Understanding Vitiligo: Causes, Diagnosis, Promising Advances in Treatment and Management and the Impact on Mental Health

  • Tadikonda Rama Rao Professor & Principal, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India
  • Hafsa Sharmeen Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India
  • Afshaan Tabassum Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India
  • Sena Jessy Jasmine Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Abstract

Vitiligo is a chronic skin disorder characterized by the loss of pigmentation, resulting in white patches on the skin. The condition arises from the destruction of melanocytes, the cells responsible for producing melanin, the pigment that gives colour to the skin, hair, and eyes. Although the exact etiology of vitiligo remains elusive, it is believed to involve a complex interplay of genetic, autoimmune, and environmental factors.


This overview provides the key aspects of vitiligo, including its epidemiology, pathogenesis, clinical manifestations, and current treatment approaches. The prevalence of vitiligo varies globally, affecting individuals of all ethnic backgrounds and age groups.


The autoimmune hypothesis proposes that the immune system mistakenly targets and attacks melanocytes, leading to their destruction. Triggering factors, such as oxidative stress, viral infections, and neural factors, may contribute to the initiation and progression of vitiligo.


Clinically, vitiligo can significantly impact the quality of life for affected individuals, both psychologically and socially. The distribution and extent of involvement vary, and the condition can affect any part of the body.


Various treatment modalities are available for vitiligo, ranging from topical corticosteroids and calcineurin inhibitors to phototherapy and surgical interventions. While these approaches may help to re-pigment the skin to some extent, there is no definitive cure, and the outcomes can be unpredictable. Ongoing research is focused on understanding the molecular mechanisms underlying vitiligo and developing targeted therapies to address the root causes of the disease.


Keywords: Vitiligo, Autoimmune, Melanocytes, Pigmentation, Corticosteroids, Quality of life.

Keywords: Vitiligo, Autoimmune, Melanocytes, Pigmentation, Corticosteroids, Quality of life

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Author Biographies

Tadikonda Rama Rao, Professor & Principal, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Professor & Principal, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Hafsa Sharmeen, Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Afshaan Tabassum, Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Sena Jessy Jasmine, Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Department of Pharm D, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

References

1. Khaitan BK., Sindhuja T. Autoimmunity in vitiligo: Therapeutic implications and opportunities, 2022 [cited January 2022]; 21(1). https://doi.org/10.1016/j.autrev.2021.102932 PMid:34506987
2. Mohr N, Petersen J, Kristen N, Augustin M. Epidemiology of Vitiligo - A Dual Population-Based Approach, Dovepress Clinical Epidemiology Journals, 2021 [cited 26 May 2021]; 13:373-382. https://doi.org/10.2147/CLEP.S304155 PMid:34079380 PMCid:PMC8165096
3. Franca E, Santos RVT, Baptista LC, Da Silva MAR, Fukushima AR, Hirota VB, et al. Potential Role of Chronic Physical Exercise as a Treatment in the Development of Vitiligo, Frontiers in Physiology, 2022 [cited 10 March 2022]; 13: 843784. https://doi.org/10.3389/fphys.2022.843784 PMid:35360245 PMCid:PMC8960951
4. Gandhi K, Ezzedine K, Anastassopoulos KP., Patel R, Sikirica V, Daniel SR. et al. Prevalence of Vitiligo Among Adults in the United States, 2021 [cited 17 November 2021];158(1):43-50. https://doi.org/10.1001/jamadermatol.2021.4724 PMid:34787670 PMCid:PMC8600454
5. Bergqvist C, Ezzedine K. Vitiligo: A Review, Karger Dermatology, 2022 [cited 2022];236:571-592. https://doi.org/10.1159/000506103 PMid:32155629
6. Dutta R R., Kumar T, Ingole N. Diet and Vitiligo: The Story So Far, Springer Nature Group Cureus, 2022 [cited 14 August 2022];14(8): e28516. https://doi.org/10.7759/cureus.28516
7. Kumar R, Tyagi S. A Review on Natural Treatment's of Vitiligo, Asian Journal of Pharmaceutical Research, 2020 [cited 2020]; 10(4). https://doi.org/10.5958/2231-5691.2020.00046.5
8. Patel S, Rauf A, Khan H, Meher BR, Syed SH. A holistic review on the autoimmune disease vitiligo with emphasis on the causal factors, Elsevier ScienceDirect Biomedicine and Pharmacotherapy Journal, 2017 [cited August 2017]; 92:501-508. https://doi.org/10.1016/j.biopha.2017.05.095 PMid:28575807
9. Rashighi M, Harris JE. Vitiligo pathogenesis and emerging treatments, Elsevier ScienceDirect Dermatologic Clinics Journal, 2018 [cited 1 April 2018]; 35(2): 257-265. https://doi.org/10.1016/j.det.2016.11.014 PMid:28317534 PMCid:PMC5362109
10. AL-smadi K, Imran M, Silva VRL, Yousuf M. Vitiligo: A Review of Aetiology, Pathogenesis, Treatment, and Psychosocial Impact, MDPI Open Access Journal, 2023 [cited 22 May 2023]; 10(3):84. https://doi.org/10.3390/cosmetics10030084
11. Ludmann P. Vitiligo: Signs and Symptoms, American Academy of Dermatology Association, 2023. Available from: Vitiligo: Signs and symptoms (aad.org)
12. Ahmed jan N, Masood S. Vitiligo, National Library of Medicine, 2023 [cited 7 August 2023]. Available from: Vitiligo - StatPearls - NCBI Bookshelf (nih.gov)
13. Mutchler C. How Vitiligo Is Diagnosed, Verywell health, 2021 [cited August 2021] Available from: Vitiligo Diagnosis: Physical Examination and Labs/Tests (verywellhealth.com)
14. Gawkrodger DJ, Ormerod AD, Shaw L, Mauri-Sole I, Whitton ME, Watts MJ. et al. Guidelines for the diagnosis and management of vitiligo, British Journal of Dermatology, 2008 [cited 20 October 2008]; 159(5):1051-1076. https://doi.org/10.1111/j.1365-2133.2008.08881.x PMid:19036036
15. Neema S, Butler DF, Chan EF, Elston DM, Lebwohl MG, Wilson BB et al. Vitiligo Treatment & Management, Medscape Dermatology, 2022 [cited July 2022]. Available from: https://emedicine.medscape.com/article/1068962-treatment?Form=fpf
16. Bae. J, Yoo. H, Kim. H, Lee. J, Kim. G. Combination therapy with 308-nm excimer laser, topical tacrolimus, and short-term systemic corticosteroids for segmental vitiligo: A retrospective study of 159 patients, Journal of the American Academy of Dermatology, 2015 [cited July 2015];73(1):76-82. https://doi.org/10.1016/j.jaad.2015.04.008 PMid:25956660
17. Bae Mendes R, Alpalhão M, Filipe P. UVB phototherapy in the treatment of vitiligo: State of the art and clinical perspectives, Photodermatology, Photoimmunology & Photomedicine, 2021 [cited October 2012]; 38(3):215-223. https://doi.org/10.1111/phpp.12740 PMid:34626483
18. Frączek A, Furmańczyk M, Placek W, Saczonek A. Surgical Treatment of Vitiligo, Int.
J. Environ. Res. Public Health, 2022 [cited April 2022]; 19(8): 4812. Available from: 10.3390/ijerph19084812
19. Khunger N, Kathuria S, Ramesh V. Tissue grafts in vitiligo surgery - past, present, and future, Indian J Dermatology, 2009 [cited April-June 2009]; 54(2): 150-158. https://doi.org/10.4103/0019-5154.53196 PMid:20101311 PMCid:PMC2807155
20. Grimes P, Nashawati R. Depigmentation therapies for vitiligo, Elsevier ScienceDirect Dermatologic Clinics J, 2017 [cited April 2017]; 35(20): 219-227. https://doi.org/10.1016/j.det.2016.11.010 PMid:28317530
21. Sarveswari KN. Cosmetic camouflage in Vitiligo, Indian J Dermatology, 2010 [cited July- September 2010]; 55(3):211-214. https://doi.org/10.4103/0019-5154.70663 PMid:21063508 PMCid:PMC2965902
22. Ludmann P. Vitiligo: Self-care, American Academy of Dermatology Association, 2023. Available from: Vitiligo: Self-care (aad.org)
23. Juhlin L., Olsson MJ. Improvement of vitiligo after oral treatment with vitamin B12 and folic acid and the importance of sun exposure, Acta Derm Venereologica,1997 [cited November 1997]; 77(6):460-2. https://doi.org/10.2340/000155555577460462 PMid:9394983
24. Pullar JM., Carr AC., Vissers MCM. The Roles of Vitamin C in Skin Health, MDPI J Nutrients, 2017 [cited August 2017]; 9(8):866. https://doi.org/10.3390/nu9080866 PMid:28805671 PMCid:PMC5579659
25. Ghamdi K, Kumar A, Moussa N. The role of vitamin D in melanogenesis with an emphasis on vitiligo, IJDVL, 2013 [cited Nov-Dec 2013]; 79(6):750-8. https://doi.org/10.4103/0378-6323.120720 PMid:24177606
26. Chivu A, Bălășescu E, Pandia L, Nedelcu R, Brînzea A, Turcu G et al. Vitiligo- Thyroid Disease Association: When, in Whom, and Why Should It Be Suspected? A Systematic Review, J Personalized Medicine, 2022; 12(12): 2048. https://doi.org/10.3390/jpm12122048 PMid:36556267 PMCid:PMC9785784
27. Ferrari SM, Fallahi P, Santaguida G, Virili C, Ruffilli I, Ragusa F, et al. Circulating CXCL10 is increased in non-segmental vitiligo, in presence or absence of autoimmune thyroiditis. Autoimmunity Reviews, 2017 [cited September 2017]; 16:946-950. https://doi.org/10.1016/j.autrev.2017.07.006 PMid:28698095
28. Sangma L, Nath J, Bhagabati D. Quality of Life and Psychological Morbidity in Vitiligo Patients: A Study in a Teaching Hospital from North-East India, Indian J Dermatology, 2015 [cited Mar-Apr 2015]; 60(2): 142-146. https://doi.org/10.4103/0019-5154.152508 PMid:25814701 PMCid:PMC4372905
29. Mishra N, Rastogi M, Gahalaut P, Agrawal S. Dermatology Specific Quality of Life in Vitiligo Patients and Its Relation with Various Variables: A Hospital Based Cross- sectional Study, JDCR, 2014 [cited June 2014] ;8(6): YC01-YC03. https://doi.org/10.7860/JCDR/2014/8248.4508 PMid:25121050 PMCid:PMC4129253
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1.
Rama Rao T, Sharmeen H, Tabassum A, Jasmine SJ. Understanding Vitiligo: Causes, Diagnosis, Promising Advances in Treatment and Management and the Impact on Mental Health. JDDT [Internet]. 15Apr.2024 [cited 12Jul.2024];14(4):130-7. Available from: https://jddtonline.info/index.php/jddt/article/view/6503

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