Presentasi dr. David @Vitiligo Update 25 Juni 2011

13

Jul

Alternative names of  Vitiligo

1. Leukoderma
2. Derived from two Greek words “Leuko” & “Derma”
3. “Leuko” means white & “Derma” means skin

What is Vitiligo?

1. An acquired skin pigmentation disorder
2. a multifactorial polygenic disorder with a complex pathogenesis
3. Characterized by white patches
4. Often surrounded by a heavily pigmented border

Who is affected by Vitiligo?

1. Vitiligo affects 0.5-2% of the world population, and the average age of onset is 20 years.
2. Irrespective of sex and race
3. “blood relatives” of a person with vitiligo (Not always)

Autoimmune destruction of melanocytes

1. Thyroid disorders, particularly Hashimoto thyroiditis and Graves disease; other endocrinopathies, such as Addison disease and diabetes mellitus; and alopecia areata; pernicious anemia; inflammatory bowel disease; psoriasis; and autoimmune polyglandular syndrome are all associated with vitiligo.
2. the presence of circulating antibodies
3. [2] The role of humoral immunity is further supported by the observation that melanocytes are destroyed in healthy skin engrafted onto nude mice injected with vitiligo patient sera.[3]

Effects of Vitiligo

1. Gradual loss of melanin resulting in depigmentation
2. White patches on different parts of the body which may start progression
3. Psychological disorders
4. Does not cause any organic harm (Physical harm or disability)

Symptoms & Course of Vitiligo

1. White patches on the skin which may vary in size or shape (No fix pattern)
2. These patches may appear on different parts of the body
3. The hair present on the affected areas sometimes turn white
4. These patches may start progression and sometimes re-pigment on its own

Causes of Vitiligo

1. Inheritance (30% of vitiligo affected people inherit this skin disorder)
2. Severe mental or physical trauma
3. Other autoimmune diseases

Jurnal

• In vivo destruction of melanocytes by the IgG fraction of serum from patients with vitiligo.

Gilhar A, Zelickson B, Ulman Y, Etzioni A.

Source

Skin Research Laboratory, Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. showed the destructive effect of vitiligo patients’ serum on melanocytes. Our study highlights the important role of autoantibodies in the pathogenesis of vitiligo.

• Evidence for an autoimmune pathogenesis of vitiligo.

Ongenae K, Van Geel N, Naeyaert JM.

Source

Department of Dermatology, Ghent University Hospital, De Pintelaan, Gent, Belgium.

Recently, T-cell analyses in peripheral blood further support this hypothesis. Interestingly, new insights in the association of vitiligo and melanoma may help to clarify the role of autoimmunity in the development of vitiligo.

• IgG anti-melanocyte antibodies purified from patients with active vitiligo induce HLA-DR and intercellular adhesion molecule-1 expression and an increase in interleukin-8 release by melanocytes.

Li YL, Yu CL, Yu HS.

Source

Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Intercellular adhesion molecule-1 is an important adhesion molecule involved in leukocyte and parenchymal cell interaction and thus plays an essential part in immunologic and inflammatory reactions. It is reasonable to speculate that abnormal expressions of HLA-DR and intercellular adhesion molecule-1 on melanocytes by IgG anti-melanocyte antibodies would present vitiligo antigens and allow the antigen-specific immune effector cell attack that results in melanocytotoxicity.

• Apoptosis of melanocytes in vitiligo results from antibody penetration

Alejandro Ruiz-Argüellesa, , , Gustavo Jiménez Britob, Paola Reyes-Izquierdoa, Beatriz Pérez-Romanoa and Sergio Sánchez-Sosac

a Department of Immunology, Laboratorios Clínicos de Puebla, Diaz Ordaz 808, Puebla, PUE 72530, Mexico

b Colegio Poblano de Dermatología, Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico

c Department of Pathology, Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico

we were able to prove that serum IgG antibodies from vitiligo patients, but not from healthy controls, were capable to penetrate into cultured melanocytes in vitro, and trigger them to engage in apoptosis. Our results are consonant with the theory that melanocyte-specific antibodies are responsible for the deletion of melanocytes through antibody penetration and apoptosis.

Association with other Diseases

1. Pernicious Anemia
2. Hypothyroidism
3. Addison’s Disease

Generalized Vitiligo

Generalized vitiligo has three types

Acrofacial Vitiligo:

◦Occurs on the parts away from the center of the body

◦Affects distal end of fingers and facial orifices in circumferential pattern.

Vulgaris Vitiligo:

◦Scattered patches

◦Widely distributed

Universal Vitiligo:

◦Nearly complete depigmentation

Localized Vitiligo

Localized vitiligo has three types

Focal Vitiligo:

◦Limited to one or few areas

◦Does not progress

◦Not clearly in a segmental distribution

Segmental Vitiligo:

◦Unilateral and asymmetric in distribution

◦Only one side of the body is affected

◦Common in children

◦Usually pursues a stable course

Mucosal Vitiligo:

◦Mucous membranes are affected

Psychological Aspects  of Vitiligo

1. Sometimes causes severe psychological and social damage
2. Can result in discrimination especially in 3rd world countries
3. Can be confused with Leprosy

Conclusion

1. Vitiligo is chronic skin disorder that produces white patches on skin
2. It may start at any age and affect any part of the body
3. The main causes of this disease are Ig G Allergic reaction/ autoimmune dissease
4. It is a non-lethal disease
5. It may cause devastating psychological and social problems like tension, embarrassment or loss of self-confidence
6. The main causes of this disease are Ig G Allergic reaction/ autoimmune dissease
7. Check IgG dan stop eating IgG Antibody
8. Revitalizing n promoting melanosit growth for depigmentation process

Vitiligo is Curable

DF clinic 2 Juni 2011

maaf kalo ga ngerti coba translate pake google translate yee…hee..

pokonya kesimpulannya  menurut dr David,

vitiligo bissa disembuhkan, hanya dengan pantangan makanan, jd cek IGG itu kuncinya, kalo blum bisa cek IGG, bisa hindari makanan berikut (menurut populasi terakhir yg melakukan cek IGG)

1. Kerapu
2. rumput laut
3. gandum
4. susu
5. telur
6. cabe

data update june 2011: top score allergy pada kasus vitiligo sesuai populasi terbanyak : kerapu, telur ayam, dairy product dan rumput laut.

Hati hati minum obat krn kapsul itu terbuat dari rumput laut

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