Historical Aspects of Vitiligo

Abstract

Vitiligo was recognized long ago under different names. Firstly, the Ebers Papyrus (circa 1500 BC) mentions two types of diseases affecting the colour of the skin, one being probably leprosy and the other vitiligo. In the ancient Vedic scripture of India (circa 1400 BC), Sanskrit words “kilas” and “svitra” (white patches on the skin) can be found. The early classics of the Far East (1200 BC) mention “shirabito” (white man). The Hebrew word “Zoorat” in the bible corresponds to a group of achromic diseases including vitiligo. “Baras and alabras” were the Arabic names used to describe vitiligo. The term “vitiligo” itself was introduced in the first century of our era. The confusion of leprosy with vitiligo in the Old Testament under “Zoorat” is an important cause for the social stigma attached to white spots on the skin. Detailed and effective treatments for vitiligo are found in different sacred books. The modern photochemotherapy is an improvement of a photochemotherapy practised in the ancient world with herbals containing furocoumarins (mainly Ammi majus Linnaeus, Psoralea corylifolia) and sun. In the mid-1960s the synthetic furocoumarin (trioxsalen and trimethylpsoralen) were developed. The effectiveness of PUVA (psoralen + UVA) for the treatment of some patients with vitiligo was confirmed during 1974–1982. More recently, narrowband UVB therapy, local microphototherapy, excimer laser, topical treatments with corticosteroids and calcineurin inhibitors and melanocyte transplantation have been successively introduced.