Vitiligo – is a pathological condition characterized by progressive hypomelanosis of the skin and hair.
It is interesting that from the Latin language the term "vitiligo" translates as «vicious disease». Until 1842, the disease was identified with leprosy, until the doctors Daniel Danielsen and Karl Boek proved the opposite, highlighting vitiligo as an independent nosological form.
Despite the fact that vitiligo does not pose any direct threat to the physical health, the psychological discomfort experienced, leading even to self-isolation of patients, makes vitiligo a serious social problem.
What are the current theories regarding the etiopathogenesis of vitiligo, as well as the principles of diagnosis and treatment of this condition in an exclusive interview for estet-portal.com, MD, head of the Department of Dermatology and Venereology of the Azerbaijan State Institute for Postgraduate Medical Education named after A. A. Aliyeva, dermatovenereologist Sanan Kerimov.
Tell me, please, what are the causes of vitiligo
SK: There are many hypotheses regarding the causes of vitiligo, but all of them, to one degree or another, consider the presence of a genetic factor responsible for the occurrence of this condition.
Patients with vitiligo have a genetic predisposition to develop the condition, which is determined by the presence of certain genes.
Vitiligo manifestations are facilitated by environmental factors that create a stressful situation for the body. These include psycho-emotional overstrain, infections, and so on. The stress of the body leads to a violation of its compensatory mechanisms. At the same time, against the background of a genetic predisposition to the disease, vitiligo develops.
According to modern concepts, the etiopathogenesis of vitiligo is best explained by autoimmune theory, as well as the theory of oxidative stress.
Tell us more about the autoimmune theory of vitiligo development
S.K.: If we are talking about an autoimmune genesis of vitiligo, then we should take into account that this condition is very often combined with other autoimmune diseases.
Most likely, those genes that are responsible for the development of autoimmune processes are also responsible for the development of vitiligo.
Both in vitiligo and in autoimmune diseases, there is a violation of innate and acquired immunity. Autoimmune aggression against one's own melanocytes leads to their death, as a result of which the production of melanin decreases or even stops.
What is the role of oxidative stress in the etiopathogenesis of vitiligo
SK: As for oxidative stress, we must understand that in the body of each of us it constantly takes place to one degree or another. It's almost a physiological process.
At the same time, we also have an antioxidant system that neutralizes the effect of free radicals on our cells.
The process of melanogenesis is accompanied by oxidative stress. And in patients with defects in the antioxidant system, the necessary stabilization of free radical activity does not occur. This leads to the death of melanocytes, the cessation of melanin production and, as a result, the development of vitiligo.
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What are the modern approaches to the diagnosis of vitiligo
S.K.: Diagnosis of vitiligo is primarily based on the clinical picture of the disease.
Pathological diagnostics can only confirm what we see – depigmentation. It must be carried out if there is a need to exclude other diseases that occur with depigmentation.
In most cases, vitiligo has a typical clinical presentation, and the clinical diagnosis of the disease does not cause difficulties.
Therefore, the diagnosis of vitiligo – this is not a difficult task, which cannot be said about the treatment of such patients. Drawing up the correct therapeutic tactics for vitiligo in each individual case is a really difficult question.
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What are the current approaches to the treatment of patients with vitiligo
SK: Today there are a large number of modern methods of treating patients with vitiligo: local therapy, phototherapy, the use of systemic glucocorticoids, cytotoxic drugs, surgical methods, combined treatment.
The main difficulty in treating patients with vitiligo is choosing the right therapeutic tactics for their management.
But it is important to choose the right therapeutic tactics for managing patients with vitiligo, which, first of all, depends on the type of vitiligo, the prevalence of the process, as well as the body's response to the treatment.
Thus, there are many approaches to the treatment of vitiligo. But if you choose the wrong tactics of treatment – therapy will give only minimal results, or will not be effective at all.
If the therapeutic tactics are correct, then in most cases we get wonderful results.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Experts" section. You may also be interested in: Treatment of vitiligo: to be or not to be
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