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2006, Number 3

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Dermatología Cosmética, Médica y Quirúrgica 2006; 4 (3)

Vitiligo. Overview and current therapeutics

Vázquez-Martínez OT, Velásquez-Arenas L, Méndez-Olvera N, Ocampo-Candiani J

Language: Spanish
References: 142
Page: 187-192
PDF size: 828.53 Kb.


ABSTRACT

Vitiligo is a specific skin disorder that may be congenital or acquired. It is characterized by well-defined achromic or hypochromic maculae with no melanocytes, or if melanocytes are present, they are nonfunctional. Vitiligo could be associated with autoimmune diseases such as thyroiditis and with ophthalmic anomalies such as iritis.
This pathology is particularly serious for dark-skinned patients, black patients, and white patients who suntan intensely, with a type III to type VI phototype (Fitzpatrick), because over two thirds of these patients develop intense psychosocial stress. Treatment of this pathology is therefore of great importance.
Incidence of vitiligo ranges from 1% to 2% of the population. All races are equally affected and it may appear in both sexes.
Typical vitiligo maculae are hypochromic or achromic, round or oval, with well-defined cartographic margins.
A vitiligo macula may measure only a few millimeters or it may cover almost the whole body.
Three hypotheses have been traditionally used to explain vitiligo: 1) the neural hypothesis; 2) the self destruction hypothesis; and 3) the autoimmune hypothesis.
There are a large number of medical and surgical methods for the treatment of vitiligo.
Repigmentation of the depigmented areas can be achieved through the application of topical glucocorticoids, especially in the case of localized vitiligo. Another method that may be used is the administration of psoralens, both orally and topically, with subsequent exposure to type A ultraviolet light.
Surgical treatment is divided into: a) Techniques with no cell culture: Transplantation of melanocytes and keratinocytes in suspension, minigrafts, skin grafts through tissue expansion, split or partial-thickness skin grafts; and b) Techniques with cell cultures: Transplantation of cultured melanocytes and transplantation of cultured melanocytes and keratinocytes.


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  56. squamous cell carcinoma. Cancer 1981; 48: 1207-1214

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  58. Piel 1991; 6: 254-255

  59. Ramírez MP, Avelino-Seijo J, Medina A y col. Tumor triquilemal proliferante.

  60. Dermatol Rev Mex 1994; 38 9(1): 41-42

  61. Grasa MP et al. Tumor triquilemal proliferante. Act Dermo Sif 1984; 75:

  62. 163-168

  63. Kirkhan N. Tumors and cyst of the epidermis. Philadelphia. Lippincott-

  64. Raven 1997; 759-761

  65. Hashimoto K, Lever W. Tumors of the skin appendages. Mc Graw Hill

  66. 1999; 907-908

  67. Soto JA, López V, Hernández M. Tumor triquilemal proliferante.

  68. Dermatología Rev Mex 2001; 45: 98-100

  69. Martínez V, Gutiérrez R, Novales J. Tumor triquilémico proliferante.

  70. Comunicación de un caso. Rev Cent Dermatol Pascua 2003; 12 (3): 154-

  71. 156

  72. Takenaka H, Kishimoto S, Shibagaki R, Nagata M, Noda Y, Yasuno H.

  73. Recurrent malignant proliferating trichilemmal tumor: Local management with

  74. ethanol injection. Br J Dermatol 1998; 139: 726-729

  75. Saida T, Oohara K, Hori et al. Development of a malignant proliferating trichilemmal

  76. cyst in a patient with multiple trichilemmal cyst. Dermatologica

  77. 1983; 166: 203-208

  78. Weiss J, Heine M, Grimmel M, Jung E. Malignant proliferating trichilemmal

  79. cyst. J Am Acad Dermatol 1995; 32: 870-873

  80. Escudero F, García F, Castro J. Quiste triquilemal y tumor triquilemal proliferante.

  81. Piel 1991; 6 (5): 254-257

  82. Amaral AL, Nascimento AG, Goellner JR. Proliferating pilar (trichilemmal)

  83. cyst. Report of two cases, one with carcinomatous transformation and one

  84. with distant metastases. Arch Pathol Lab Med 1984; 108: 808-810

  85. Hashimoto Y, Matsuo S, Lizuka H. A DNA flow cytometric analysis of trichilemmal

  86. carcinoma, proliferating trichilemmal cyst and trichilemmal cyst.

  87. Acta Derm Venereol 1994; 74: 358-360

  88. Morgan RF, Dellon AL. Hoopes JE. Pilar tumors. Plast Reconstr Sur

  89. 1979; 63: 520-524

  90. López-Ríos F, Rodríguez-Peralto J, Aguilar A, Hernández L, Gallego

  91. M. Proliferating trichilemmal cyst UIT focal invasion. Am J Dermatol

  92. 2000; 22: 183-187

  93. Soon B, Yang G, Hyun K. Malignant proliferating trichilemmal tumor showing

  94. distant metastases. Am J Dermatol 1997; 19: 536-539

  95. Brownstein MH, Arluk DJ. Proliferating trichilemmal cyst: A simulant of

  96. squamous cell carcinoma. Cancer 1981; 48: 1207-1214

  97. Escudero FJ, García F, Castro JA. Quiste triquilemal y tumor triquilemal proliferante.

  98. Piel 1991; 6: 254-255

  99. Ramírez MP, Avelino-Seijo J, Medina A y col. Tumor triquilemal proliferante.

  100. Dermatol Rev Mex 1994; 38 9(1): 41-42

  101. Grasa MP et al. Tumor triquilemal proliferante. Act Dermo Sif 1984; 75:

  102. 163-168

  103. Kirkhan N. Tumors and cyst of the epidermis. Philadelphia. Lippincott-

  104. Raven 1997; 759-761

  105. Hashimoto K, Lever W. Tumors of the skin appendages. Mc Graw Hill

  106. 1999; 907-908

  107. Soto JA, López V, Hernández M. Tumor triquilemal proliferante.

  108. Dermatología Rev Mex 2001; 45: 98-100

  109. Martínez V, Gutiérrez R, Novales J. Tumor triquilémico proliferante.

  110. Comunicación de un caso. Rev Cent Dermatol Pascua 2003; 12 (3): 154-

  111. 156

  112. Takenaka H, Kishimoto S, Shibagaki R, Nagata M, Noda Y, Yasuno H.

  113. Recurrent malignant proliferating trichilemmal tumor: Local management with

  114. ethanol injection. Br J Dermatol 1998; 139: 726-729

  115. Saida T, Oohara K, Hori et al. Development of a malignant proliferating trichilemmal

  116. cyst in a patient with multiple trichilemmal cyst. Dermatologica

  117. 1983; 166: 203-208

  118. Weiss J, Heine M, Grimmel M, Jung E. Malignant proliferating trichilemmal

  119. cyst. J Am Acad Dermatol 1995; 32: 870-873

  120. Escudero F, García F, Castro J. Quiste triquilemal y tumor triquilemal proliferante.

  121. Piel 1991; 6 (5): 254-257

  122. Amaral AL, Nascimento AG, Goellner JR. Proliferating pilar (trichilemmal)

  123. cyst. Report of two cases, one with carcinomatous transformation and one

  124. with distant metastases. Arch Pathol Lab Med 1984; 108: 808-810

  125. Hashimoto Y, Matsuo S, Lizuka H. A DNA flow cytometric analysis of trichilemmal

  126. carcinoma, proliferating trichilemmal cyst and trichilemmal cyst.

  127. Acta Derm Venereol 1994; 74: 358-360

  128. Morgan RF, Dellon AL. Hoopes JE. Pilar tumors. Plast Reconstr Sur

  129. 1979; 63: 520-524

  130. López-Ríos F, Rodríguez-Peralto J, Aguilar A, Hernández L, Gallego

  131. M. Proliferating trichilemmal cyst UIT focal invasion. Am J Dermatol

  132. 2000; 22: 183-187

  133. Soon B, Yang G, Hyun K. Malignant proliferating trichilemmal tumor showing

  134. distant metastases. Am J Dermatol 1997; 19: 536-539

  135. Brownstein MH, Arluk DJ. Proliferating trichilemmal cyst: A simulant of

  136. squamous cell carcinoma. Cancer 1981; 48: 1207-1214

  137. Escudero FJ, García F, Castro JA. Quiste triquilemal y tumor triquilemal proliferante.

  138. Piel 1991; 6: 254-255

  139. Ramírez MP, Avelino-Seijo J, Medina A y col. Tumor triquilemal proliferante.

  140. Dermatol Rev Mex 1994; 38 9(1): 41-42

  141. Grasa MP et al. Tumor triquilemal proliferante. Act Dermo Sif 1984; 75:

  142. 163-168




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