Titulus: Vitiligobehandelcrème

Vitiligo is een huidziekte die gekenmerkt wordt door de afname van pigmentatie van delen van de huid, oogleden en haar. Er zijn verschillende vermoedelijke oorzaken voor vitiligo, waaronder genetische factoren, stress en auto-immuunreacties.

== Ziekteverschijning ==

De huidafname verloopt in verschillende stadia van ontwikkeling, beginnend met gelevormde witte plekken die zich uitbreiden en daarna veranderen in ronde, ellipsoïde of langgerekte plakjes. In zeldzame gevallen kan het ook leiden tot beharing en pigmentatieverlies aan andere delen van het lichaam.

== Ontstaan vitiligo ==

De exacte oorzaak van vitiligo is nog steeds onbekend, maar er worden verschillende theorieën geformuleerd. Een aantal onderzoekers heeft gesteld dat vitiligo te maken kan hebben met genetische factoren en auto-immuunreacties tegen melanocyten (cellen die verantwoordelijk zijn voor de productie van pigment). Anderen hebben voorgesteld dat stress alsFactor kan spelen in het ontstaan van de ziekte, hoewel deze hypothese nog steeds onderwerp van discussie is. Bijvoorbeeld Latoya Jackson, dochter van de beroemde artiest Michael Jackson, lijdt ook aan vitiligo en gaf verslag over de stressfactoren waar ze mee te maken had.

== Vitiligobehandelcrème ==

Er zijn verschillende soorten vitiligo-behandelcreme beschikbaar op de markt, waaronder corticosteroïden, immunosuppressiva en chemotherapeutica. Deze medicamenten werken door de bevordering van de groei van melanocyten en het tegengaan van de celdoorstroom naar de zieke gebieden. Het gebruik van dit type geneesmiddelen blijft echter omstreden bij patiënten wegens kans op zijdelingse effekten zoals dikteveranderingen en beharing.

Ook bestaat er sinds 2015 een alternatieve behandeling voor vitiligo: PC-Kusbehandeling (Pigment Correction), een proces waarbij het eigen lichaamsvlies getatoeëerd wordt met pigmenten en vervolgens met laser treatement herstellen. Omdat deze behandeling relatief nieuw is, is het aantal gevallen waarin succesvolle behandeling plaatsvindt relatief klein, en gaan de resultaten van individuele gevallen sterk uiteen. Hoewel deze behandeling ook bekendstaat als 'revolutionair', is er nog steeds veel onzekerheid over het aantal sessions nodig om effectief verdien voor patenten te bereiken, alsmede over eventuele potentiële klinische complicaties.

Referenties

• Andrade PEL, Oliveira ELM, Xavier VG. Terapia local com FDA-approved steroid cream for vitiligo: A randomized, double-blind, placebo-controlled study with follow up to 7 years
• Jabés MAH Jr., Soares LGMS, Monteiro ABCP et al. Clinical and histological evaluations of the PGW-UVA-1 combination treatment for refractory stable vitiligo
• Lebwohl MG et al. The effects of stress on psoriasis: an interactive relationship
• Zaghi M et al. Effectiveness of Narrowband UVB Phototherapy in the Management of Vitiligo During Pregnancy

Vitiligo

Vitiligo (/vɪˈtaɪlɪɡoʊ/) is an autoimmune, chronic, and progressive depigmenting disorder that causes white spots or patches to appear on the skin. It occurs when pigment-producing cells (melanocytes) in the body stop functioning, resulting in a lack of melanin - the pigment responsible for skin color. This can lead to irregular white patches on any part of the body, including the hair, mucous membranes, and inside the mouth.

Etymology

The term "vitiligo" comes from the Latin words vitiligō, meaning "to be sprinkled with bile," and leukós, meaning "white." This reflects the ancient belief that bile could cause loss of pigmentation.

Symptoms

The primary symptoms of vitiligo are smooth, white areas of skin caused by melanocyte destruction. These areas can appear on any part of the body, but are most commonly found on sun-exposed areas like the hands, arms, face, feet, and lips. In some cases, vitiligo can also cause premature graying or whitening of the hair on the scalp and elsewhere on the body.

Types

Vitiligo is classified into two main types: segmental vitiligo and non-segmental vitiligo.

Segmental Vitiligo

Segmental vitiligo affects only one side or part of the body and typically occurs in childhood or adolescence. The affected area usually grows slowly and may stop spreading after several years.

Non-Segmental Vitiligo

Non-segmental vitiligo is more common than segmental vitiligo and can affect people at any age. It appears as symmetrical white patches on both sides of the body. There are further subtypes within non-segmental vitiligo, including generalized vitiligo, focal vitiligo, acrofacial vitiligo, and vulgaris vitiligo.

Causes

The exact cause of vitiligo remains unknown, but it is believed to result from an autoimmune response where the immune system mistakenly attacks melanocytes. Several genetic factors have been associated with an increased risk of developing vitiligo, but a definitive genetic cause has not been identified. Exposure to certain triggers such as stress, injury to the skin, sunburn, or infectious diseases may contribute to the development or progression of vitiligo in genetically susceptible individuals.

Diagnosis

A diagnosis of vitiligo is typically made based on physical examination by a healthcare professional. In some cases, a Wood's lamp may be used to visualize the absence of pigment in affected areas. Biopsy and blood tests are rarely necessary for diagnosis but may be used to rule out other conditions that can cause loss of skin color.

Treatment

There is no cure for vitiligo, but various treatment options are available to help manage its symptoms and promote repigmentation. Topical corticosteroids, topical calcineurin inhibitors, and phototherapy using UVB lamps are common treatments for mild cases. For more extensive or recalcitrant vitiligo, topical immunomodulators or systemic treatments such as oral corticosteroids, narrowband UVB phototherapy, or excimer laser therapy may be considered. In severe cases or where conventional treatments have failed, surgical options such as skin grafting or tissue culturing may be considered. Additionally, permanent makeup techniques can help camouflage white patches on the skin. People with leucoderma (the Indian term for vitiligo) may benefit from Ayurvedic therapies in combination with modern treatments.

Prognosis

The course and prognosis of vitiligo vary greatly among individuals. While some people experience stable disease with minimal progression, others may experience rapid spread and ongoing repigmentation loss. In many cases, the condition goes through cycles of activity and remission. There is currently no way to predict how quickly or slowly vitiligo will progress in any given individual.

History

Historical records document vitiligo throughout human history, with reference to Ancient Egyptians, Greeks, Chinese, and Indian cultures. In recent years, advances in understanding the immune mechanisms underlying vitiligo have led to targeted treatments aimed at managing this complex disorder.