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At least 19 recordsLinked to original sources
PubMed1978

Cockade-like vitiligo and linear vitiligo a variant of fitzpatrick's trichrome vitiligo.

The authors report 2 cases of atypical vitiligo in which they observed 1) "cockade-like" lesions resembling those of "trichrome" vitiligo (from the centre to the periphery, achromic area, hypochromic ring, normal or hyperchromic border), 2) numerous linear achromic lesions corresponding to former excoriations (Koebner's phenomenon, isomorphic phenomenon). Related affections are discussed with reference to these cases; the trichrome vitiligo described by Lerner and Fitzpatrick, and the primary leukomelanodermas described in black patients by Basset and by Sarrat and Nouhouayi.

Adolescent↗
PubMed1996

Identification of autoantibody to melanocytes and characterization of vitiligo antigen in vitiligo patients.

Patients with vitiligo have circulating antibodies to melanocytes. To identify vitiligo antibodies and characterize the antigens by vitiligo antibodies, sera of 18 patients with vitiligo, 18 with Behcet's disease, 22 with syphilis and 14 normal control subjects were analyzed by indirect immunofluorescence, live cell ELISA, and immunoblotting. In indirect immunofluorescent microscopy and live cell ELISA, most vitiligo sera showed positive immunofluorescence and high optical density on the surface of melanocytes cultured from normal and vitiligo patients, indicating that autoantibodies in the vitiligo sera may react with vitiligo antigens on the surface of melanocytes. When the same experiments were performed with malignant melanoma cell lines and fibroblasts, no significant differences in the immunofluorescence and optical density were observed between normal and vitiligo sera. And the sera of patients with Behcet's disease or syphilis showed no significant difference in the reaction of live cell ELISA to fibroblasts, IGR-3 and melanocytes. The antibody titers of vitiligo patients in live cell ELISA decreased following systemic steroid treatments. Immunoblot analysis demonstrated that 44% of vitiligo sera was directed to melanocyte antigen with a molecular weight of 65 kDa. Inhibition assay using rabbit anti-melanocyte antibody showed inhibition of reaction between vitiligo sera and melanocytes in ELISA and immunoblotting. These findings support the hypothesis that the sera of vitiligo patients have autoantibodies mostly directed to the 65-kDa antigen and this antigen may originate mostly from the melanocyte surface.

Animals↗
PubMed2004

Difference in pathogenesis between vitiligo vulgaris and halo nevi associated with vitiligo is supported by an HLA association study.

Human leukocyte antigen (HLA) class II associations with two subtypes of vitiligo: vitiligo vulgaris and halo nevi associated with vitiligo were investigated. In previous studies associations between vitiligo and HLA antigens have been reported but these two subtypes have never been taken into account. However from a clinical and histological point of view, a difference in (auto)-immune pathogenesis can be expected. This difference might be reflected in an association with different HLA alleles. Seventy-six unrelated Dutch Caucasians, 40 with vitiligo vulgaris and 36 with halo nevi associated with vitiligo were included. A panel of randomly chosen HLA typed healthy Dutch blood donors (n = 2400) served as control population. HLA-DR and -DQ typing was carried out on blood samples by amplifying genomic DNA using polymerase chain reaction followed by dot blot hybridization with sequence specific oligonucleotides. The main outcome measures were odds ratio (OR), uncorrected P-value (P(u)) and corrected P-value. There were distinct differences in the clinical manifestations between vitiligo vulgaris and halo nevi associated with vitiligo with respect to precipitating factors, extent and progress of the disease and the association with other auto-immune diseases in the two subtypes and their respective first degree family members. Our stratification reveals differences in HLA class II between both subtypes and between subtypes and controls. A case-control association study showed a significant positive association of HLA-DR4 (OR = 2.787, P(u) = 0.0022) and DR53 (OR = 2.249, P(u) = 0.0153) and a negative association of HLA-DR3 (OR = 0.195, P(u) = 0.0024) with vitiligo vulgaris. The group with halo nevi associated with vitiligo did not show these associations, but had a significant negative association with HLA-DR11 (OR = 0.083, P(u) = 0.0067). In conclusion, the differences in HLA association within clinical subtypes of vitiligo support our suggestion that vitiligo vulgaris and halo nevi associated with vitiligo have distinct pathogenic mechanisms.

Adolescent↗
PubMed1986

Correlation between vitiligo antibodies and extent of depigmentation in vitiligo.

We correlated the level of vitiligo antibodies to the extent of depigmentation in thirty-two patients with vitiligo. Vitiligo antibodies were assayed by protein A-sepharose immunoprecipitation method. Antibodies were present in four of eight (50%) patients with minimal vitiligo (less than 2% body surface involved), in nine of ten (90%) patients with moderate vitiligo (2 to 5% surface involved), and in thirteen of fourteen (93%) patients with more extensive disease (greater than 5% surface involved). The level of vitiligo antibodies in the three groups expressed as a binding index was 2.9% +/- 2.03, 5.6% +/- 2.92, and 8.0% +/- 3.03 SD, respectively. These results suggest that there is a relation between the incidence and level of vitiligo antibodies and the extent of depigmentation in vitiligo.

Adult↗
PubMed2004

Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index.

BACKGROUND: There is currently no quantitative tool for evaluating vitiligo treatment response using parametric methods. OBJECTIVE: To develop and apply a simple clinical tool, the Vitiligo Area Scoring Index (VASI), to model the response of vitiligo to narrowband UV-B (NB-UV-B) phototherapy using parametric tests. DESIGN: Prospective, randomized, controlled, bilateral left-right comparison trial. SETTING: North American tertiary care, university-affiliated phototherapy center. PATIENTS: Patients older than 18 years with stable vitiligo involving at least 5% of their total body surface in a symmetric distribution. INTERVENTION: Treatment with NB-UV-B was given 3 times a week to half of the body on all patients for either 60 treatments or 6 months. The contralateral side served as a no-treatment control. MAIN OUTCOME MEASURE: Repigmentation was assessed using the VASI, which was based on a composite estimate of the overall area of vitiligo patches at baseline and the degree of macular repigmentation within these patches over time. The VASI was validated separately against physician and patient global assessments. The overall reductions in VASI for NB-UV-B and control groups were modeled by multilevel regression with random effects and compared parametrically. RESULTS: The VASI scoring correlated well with both patient and physician global assessments (P =.05 and P<.001, respectively, using ordinal logistic regression). The extent of repigmentation after 6 months on the treated side was 42.9% (95% confidence interval, 26.7%-59.0%) vs 3.3% (95% confidence interval -19.3% to 30.0%) on the untreated side (P<.001). A significant difference between control and NB-UV-B groups was apparent within the first 2 months of therapy. The legs, trunk, and arms were much more likely to repigment than the feet and hands. CONCLUSIONS: The VASI is a quantitative clinical tool that can be used to evaluate vitiligo parametrically. Patients treated with NB-UV-B can be expected to achieve approximately 42.9% repigmentation of their vitiligo after 6 months of treatment, with the greatest response being achieved over the trunk and nonacral portions of the extremities.

Adult↗
PubMed1976

[Occupational vitiligo caused by para-tertiary-butylphenol, a trias of vitiligo, hepatosis and struma].

In the period between 1956-1974 twelve cases of occupational vitiligo due to para-tertiary butylphenol were observed. In addition another 12 cases of vitiligo of other etiology occurred. Occupational vitiligo cannot be distinguished from ordinary vitiligo. 21 patients had, aside from their leukodermia a normal thyroid function, and 18 patients showed symptoms of chronic liver damage. The trias of vitiligo, hepatic disease and struma euthyreotica was noticeable. Autoimmunisation tests were positive in cases of vitiligo of unknown etiology. The localization of vitiligo may be compared to viscero-cutaneous reflexes.

Autoimmune Diseases↗
PubMedDate not supplied

Management of vitiligo patients and attitude of dermatologists towards vitiligo.

As vitiligo does not cause any physical impairment, it is often considered unimportant by physicians. Vitiligo patients repeatedly experience disinterest from the medical world regarding their skin problem. A questionnaire survey was used to assess the management of vitiligo patients and the attitude of dermatologists towards vitiligo in Belgium. Vitiligo patients (n = 244) visiting an academic affiliated dermatology department were included and 454 out of 558 Belgian dermatologists returned a mailed questionnaire. Vitiligo patients do not often visit a doctor concerning their disease and do not often treat their disease. Disease severity as reported by the patient is correlated with the number of doctor visits (p = 0.001) but not to treatment of the disease. Information about the treatment and physician's encouragement to treat seem important in motivating patients to treat their vitiligo, but 50% of the patients were not adequately informed about their disease and its treatment during their first doctor visit. Today, nearly all the dermatologists report widely informing their patients, but only 36% of them encourage their patients to treat their disease, being pessimistic concerning expected treatment results. Interestingly, two thirds of the patients who ever treated their disease find it worthwhile.

Academic Medical Centers↗
PubMed1986

Psychosocial effect of vitiligo: a comparison of vitiligo patients with "normal" control subjects, with psoriasis patients, and with patients with other pigmentary disorders.

To ascertain the psychosocial effects of vitiligo, patients with vitiligo were compared with control subjects without skin diseases who were matched for age, sex, race, educational level, and marital status. Vitiligo patients were also compared with a matched sample of psoriasis patients and a matched sample of patients with other pigmentary disorders involving discoloration. The vitiligo patients scored lower on the Coopersmith Self-Esteem Inventory than did the "normal" control subjects. Vitiligo patients exhibited better adjustment to their disorder and experienced less social discrimination than did psoriasis patients, although the two groups did not differ on overall self-esteem. Patients with vitiligo did not differ significantly from those with other pigmentary disorders on any measure.

Adaptation, Psychological↗
PubMed2001

Specific cytotoxic T lymphocyte responses against Melan-A/MART1, tyrosinase and gp100 in vitiligo by the use of major histocompatibility complex/peptide tetramers: the role of cellular immunity in the etiopathogenesis of vitiligo.

Vitiligo is a common skin disease characterized by the presence of well circumscribed, depigmented, milky white macules devoid of identifiable melanocytes. Although the detection of circulating anti-melanocytic antibodies and of infiltrating lymphocytes at the margin of lesions supports the view that vitiligo is an autoimmune disorder, its etiology remains unknown. In particular, it is still a matter of debate whether the primary pathogenic role is exerted by humoral or cellular abnormal immune responses. In this study, the presence of specific cytotoxic T lymphocyte responses against the melanocyte differentiation antigens Melan-A/MART1, tyrosinase, and gp100 in vitiligo patients have been investigated by the use of major histocompatibility complex/peptide tetramers. High frequencies of circulating melanocyte-specific CD8+ T cells were found in all vitiligo patients analyzed. These cells exerted anti-melanocytic cytotoxic activity in vitro and expressed skin-homing capacity. In one patient melanocyte-specific cells were characterized by an exceptionally high avidity for their peptide/major histocompatibility complex ligand. These findings strongly suggest a role for cellular immunity in the pathogenesis of vitiligo and impact on the common mechanisms of self tolerance.

Antigens, Neoplasm↗
PubMed1996

5-azacytidine treatment induces autoimmune vitiligo in parental control strains of the Smyth line chicken model for autoimmune vitiligo.

The effect of 5-Azacytidine (5-AzaC) on melanization was examined in two sublines of the Smyth line (SL) chicken model for autoimmune vitiligo, in two MHC-matched vitiligo-susceptible but normally pigmented controls (BL), and in nonsusceptible controls (LBL). 5-AzaC was administered ip every 3 days from day of hatch to 18 weeks at levels of 1 or 3 mg/kg body wt. Both treatments increased (P < 0.01) the incidence of autoimmune vitiligo in BL controls. In contrast, treatment significantly depressed (P < 0.01) the expected high incidence of vitiligo in one SL subline, but not in the other. There were no apparent pigmentation changes in 5-AzaC-treated LBL controls. 5-AzaC had dose-dependent depressing effects (P < 0.01) on body and lymphoid organ weights. Histological and mitogen assay data suggest negative effects on lymphocyte number and function. The data show that 5-AzaC can initiate autoimmune disease in genetically susceptible but phenotypically normal individuals.

Animals↗
PubMed1984

Vitiligo and melanoma: can genetically abnormal melanocytes result in both vitiligo and melanoma within a single family?

We found twelve families with melanoma who had close family members with halo nevi, early graying of hair, a halo primary melanoma, or ordinary vitiligo. On the basis of these findings and the observation of others in fish, horses, and pigs with melanomas, we suggest that the melanocytes of people with vitiligo or with a genetic background for vitiligo are predisposed to undergo a malignant transformation. The presence of vitiligo appears as a manifestation of host suppression of malignant melanocytes.

Adolescent↗
PubMed1982

Retinitis pigmentosa associated with hearing loss, thyroid disease, vitiligo, and alopecia areata: retinitis pigmentosa and vitiligo.

A 54-year-old woman with retinitis pigmentosa and hearing loss developed white skin patches that were subsequently diagnosed as vitiligo. A review of the literature reveals that, although the association of vitiligo with various tapedoretinal degenerations has been reported on several occasions, the association with typical retinitis pigmentosa is quite rare. This combination of disorders associated with pigment loss is of interest as immunologic disturbances have been implicated on both.

Alopecia Areata↗
PubMed1984

Immunopathology of vitiligo vulgaris, Sutton's leukoderma and melanoma-associated vitiligo in relation to steroid effects. I. Circulating antibodies for cultured melanoma cells.

Sera of patients with various types of vitiligo have been found to contain circulating antibodies for the cytoplasmic components of human melanoma cell lines. This incidence is high, especially in generalized vitiligo vulgaris with or without Sutton's phenomenon. There is good correlation between the antibodies and positive microsome test, thyroid test, DNA test, as well as the effect of steroid ointment.

Adolescent↗
PubMed1993

[Vitiligo--an enigmatic disease. II. Therapy of vitiligo].

The work gives a review of therapeutic methods of vitiligo. PUVA therapy, application of cortisonoids, khellin (including UVA), phenylalanine (including UVA), melagenina, and laser therapy represent non-surgical methods. Surgical methods include application of fluorouracil following dermabrasion, of autologous epidermal grafting transplantation of in vitro cultured epidermis, in vitro cultured melanocytes and micropigmentation by pigment. Auxiliary methods are represented by administration of carotene, using sunscreens and if necessary cosmetic treatment. Entire depigmentation is done in accordance with the extent of vitiligo, unsuccessful repigmentation and the age of the patient. The conclusion points out psychosocial aspects and the necessity of mutual cooperation of both, physician and patient. (Ref. 53.)

Humans↗
PubMed1984

Immunopathology of vitiligo vulgaris, Sutton's leukoderma and melanoma-associated vitiligo in relation to steroid effects. II. The IgG and C3 deposits in the skin.

Microsome, thyroid and DNA tests on patients with generalized vitiligo vulgaris, with or without Sutton's leukoderma, show a high positive rate without thyroid diseases. A small, but not negligible, amount of IgG and C3 deposits in the basement-membrane zone and keratinocytes, has been frequently seen in these diseases by immunohistology and immuno-electron microscopy. This evidence strongly suggests an autoimmune character for these diseases.

Adult↗
PubMed1976

[Post-traumatic achromia in vitiligo (vitiligo facticio)].

Two patients affected with vitiligo showed achromic lesions in areas of skin apparently normal submitted to the action of external traumatic agents. In the first case the striate linear lesion might be attributed to the excoriation due to pruritus determined by scabies. In the second one an angular lesion in both feet was strictly limited to the areas exposed to the straps of sandals.

Adult↗