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What Is It Called When You Have Two Skin Colors

Written By Thursday, May 12, 2022 Add Comment Edit

Skin condition where patches lose pigment

Medical condition

Vitiligo
Vitiligo2.JPG
Non-segmental vitiligo of the paw
Pronunciation
Specialty Dermatology
Symptoms Patches of white skin[one]
Elapsing Long term[ane]
Causes Unknown[i]
Run a risk factors Family history, other autoimmune diseases[2]
Diagnostic method Tissue biopsy[2]
Handling Sunscreen, makeup, topical corticosteroids, phototherapy[i] [2]
Frequency one% of people[3]

Vitiligo (), too called leucoderma, is a long-term skin condition characterized by patches of the skin losing their pigment.[i] The patches of skin afflicted get white and usually have sharp margins.[1] The hair from the skin may too become white.[1] The inside of the rima oris and olfactory organ may also exist involved.[2] Typically both sides of the torso are affected.[1] Oft the patches begin on areas of skin that are exposed to the sunday.[2] It is more noticeable in people with dark peel.[2] Vitiligo may upshot in psychological stress and those affected are sometimes stigmatized.[1]

The exact cause of vitiligo is unknown.[1] It is believed to be due to genetic susceptibility that is triggered by an environmental factor such that an autoimmune disease occurs.[1] [2] This results in the destruction of skin paint cells.[2] Take chances factors include a family unit history of the condition or other autoimmune diseases, such as hyperthyroidism, alopecia areata, and pernicious anemia.[2] It is not contagious.[iv] Vitiligo is classified into 2 main types: segmental and non-segmental.[i] Most cases are non-segmental, meaning they touch both sides; and in these cases, the afflicted expanse of the skin typically expands with fourth dimension.[1] About 10% of cases are segmental, significant they by and large involve 1 side of the torso; and in these cases, the affected expanse of the skin typically does not expand with time.[i] Diagnosis can exist confirmed by tissue biopsy.[two]

There is no known cure for vitiligo.[one] For those with light skin, sunscreen and makeup are all that is typically recommended.[one] Other treatment options may include steroid creams or phototherapy to darken the light patches.[two] Alternatively, efforts to lighten the unaffected peel, such every bit with hydroquinone, may be tried.[two] Several surgical options are available for those who do not improve with other measures.[2] A combination of treatments generally has amend outcomes.[3] Counselling to provide emotional support may be useful.[i]

Globally about 1% of people are affected by vitiligo.[3] In some populations information technology affects as many as 2–3%.[five] Males and females are every bit affected.[1] About half show the disorder earlier age 20 and almost develop it before age xl.[1] Vitiligo has been described since aboriginal history.[ane]

Signs and symptoms [edit]

The only sign of vitiligo is the presence of pale patchy areas of depigmented skin which tend to occur on the extremities.[6] [seven] Some people may experience itching earlier a new patch occurs.[8] The patches are initially pocket-sized, but often abound and change shape.[six] [nine] When skin lesions occur, they are near prominent on the face up, hands and wrists.[6] [7] The loss of skin pigmentation is particularly noticeable around body orifices, such every bit the mouth, optics, nostrils, genitalia and omphalus.[6] [seven] Some lesions have increased pare pigment effectually the edges.[ten] Those afflicted by vitiligo who are stigmatized for their status may experience low and similar mood disorders.[11]

  • Vitiligo on lighter peel

  • Non-segmental vitiligo on nighttime skin, hand facing up

  • Non-segmental vitiligo of the eyelids

Causes [edit]

Although multiple hypotheses have been suggested as potential triggers that cause vitiligo, studies strongly imply that changes in the immune system are responsible for the condition.[1] [12] Vitiligo has been proposed to exist a multifactorial disease with genetic susceptibility and environmental factors both thought to play a role.[1]

The TYR gene encodes the protein tyrosinase, which is not a component of the immune organisation, but is an enzyme of the melanocyte that catalyzes melanin biosynthesis, and a major autoantigen in generalized vitiligo.[ane] The National Institutes of Health states that some believe that sunburns can crusade or exacerbate the condition, but that this thought is non well-supported by expert bear witness.[thirteen]

Immune [edit]

Variations in genes that are role of the allowed system or part of melanocytes accept both been associated with vitiligo.[1] It is also thought to be acquired by the immune organization attacking and destroying the melanocytes of the pare.[14] A genome wide association study constitute approximately 36 independent susceptibility loci for generalized vitiligo.[15]

Autoimmune associations [edit]

Vitiligo is sometimes associated with autoimmune and inflammatory diseases such as Hashimoto's thyroiditis, scleroderma, rheumatoid arthritis, type 1 diabetes mellitus, psoriasis, Addison's illness, pernicious anemia, alopecia areata, systemic lupus erythematosus, and celiac disease.[i] [16]

Among the inflammatory products of NALP1 are caspase 1 and caspase 7, which activate the inflammatory cytokine interleukin-1β. Interleukin-1β and interleukin-18 are expressed at high levels in people with vitiligo.[17] In ane 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 development, and is institute in humans, chimpanzee, rhesus monkey, and the bush babe. Addison'south illness (typically an autoimmune destruction of the adrenal glands) may also be seen in individuals with vitiligo.[18] [19]

Diagnosis [edit]

UV photograph of a hand with vitiligo

UV photo of a foot with vitiligo

An ultraviolet lite can be used in the early on phase of this disease for identification and to determine the effectiveness of treatment.[20] Using a Wood's light, skin will change color (fluoresce) when information technology is affected by certain bacteria, fungi, and changes to pigmentation of the skin.[21]

Classification [edit]

Classification attempts to quantify vitiligo have been analyzed as being somewhat inconsistent,[22] while recent consensus have agreed to a system of segmental vitiligo (SV) and non-segmental vitiligo (NSV). NSV is the well-nigh mutual type of vitiligo.[1]

Non-segmental [edit]

In non-segmental vitiligo (NSV), there is usually some form of symmetry in the location of the patches of depigmentation. New patches also appear over fourth dimension and can be generalized over large portions of the body or localized to a item area. Extreme cases of vitiligo, to the extent that little pigmented skin remains, are referred to as vitiligo universalis. NSV tin can come near at any age (dissimilar segmental vitiligo, which is far more prevalent in teenage years).[ten]

Classes of not-segmental vitiligo include the post-obit:

  • Generalized vitiligo: the virtually common pattern, wide and randomly distributed areas of depigmentation[23]
  • Universal vitiligo: depigmentation encompasses about of the trunk[23]
  • Focal vitiligo: one or a few scattered macules in one surface area, virtually common in children[23]
  • Acrofacial vitiligo: fingers and periorificial areas[23]
  • Mucosal vitiligo: depigmentation of only the mucous membranes[23]

Segmental [edit]

Segmental vitiligo (SV) differs in advent, cause, and frequency of associated illnesses. Its treatment is dissimilar from that of NSV. Information technology tends to affect areas of skin that are associated with dorsal roots from the spinal cord and is most often unilateral.[one] [24] It is much more than stable/static in course and its association with autoimmune diseases appears to be weaker than that of generalized vitiligo.[24] SV does non improve with topical therapies or UV light, yet surgical treatments such as cellular grafting can be effective.[10]

Differential diagnosis [edit]

Chemical leukoderma is a similar condition due to multiple exposures to chemicals.[25] Vitiligo however is a risk factor.[25] Triggers may include inflammatory pare conditions, burns, intralesional steroid injections and abrasions.[26]

Other conditions with similar symptoms include the following:

  • Albinism
  • Halo nevus
  • Idiopathic guttate hypomelanosis (white sunspots)[23]
  • Piebaldism[23]
  • Pityriasis alba
  • Postinflammatory hypopigmentation
  • Principal adrenal insufficiency
  • Progressive macular hypomelanosis[23]
  • Tinea versicolor[23]
  • Tuberculoid leprosy

Treatment [edit]

There is no cure for vitiligo but several treatment options are bachelor.[ane] The all-time evidence is for practical steroids and the combination of ultraviolet low-cal in combination with creams.[27] Due to the higher risks of pare cancer, the United Kingdom'south National Health Service suggests phototherapy exist used just if master treatments are ineffective.[28] Lesions located on the hands, feet, and joints are the nearly hard to repigment; those on the face are easiest to return to the natural skin colour as the peel is thinner in nature.[ane]

Immune mediators [edit]

Topical preparations of immune suppressing medications including glucocorticoids (such as 0.05% clobetasol or 0.x% betamethasone) and calcineurin inhibitors (such as tacrolimus or pimecrolimus) are considered to be beginning-line vitiligo treatments.[1]

Phototherapy [edit]

Phototherapy is considered a second-line treatment for vitiligo.[1] Exposing the skin to light from UVB lamps is the almost common treatment for vitiligo. The treatments tin can be done at dwelling house with an UVB lamp or in a dispensary. The exposure time is managed so that the skin does not suffer overexposure. Treatment tin can take a few weeks if the spots are on the cervix and face up and if they existed not more than 3 years. If the spots are on the hands and legs and have been at that place for more than 3 years, it tin take a few months. Phototherapy sessions are washed 2–3 times a calendar week. Spots on a large area of the body may require total body handling in a clinic or hospital. UVB broadband and narrowband lamps can be used,[29] [30] but narrowband ultraviolet picked around 311 nm is the pick. It has been constitutively reported that a combination of UVB phototherapy with other topical treatments improves re-pigmentation. Nonetheless, some people with vitiligo may not come across any changes to skin or re-pigmentation occurring. A serious potential side issue involves the risk of developing skin cancer, the same chance every bit an overexposure to natural sunlight.[ citation needed ]

Ultraviolet light (UVA) treatments are ordinarily carried out in a infirmary clinic. Psoralen and ultraviolet A calorie-free (PUVA) handling involves taking a drug that increases the skin's sensitivity to ultraviolet light, then exposing the skin to high doses of UVA lite. Handling is required twice a week for 6–12 months or longer. Considering of the high doses of UVA and psoralen, PUVA may crusade side effects such every bit sunburn-blazon reactions or skin freckling.[28]

Narrowband ultraviolet B (NBUVB) phototherapy lacks the side-effects acquired by psoralens and is as effective as PUVA.[i] Every bit with PUVA, treatment is carried out twice weekly in a clinic or every day at home, and there is no need to use psoralen.[28] Longer treatment is often recommended, and at to the lowest degree 6 months may be required for effects to phototherapy.[31] NBUVB phototherapy appears better than PUVA therapy with the most constructive response on the face and neck.[31]

With respect to improved repigmentation: topical calcineurin inhibitors plus phototherapy are improve than phototherapy alone,[32] hydrocortisone plus laser lite is improve than laser calorie-free alone, gingko biloba is better than placebo, and oral mini-pulse of prednisolone (OMP) plus NB-UVB is better than OMP alone.[8]

Pare camouflage [edit]

In balmy 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 tanning of unaffected peel.[23]

De-pigmenting [edit]

In cases of all-encompassing vitiligo the option to de-pigment the unaffected skin with topical drugs like monobenzone, mequinol, or hydroquinone may exist considered to render the skin an even color. The removal of all the pare pigment with monobenzone is permanent and vigorous. Sun-safety must be adhered to for life to avert severe sunburn and melanomas. Depigmentation takes most a year to complete.[28]

History [edit]

Descriptions of a illness believed to be vitiligo date back to a passage in the medical text Ebers Papyrus c.  1500 BCE in ancient Egypt. Mentions of whitening of the skin were besides nowadays c. 1400 BCE in sacred Indian texts such as Atharvaveda. The Hebrew discussion "Tzaraath" from the Old Attestation book of Leviticus[33] dating to 1280 BCE[34] (or 1312 BCE[35]) described a group of pare diseases associated with white spots, and a subsequent translation to Greek led to continued conflation of those with vitiligo with leprosy and spiritual uncleanliness.[33]

Medical sources in the ancient world such as Hippocrates oft did not differentiate between vitiligo and leprosy, often grouping these diseases together. The proper name "vitiligo" was first used by the Roman physician Aulus Cornelius Celsus in his classic medical text De Medicina.[33]

The etymology of the term "vitiligo" is believed to be derived from "vitium", pregnant "defect" or "blemish".[33]

Lodge and civilisation [edit]

The change in appearance caused by vitiligo can bear on a person's emotional and psychological well-beingness and may create difficulty in becoming or remaining employed, particularly if vitiligo develops on visible areas of the torso, such as the face, hands, or artillery. Participating in a vitiligo back up grouping may improve social coping skills and emotional resilience.[36] Notable cases include popular singer Michael Jackson,[37] Canadian fashion model Winnie Harlow,[38] actor David Dastmalchian, and Argentine musician Charly García. French histrion Michaël Youn is also affected,[39] equally is sometime French Prime Minister Edouard Philippe.[40]

Research [edit]

As of July 2013[update], afamelanotide is in phase 2 and III clinical trials for vitiligo and other skin diseases.[41]

A medication for rheumatoid arthritis, tofacitinib, has been tested for the treatment of vitiligo.[42]

In October 1992, a scientific written report was published of successfully transplanting melanocytes to vitiligo-affected areas, effectively re-pigmenting the region.[43] The procedure involved taking a thin layer of pigmented skin from the person's gluteal region. Melanocytes were then separated out to a cellular suspension that was expanded in culture. The area to exist treated was then denuded with a dermabrader and the melanocytes graft practical. Between seventy and 85 percentage of people with vitiligo experienced nearly complete repigmentation of their peel. The longevity of the repigmentation differed from person to person.[44]

References [edit]

  1. ^ a b c d e f g h i j chiliad l m n o p q r s t u v w x y z aa ab ac ad ae af Ezzedine, K; Eleftheriadou, Five; Whitton, M; van Geel, N (4 July 2015). "Vitiligo". Lancet. 386 (9988): 74–84. doi:10.1016/s0140-6736(xiv)60763-7. PMID 25596811. S2CID 208791128.
  2. ^ a b c d e f g h i j k l m "Questions and Answers about Vitiligo". NIAMS. June 2014. Archived from the original on 21 August 2016. Retrieved 11 August 2016.
  3. ^ a b c Whitton, M; Pinart, Grand; Batchelor, JM; et al. (May 2016). "Evidence-based direction of vitiligo: summary of a Cochrane systematic review". The British Journal of Dermatology. 174 (five): 962–69. doi:ten.1111/bjd.14356. PMID 26686510. S2CID 38560830.
  4. ^ Chopra, Parul; Niyogi, Rageshree; Katyal, Gauri (2009). Skin and Hair Care: Your Questions Answered. Byword Books Private Limited. p. 2. ISBN978-8181930378. Archived from the original on 23 March 2017.
  5. ^ Krüger C; Schallreuter KU (October 2012). "A review of the worldwide prevalence of vitiligo in children/adolescents and adults". Int J Dermatol. 51 (10): 1206–12. arXiv:0706.4406. doi:10.1111/j.1365-4632.2011.05377.x. PMID 22458952. S2CID 5084045.
  6. ^ a b c d National Institute of Arthritis and Musculoskeletal and Peel Diseases (March 2007). "What Is Vitiligo? Fast Facts: An Easy-to-Read Series of Publications for the Public Additional". Archived from the original on 15 July 2010. Retrieved eighteen July 2010.
  7. ^ a b c Halder RM (2007). "72. Vitiligo". In Wolff Thousand, Freedberg IM, Fitzpatrick TB (eds.). Fitzpatrick's dermatology in full general medicine (seventh ed.). New York: McGraw-Loma Professional. ISBN978-0-07-146690-five. OCLC 154751587.
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  9. ^ Halder, RM; Chappell, JL (2009). "Vitiligo update". Seminars in Cutaneous Medicine and Surgery. 28 (2): 86–92. doi:10.1016/j.sder.2009.04.008. PMID 19608058.
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  12. ^ Ongenae, Katia; Van Geel, Nanny; Naeyaert, Jean-Marie (April 2003). "Show for an Autoimmune Pathogenesis of Vitiligo". Paint Cell Research. sixteen (2): ninety–100. doi:10.1034/j.1600-0749.2003.00023.x. PMID 12622785.
  13. ^ "Questions and Answers about Vitiligo". National Institute of Arthritis and Musculoskeletal and Skin Diseases. 30 Oct 2016. Retrieved 22 July 2018.
  14. ^ Staff, Mayo Clinic (xv May 2014). "Vitiligo Causes". Mayoclinic. Archived from the original on 30 April 2015. Retrieved 22 April 2015.
  15. ^ Spritz, Richard A. (May 2013). "Mod vitiligo genetics sheds new light on an ancient affliction". The Journal of Dermatology. forty (v): 310–eighteen. doi:10.1111/1346-8138.12147. PMC3783942. PMID 23668538.
  16. ^ Van Driessche F, Silverberg N (2015). "Electric current Management of Pediatric Vitiligo". Paediatr Drugs (Review). 17 (4): 303–xiii. doi:10.1007/s40272-015-0135-3. PMID 26022363. S2CID 20038695.
  17. ^ Lamkanfi M, Vande Walle L, Kanneganti TD (2011). "Deregulated inflammasome signaling in affliction". Immunol Rev (Review). 243 (ane): 163–73. doi:10.1111/j.1600-065X.2011.01042.x. PMC3170132. PMID 21884175.
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  19. ^ Jin Y, Mailloux CM, Gowan Yard, et al. (2007). "NALP1 in vitiligo-associated multiple autoimmune affliction" (PDF). The New England Periodical of Medicine. 356 (12): 1216–25. doi:10.1056/NEJMoa061592. PMID 17377159.
  20. ^ Wang, Yen-Jen; Chang, Chang-Cheng; Cheng, Kun-Lin (Dec 2017). "Wood's lamp for vitiligo disease stability and early recognition of initiative pigmentation later epidermal grafting". International Wound Journal. 14 (six): 1391–94. doi:10.1111/iwj.12800. PMC7949874. PMID 28799192. S2CID 205222684.
  21. ^ Al Aboud, Daifallah M.; Gossman, William (2019). "Wood Light (Woods Lamp)". StatPearls. StatPearls Publishing. PMID 30725878.
  22. ^ Picardo, Mauro; Taïeb, Alain, eds. (2009). "Introduction". Vitiligo. Berlin: Springer. ISBN978-iii-540-69360-4.
  23. ^ a b c d due east f g h i j Halder, R. M.; et al. (2007). "Vitiligo". In Wolff, Chiliad.; et al. (eds.). Fitzpatrick's Dermatology in Full general Medicine (7th ed.). New York: McGraw-Hill Professional. ISBN978-0-07-146690-v.
  24. ^ a b van Geel Northward, Mollet I, Brochez L, et al. (Feb 2012). "New insights in segmental vitiligo: case report and review of theories". British Journal of Dermatology. 166 (2): 240–46. doi:10.1111/j.1365-2133.2011.10650.x. PMID 21936857. S2CID 32746282.
  25. ^ a b James, William Daniel; Berger, Timothy G.; Elston, Dirk Thou. (2015). "Disturbances of Pigmentation". Andrews' Diseases of the Peel: Clinical Dermatology. Elsevier. ISBN978-0323319676.
  26. ^ James, William D.; Berger, Timothy K.; et al. (2006). Andrews' Diseases of the Peel: Clinical Dermatology. Saunders Elsevier. p. 864. ISBN978-0-7216-2921-vi.
  27. ^ Whitton, ME; Ashcroft, DM; González, U (October 2008). "Therapeutic interventions for vitiligo". Periodical of the American University of Dermatology. 59 (4): 713–17. doi:10.1016/j.jaad.2008.06.023. PMID 18793940.
  28. ^ a b c d Betimes. "Vitiligo -Treatment". Patient UK. NHS. Archived from the original on half dozen June 2013. Retrieved three June 2013.
  29. ^ Scherschun, L; Kim, JJ; Lim, HW (2001). "Narrow-ring ultraviolet B is a useful and well-tolerated treatment for vitiligo". Journal of the American Academy of Dermatology. 44 (6): 999–1003. doi:10.1067/mjd.2001.114752. PMID 11369913. S2CID 17431219.
  30. ^ Don, Philip; Iuga, Aurel; Dacko, Anne; Hardick, Kathleen (2006). "Handling of vitiligo with broadband ultraviolet B and vitamins". International Journal of Dermatology. 45 (ane): 63–65. doi:10.1111/j.1365-4632.2005.02447.x. PMID 16426381. S2CID 454415.
  31. ^ a b Bae, Jung Min; Jung, Han Mi; Hong, Bo Young; Lee, Joo Hee; Choi, Won Joon; Lee, Ji Hae; Kim, Gyong Moon (1 July 2017). "Phototherapy for Vitiligo: A Systematic Review and Meta-analysis". JAMA Dermatology. 153 (7): 666–74. doi:10.1001/jamadermatol.2017.0002. ISSN 2168-6068. PMC5817459. PMID 28355423.
  32. ^ Bae, Jung Min; Hong, Bo Young; Lee, Joo Hee; Lee, Ji Hae; Kim, Gyong Moon (May 2016). "The efficacy of 308-nm excimer laser/light (EL) and topical agent combination therapy versus EL monotherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials (RCTs)". Journal of the American Academy of Dermatology. 74 (5): 907–15. doi:x.1016/j.jaad.2015.11.044. PMID 26785803.
  33. ^ a b c d Gauthier, Yvon; Benzekri, Laila (2009). "Historical Aspects". In Picardo, Mauro; Taïeb, Alain (eds.). Vitiligo (Online-Ausg. ed.). Berlin: Springer. ISBN978-3-540-69360-iv.
  34. ^ Kurzweil, Arthur (2008). The Torah For Dummies (PDF). For Dummies. p. xi. ISBN978-0-470-28306-6 . Retrieved 19 August 2010.
  35. ^ History Crash Course #36: Timeline: From Abraham to Destruction of the Temple Archived twenty July 2014 at the Wayback Automobile, by Rabbi Ken Spiro, Aish.com. Retrieved 2010-08-19.
  36. ^ Chaturvedi, SK; Singh, G; Gupta, N (October 2005). "Stigma experience in skin disorders: an Indian perspective". Dermatologic Clinics. 23 (4): 635–42. doi:10.1016/j.det.2005.05.007. PMID 16112439.
  37. ^ Vogel, Joseph (17 March 2018). "Black and White: how Dangerous kicked off Michael Jackson's race paradox". The Guardian . Retrieved 14 September 2019.
  38. ^ "Winnie Harlow: Canadian Model With Rare Skin Condition Lands 2 Major Campaigns". Circuitous . Retrieved 17 February 2020.
  39. ^ Média, Prisma. "Michaël Youn : l'étonnante maladie génétique dont il est atteint… au niveau du pénis - Voici". Voici.fr (in French). Retrieved 25 September 2021.
  40. ^ Match, Paris. "Dans les coulisses de la campagne d'Edouard Philippe au Havre". parismatch.com (in French). Retrieved 25 September 2021.
  41. ^ Fabrikant J; et al. (July 2013). "A review and update on melanocyte stimulating hormone therapy: afamelanotide". J Drugs Dermatol. 12 (seven): 775–79. PMID 23884489.
  42. ^ "For vitiligo patient, arthritis drug restores pare color". 24 June 2015. Archived from the original on 22 July 2015.
  43. ^ Olsson MJ, Juhlin L (1992). "Melanocyte transplantation in vitiligo". Lancet. 340 (8825): 981. doi:10.1016/0140-6736(92)92875-1000. PMID 1357390. S2CID 19599682.
  44. ^ Olsson MJ, Juhlin Fifty (2002). "Long-term follow-up of leucoderma patients treated with transplants of autologous cultured melanocytes, ultrathin epidermal sheets and basal cell layer suspension". The British Journal of Dermatology. 147 (5): 893–904. doi:10.1046/j.1365-2133.2002.04837.10. PMID 12410698. S2CID 42396825.

External links [edit]

  • Vitiligo at Curlie
  • Questions and Answers about Vitiligo – United states National Plant of Arthritis and Musculoskeletal and Peel Diseases

Source: https://en.wikipedia.org/wiki/Vitiligo

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