanocytes disappear, and the treatment response is poor. The latter reacts positively to DOPA, and the melanocytes do not disappear but only decrease in number, so the chance of cure is high.