Identifying key components for psychological intervention for people with vitiligo
A poster based on the findings of a survey of patients and health professionals to identify psychological interventions for vitiligo has been accepted for display at the 2015 BAD meeting in Manchester. The work was funded by a grant from the UK Dermatology Clinical Trials Network.
Piperine Update Report
Black pepper, piperine and vitiligo – a personal history from Amala Soumyanath (nee Amala Raman).
Amala Soumyanath led the research that discovered piperine as a potential treatment for vitiligo. Here she tells the story from her personal point of view, and brings us up to date with current developments:
A Personal Passion: My First Introduction to Vitiligo
My connection with vitiligo began on an ordinary working day - almost 20 years ago! As a registered pharmacist with a Ph.D, I held a faculty position in the Department of Pharmacy, King’s College London.
Quality of Life and Psychological Aspects
Dr Kiprono and colleagues from Tanzania found that in vitiligo patients of African descent there was a moderate impairment of quality of life when studied using the Dermatology Life Quality Index (DLQI: International Journal of Dermatology 2013; 52: 191-4). In Turkey, Dr Bilgic and colleagues looked at depression in children and adolescents with vitiligo (see Clinical and Experimental Dermatology 2011; 36: 360-5).
Vitiligo - Thyroid Disease and Skin Cancer
In the course of their clinical work, dermatologists have noted for some years an association between vitiligo and thyroid disease. Vrijman and colleagues from Amsterdam, The Netherlands, undertook a review of this and found that there was indeed an association (see British Journal of Dermatology 2012; 167: 1224-35).
Segmental Vitiligo and the Classification of Vitiligo
Segmental vitiligo, is characterized by a unilateral and localised distribution of vitiligo patches. Dr van Geel and collaborators have looked at this type of vitiligo (see British Journal of Dermatology 2013; 168: 56-64). So far, the underlying mechanism is still an enigma.
Köebner Phenomenom and Halo Naevi
The Koebner phenomenon (KP) refers to the development of vitiligo within an area of skin that has been damaged by localised, often mild trauma eg an injury. Dr N van Geel and colleagues of Ghent have looked at this phenomenon (see British Journal of Dermatology 2012;167:1017-24.). They developed a new assessment method for KP, taking into account both the history and clinical examination of people with vitiligo; this seems to be a useful and valuable tool for assessing KP in daily practice.
(How the condition develops)
The pathogenesis of vitiligo is believed to involve oxidative stress (an imbalance between the presence of toxic so-called reactive oxygen species (ROS) and the body’s ability to detoxify them). Based on this, according to Dell’Anna and colleagues in Rome, Italy, the generation of reactive oxygen species (ROS) by the mitochondria within melanocytes and blood cells may be relevant in the development of vitiligo (Journal of Cellular Physiology 2010; 223: 187-93).
Genetic and Epidermis Research
The research group of Professor Richard Spritz in the University of Colorado USA has undertaken many important studies of the genetic basis of vitiligo over the last few years. In the most recent paper (Nature Genetics 2012; 44: 676-80) they summarise that most genes that indicate a susceptibility to vitiligo are involved with proteins or parts of the pigment cell that are important for the functioning of the immune system.
It is difficult to find a systemic treatment for vitiligo at the moment (one that affects the whole body). Dr Szczurko et al have looked at ginkgo biloba (BMC Complementary and Alternative Medicine 2011 Mar 15;11:21). They report on a trial given to twelve participants aged 12 to 35 years old who were treated with 60 mg of standardized Ginkgo biloba two times per day for 12 weeks.
Surgical treatments are only suitable for people with stable vitiligo. They involve transplanting pigment cells (melanocytes) from someone’s normally pigmented skin into their vitiligo skin. Recent research in India suggests that the results of this procedure can be improved by suspending the melanocytes in the patients' own serum (plasma in blood).
Topical, Light and Laser Treatments
Treatments in the form of creams or ointments are the usual place to start with treatments for vitiligo, although it does depend on where it is on the body and its extent. They are known as topical immunomodulator s because they can suppress the immune response in vitiligo patches.