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Vitiligo: An Inflammatory Condition With Psychological Impact

Posted on July 21, 2020

  • Vitiligo is a skin condition that destroys cells that produce pigment, causing white patches on the skin.
  • Vitiligo can cause psychological stress and impair social functioning, thus having a severe impact on quality of life.
  • Clinical trials testing new potential vitiligo treatments are underway.
  • Inflammation plays a major role in vitiligo.
  • Modifying aspects of the immune system involved in inflammation may be an effective way to treat vitiligo.

Vitiligo Affects More Than Just Skin

Lighter patches of skin may be the only visible symptom of vitiligo, but the skin condition can have a huge impact on people’s lives and well-being. In multiple global studies of people with vitiligo, participants consistently report that vitiligo has a negative effect on their self-esteem and quality of life.1

For adults, vitiligo can affect all aspects of social life from shaking hands when first meeting someone to career opportunities to people’s sexual lives.1,2 Teenagers, especially those ages 15 to 17, can be significantly impacted by their vitiligo.1 In one study involving 350 children up to age 17 with vitiligo, those whose vitiligo affected more than 25 percent of their body surface area reported self-consciousness, fear, and bullying.1

Several studies have found that people with vitiligo patches on prominent areas, such as the face and hands, and sensitive areas, such as the genitals, experience a more severe impact on their quality of life.1 Although vitiligo is more visible in people with darker skin due to the higher contrast of the depigmented patches, even those with lighter skin consistently report some degree of emotional distress due to the condition.1

Do you know your vitiligo type?

Why Is It Important to Find New Vitiligo Treatments?

At this time, there are no approved drug treatments for repigmentation of the skin in people with vitiligo.3 Treatments available now for vitiligo vary in their effectiveness.4 Light therapy has been shown to be effective; however, it requires two or three trips each week to a clinic for six to 12 months, which can be burdensome and impractical.3 Some treatments for vitiligo can cause serious side effects.5 So far, no vitiligo treatment has been able to produce long-lasting effects or modify the course of the disease.6

In people with vitiligo, melanocytes – the cells that make skin pigment – die off, leaving uneven white patches.7 Vitiligo is believed to be an autoimmune disorder caused when the immune system mistakenly attacks and destroys melanocytes.7

The Role of Inflammation

Inflammation is the body’s response to an irritant.8 Your body responds with inflammation when it is invaded by germs and foreign objects, for example, a splinter.8 Inflammation is also a common feature of autoimmune conditions.9 In autoimmune diseases, the immune system mistakes the body’s own tissues as dangerous invaders and mounts an inappropriate attack – inflammation – against them.9 In people with vitiligo, melanocytes become the target of autoimmune inflammatory attacks.

In autoimmune diseases such as vitiligo, inflammation is associated with an overproduction of substances called chemokines.9 Chemokines are chemicals that function as signals to attract immune cells to a part of the body to join an attack against an invader.9 In cases of vitiligo, chemokines call autoimmune cells to the skin, worsening the attack on melanocytes and creating white patches. Researchers do not completely understand what causes the immune cells to attack melanocytes. Treatments that modify how chemokines participate in autoimmune attacks may be one way to treat vitiligo.

Do you have questions about participating in a clinical trial? Read myths and facts about joining a clinical study.

References

  1. Grimes, P.; Miller, M. (2018). Vitiligo: Patient stories, self-esteem, and the psychological burden of disease. International Journal of Women's Dermatology, 4(1), 32-37. doi:10.1016/j.ijwd.2017.11.005
  2. Florez-Pollack, S., Jia, G., Zapata, L., Rodgers, C., Hernandez, K., Hynan, L. S.; Pandya, A. G. (2017). Association of Quality of Life and Location of Lesions in Patients With Vitiligo. JAMA Dermatology, 153(3), 341. doi:10.1001/jamadermatol.2016.4670
  3. Frisoli, M. L.; Harris, J. E. (2017). Vitiligo: Mechanistic insights lead to novel treatments. Journal of Allergy and Clinical Immunology, 140(3), 654-662. doi:10.1016/j.jaci.2017.07.011
  4. Speeckaert, R., Speeckaert, M. M.; Geel, N. V. (2015). Why treatments do(n't) work in vitiligo: An autoinflammatory perspective. Autoimmunity Reviews, 14(4), 332-340. doi:10.1016/j.autrev.2014.12.003
  5. Vitiligo: Diagnosis and treatment. (n.d.). Retrieved April 16, 2020, from https://www.aad.org/diseases/a-z/vitiligo-treatment
  6. Doctors Treatment Guidelines. (VR Foundation). Retrieved April 16, 2020, from https://vrfoundation.org/treatment_guidelines
  7. Vitiligo: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved April 16, 2020, from https://medlineplus.gov/ency/article/000831.htm
  8. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is an inflammation? 2010 Nov 23 [Updated 2018 Feb 22]. Retrived April 16, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK279298/
  9. Hyde, D. (n.d.). Inflammation and Autoimmune Disease. Retrieved April 16, 2020, from http://www.gluegrant.org/inflammation-autoimmune.htm
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