Magdalena Jurzak, Katarzyna Adamczyk, Dominika Dymitruk, Ludmiła Węglarz

Współczesne poglądy na etiopatogenezę i leczenie bielactwa nabytego

Recent perspectives on vitiligo etiopathogenesis and treatment

Vitiligo is a skin disease classified as a disorder of pigmentation. These kinds of disorders are caused by incorrect melanin synthesis and/or its distribution in skin. Besides vitiligo (lat. vitiligo), which is classified as acquired type of leukoderma, congenital lack of skin pigmentation is also known. This kind of disease is called albinism (lat. albinismus). A number of different forms of each type of vitiligo and albinism can be distinguished. They differ by manner of inheritance, lesions localization, size and reaction on medical treatment. Vitiligo is a common dermatosis affecting about 0,5–4% of world’s population, independently of patients age, sex and race. Vitiligo manifest by white well circumscribed patches of skin void of melanin that develops as a result of abnormal melanocytes function/ melanocytes damage or deficiency/destruction of melanocytes.
The disease is probably associated with patient genetic predisposition, but full pathogenesis of vitiligo is still unknown. There are few well known hypotheses concerning the etiology of vitiligo: autoimmune, neurochemical, oxidative stress hypotheses and melanocytorrhagy. In last few years shows up new hypothesis of vitiligo called theory of convergence that develops pathomechanism of disease from coexistence and overlapping of couple different factors. Patient education and cosmetic methods of lesions camouflage are very important in vitiligo therapeutic process. Skin photoprotection in lesion area is received by application of cosmetics with high factors UVA and UVB. This kind of cosmetics not only prevents skin from sunburns in the area of vitiligo lesions but also restrain healthy skin tanning that normally emphasize vitiligo white patches. Camouflage make-up known also as a corrective make-up is a cosmetic method of camouflage skin imperfections that is very useful in vitiligo treatment. Vitiligo is considered as a cosmetic defect that does not require medical treatment. This kind of attitude is not fully right. Many patients, because of visible signs of disease, reveal psychosocial disturbances. There are many methods of vitiligo treatment. Unfortunately none of currently employed therapies is fully effective. No applied in vitiligo therapy let to full repigmentation in lesion areas. Among currently accepted methods in vitiligo treatment, the most common are pharmacology, phototherapy and photochemotherapy. Among surgical methods applied in vitiligo treatment are autologous minigrafts, epidermis transplantation, transplantation of cultured keratinocyte/melanocyte cocultures, noncultured suspension of epidermal cells and transplantation of cultured autologous melanocytes. Lack of fully effective method of vitiligo treatment prompts to further research, that will hopefully let to discover unambiguous etiology of vitiligo.
Keywords: melanocytes, vitiligo, camouflage, therapy, cell culture.
© Farm Pol, 2011, 67(8): 533-542