White Skin Patches Research Articles

Changes in epidermal thickness and their correlation with clinical characteristics in patients with vitiligo

Vitiligo is an autoimmune disorder characterized by epidermal melanocyte damage, with the typical clinical manifestation of white patches of skin. Keratinocytes, which work in concert with melanocytes to maintain the structural and functional integrity of the skin, are implicated in the progression of vitiligo. Recent studies have reported abnormal keratinocyte proliferation and epidermal thickening in some patients with vitiligo; however, the relationship between these changes and the clinical characteristics of vitiligo remains unclear. We assessed the changes in epidermal thickness in patients with vitiligo and their correlation with clinical characteristics. Compared to the non-lesional skins, the stratum corneum, viable epidermis, and full epidermis in the lesional skins were all significantly thicker. The thickness of the stratum corneum in the head, neck, and trunk was greatly lower than that in the extremities. The thickness of the stratum corneum in the sun-exposed area was higher than that in the sun-protected area, whereas the thickness of the viable epidermis decreased. In conclusion, our study found that the epidermis in the lesional skins of patients with vitiligo was significantly thickened, especially in the sun-exposed areas and extremities.

NOOR: Illuminating Vitiligo through Cinematic Entrepreneurship and Social Change

The moving and inspiring short film NOOR explores the experiences of those impacted NOOR is a moving and thought provoking short film that delves into the lives of people affected by Vitiligo (Pulberi). The disease causes depigmentation of the skin, causing white patches of skin on the body. The film highlights the tests, trials, and consequential successes faced by such a person, all the while learning to accept oneself as one is with the resultant self-confidence. The aim of this treatise is to develop an impactful cinematic experience that portrays the unique experiences of persons who suffer from Vitiligo, including psychological misery, suffering social stigma, and the resultant effects on self-esteem and confidence. The much-needed unknown disorder is shown in the film so that its psychological effects and the tribulations faced by people who have it can be seen. The drive to delve into the topic of Vitiligo stems from the necessity to discuss uncomfortable subjects that are usually misunderstood and face social stigma. Vitiligo imposes a significant effect on one’s mental status, self-esteem, and self-confidence, not to mention its visibility. The crux of the film revolves around the theme of a person suffering from Vitligo who has a driving passion to create a career in athletics, which is hindered due to her condition. The entrepreneurial component of this endeavor is conceptualizing NOOR's potential beyond its function as a film. It acts as a model for a broader commercial project—a whole multimedia platform focused on raising awareness and empowering individuals with Vitiligo. This platform goes beyond conventional cinema by including interactive experiences, educational tools, and a community involvement program. The main objective is to utilize this film representation not just for educational purposes but also as a stimulus for societal contemplation, encouraging conversations regarding traditional beauty norms, and nurturing a more comprehensive and compassionate community. This method harnesses the potential for entrepreneurship by creating engaging visual material and generating chances for social change and empowerment focused on Vitiligo.

Melanogrit potentiates melanogenesis by escalating cellular tyrosinase activity and MITF levels via pERK inhibition.

Vitiligo is characterized by the development of white patches on the skin either due to the loss of functional melanocytes or perturbations in the melanogenesis pathway. In the present study, we investigated the therapeutic potential of herbo-mineral formulation, Melanogrit in neutralizing the white patches in the skin. The study utilized UPLC/MS-QToF technique to determine the diversified phytochemical profile in Melanogrit. The murine B16F10 cells when treated with Melanogrit underwent morphological changes, including increased angularity, enlarged cell size, and greater dendritic protrusions. To establish an equivalent model to study melanogenesis, we carefully optimized the dosage of α-melanocyte stimulating hormone (αMSH) in B16F10 cells as an alternative to using melanocyte-keratinocyte cocultures. The study determined a sub-optimal dose of αMSH (0.2 nM) in B16F10 cells that does not manifest any measurable effects on melanogenesis. In contrast, Melanogrit when used in conjunction with 0.2 nM αMSH, induced a dose-dependent increase in extracellular and intracellular melanin levels. Melanogrit transcriptionally up-regulated the decisive genes of the melanogenesis pathway, MITF, TYR, and TRP1, which was evident from the increased cellular tyrosine activity. Our findings also demonstrated that Melanogrit ameliorated the MITF protein levels by inhibiting pERK; notably without involving GSK3β in the process. Taken together, our findings strongly suggest that Melanogrit has the potential to stimulate melanogenesis, making it a promising candidate for clinical applications in the treatment of white skin patches that develop in vitiligo patients.

34630 The mental health and psychosocial burden among patients living with vitiligo in the United States: Findings from the VALIANT study

Vitiligo is a chronic autoimmune disease characterized by the destruction of melanocytes, resulting in pale or white patches of skin. The population-based Vitiligo and Life Impact Among International Communities (VALIANT) study sought to understand the impact and burden of vitiligo on patients’ quality of life (QoL) from the perspective of patients and physicians in 17 countries. Participants aged ≥18 years who self-reported a clinical vitiligo diagnosis were recruited via an online panel and were asked questions regarding their mental health, psychosocial burden, and behavior in professional and social situations.

34631 Do patients with vitiligo and health care professionals treating them recognize the burden in living with the disease in the United States? Findings from the VALIANT study

Vitiligo is a chronic autoimmune disease characterized by the destruction of melanocytes, resulting in pale or white patches of skin. The population-based Vitiligo and Life Impact Among International Communities (VALIANT) study sought to understand the impact and burden of vitiligo on quality of life (QoL) from the patient and physician perspective from around the world. The VALIANT study recruited adult participants (aged ≥18 years who self-reported a vitiligo diagnosis) via an online panel. Participants were asked questions regarding their mental health, psychosocial burden, and behavior in professional and social situations.

EE294 Burden of Behavioral Health Conditions Among Individuals with Vitiligo in an Insured US Population

Vitiligo is an inflammation-mediated chronic autoimmune disease characterized by the destruction of melanocytes, resulting in pale or white patches of skin. Individuals with vitiligo often experience substantial psychosocial burden. Here we describe behavioral health burden in individuals with vitiligo in the United States.

Citrate-Coated Platinum Nanoparticles Exhibit a Primary Particle-Size Dependent Effect on Stimulating Melanogenesis in Human Melanocytes

Hypopigmentation disorders due to an underproduction of the pigment melanin by melanocytes cause uneven skin coloration, while in hair follicles they cause grey hair. There is a need for novel materials which can stimulate melanogenesis in the skin and hair for personal care use. While titanium dioxide, gold and silver nanoparticles have been extensively used for applications in cosmetic and personal-care products (PCP), the use of relatively inert platinum nanoparticles (PtNPs) has remained underappreciated. PtNPs have been reported to be a mimetic of the enzyme catechol oxidase with small size PtNPs reported to exhibit a higher catechol oxidase activity in a cell-free system, but no testing has been conducted in melanocytes to date. Herein, we have investigated if PtNPs of two sizes (SPtNP: 5 nm; LPtNP: 50 nm) might have an effect on melanogenesis. To this end, we have used MNT-1 human melanoma cells and primary human melanocytes from moderately-pigmented skin (HEMn-MP). Both SPtNP and LPtNP were nontoxic over a concentration range 6.25–25 μg/mL, hence these concentrations were used in further experiments. Both PtNPs stimulated higher extracellular melanin levels than control; SPtNP at concentrations 12.5 and 25 μg/mL significantly stimulated higher levels of extracellular melanin as compared to similar concentrations of LPtNP in MNT-1 cells, in the absence of ROS generation. The effects of PtNPs on melanin secretion were reversible upon removal of PtNPs from the culture medium. The results of primary particle size-specific augmentation of extracellular melanin by SPtNPs were also validated in HEMn-MP cells. Our results thus provide a proof-of-principle that SPtNP might hold potential as a candidate for the treatment of white skin patches, for sunless skin-tanning and for use in anti-greying hair products in cosmetics.

Determination of oxidative stress in vitiligo by measuring superoxide dismutase levels in vitiliginous skin

Objective This study was conducted to determine the association between oxidative stress and vitiligo by measuring antioxidant enzyme superoxide dismutase (SOD) in vitiliginous skin. Background Vitiligo is an acquired depigmenting disease characterized by milky white patches of skin due to local destruction and loss of the epidermal melanocytes. Complex genetic, immunological, neural and self-destructive mechanisms interplay in its pathogenesis. According to autocytotoxic hypothesis, oxidative stress has been suggested to be the initial pathogenic event in melanocyte degeneration. Oxidative stress is defined as a disruption of the delicate balance between the formation of reactive oxygen species and the antioxidant defense system, The dismutation of superoxide (O2-) by SOD to hydrogen peroxide (H2O2) is generally considered to be the primary antioxidant defense of the body, because this enzyme prevents the further generation of free radicals. SOD exists in virtually every oxygen-respiring organism, and its major function is to catalyze dismutative reaction. Patients and methods We determined the activity of SOD in lesional skin only of 20 female patients with vitiligo. The ages of the patients ranged from 18 to 53 years. A total of 17 patients had nonsegmental vitiligo and three had segmental vitiligo, and 10 age-matched and gender-matched apparently healthy volunteers with no past, present or family history of vitiligo, served as a control group. Every case and control was subjected to skin biopsy, and SOD assay of the obtained biopsy was carried out by spectrophotometry. Results A significant difference was found between cases and controls with regard to tissue SOD (P = 0.01, Conclusion There was a significant association between oxidative stress and vitiligo.

The genetic architecture of vitiligo.

Vitiligo is an autoimmune disease in which destruction of skin melanocytes results in patches of white skin and hair. Genome-wide linkage studies and genome-wide association studies in European ancestry cases identified over 50 vitiligo susceptibility loci, defining a model of melanocyte-directed autoimmunity. Vitiligo heritability is exceedingly high, ~2/3 coming from common and ~1/3 from rare genomic variants; ~20% of vitiligo risk is environmental. Vitiligo genetic risk is polygenic, with greater additive risk in multiplex vitiligo families than simplex cases. Vitiligo age-of-onset is bimodal, also involving a major genetic component; a MHC enhancer haplotype confers extreme risk for vitiligo (OR 8.1) and early disease onset, increasing expression of HLA-DQB1 mRNA and HLA-DQ protein and thus perhaps facilitating presentation of triggering antigens. Vitiligo triggering also involves a major environmental component; dramatic delay in vitiligo age-of-onset, especially from 1973 to 2004, suggests that exposure or response to a key vitiligo environmental trigger diminished during this period. Together, these findings provide deep understanding of vitiligo pathogenesis and genetic architecture, suggesting that vitiligo represents a tractable model for investigating complex disease genetic architecture and predictive aspects of personalized medicine.

High Incidence of Hypopigmented Marks in the Endangered Florida Bonneted Bat

Abstract Aberrant patches of white skin or fur known as hypopigmented marks have been observed in many mammal species worldwide, but they are typically limited to only a few individuals in a population. Hypopigmented marks were documented in only two museum specimens of the federally endangered Florida bonneted bat (Eumops floridanus) as early as 1950, but recent observations suggest that these marks may be more common in this species than previously believed. To better understand the occurrence and persistence of hypopigmented marks in Florida bonneted bats, we evaluated the variation in frequency, compared effects on survival, and assessed spatial and temporal differences of specimens at an intensively studied site and across the species range. From 2014 through 2017, we regularly captured Florida bonneted bats for demographic studies at Babcock–Webb Wildlife Management Area in Charlotte County and we observed hypopigmented marks on 172 (80.8%) of 213 individuals, the highest incidence known for bats. The proportion of hypopigmented marks did not differ with sex, age at first capture, or reproductive status, and importantly, we documented the persistence of hypopigmented marks in individuals over multiple months. We also found no difference in survival or capture probability between hypopigmented and solid-colored individuals. Using data from concurrent mist-net studies, we assessed the proportion of Florida bonneted bats with hypopigmented marks across the species range and found a higher proportion of individuals with hypopigmented marks in the two northern counties (80.8% in Charlotte County and 61.5% in Polk County) compared with the two southern counties (21.1% in Miami–Dade County and 16.7% in Collier County). Additionally, we compared the proportion of hypopigmented individuals in Miami–Dade County between recently captured/collected bats (post-2004) and historically (pre-1965) collected museum specimens and found more hypopigmented marks in recently captured bats. The persistence of hypopigmented marks over time, the presence of marks on bats from different locations, and our finding of no effect of age on the presence of marks all strongly suggest that the hypopigmented marks in Florida bonneted bats are the result of genetic rather than environmental factors. Further study is required to understand the mechanism underlying the high incidence of hypopigmented marks and to determine whether the prevalence of hypopigmented marks indicates low genetic diversity that could threaten Florida bonneted bats.

Photosensitization of peptides and proteins by pterin derivatives

Abstract Proteins are one of the preferential targets of the photosensitized damaging effects of ultraviolet (UV) radiation on biological system. Pterins belong to a family of heterocyclic compounds, which are widespread in living systems and participate in relevant biological functions. In pathological conditions, such as vitiligo, oxidized pterins accumulate in the white skin patches of patients suffering this depigmentation disorder. It is known that pterins are able to photosensitize damage in nucleotides and DNA by type I (electron transfer) and type II (singlet oxygen) mechanisms. Recently, it has been demonstrated that proteins and its components may also be damaged when solutions containing both proteins and pterin are exposed to UV-A radiation. Therefore, given the biological and medical relevance of the photosensitizing properties of these molecules, we present in this article an overview of the capability of different pterin derivatives to photoinduce damage in proteins present in the skin, focusing our attention on the chemical modifications of tyrosine and tryptophan residues.

A Randomized Double Blind Clinical Trial on a Sabgh Formulation for Patients With Vitiligo.

The cosmetic problem that vitiligo produces affects patients psychologically. Many patients with vitiligo are suggested to cover their white skin patches with cosmetic products. There are formulations in traditional Iranian pharmacy to color these white skin patches. In this study, one of these formulations was compared with a cosmetic formulation. Two groups of patients were selected. One group used a marketed formulation and other group used a traditional Iranian Pharmacy formulation. The quality of life of the patients was compared based on the Dermatology Life Quality Index Questionnaire. Both interventions were associated with statistically improved Dermatology Life Quality Index scores over the 8-week intervention (P < .05), although the difference between the 2 was not statistically significant (P = .436). Traditional Iranian Pharmacy formulation is effective in increasing the quality of life in vitiligo patients.

The Psychosocial Complications of Vitiligo

Copyright: © 2014 Chandler DJ. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Vitiligo is an acquired chronic depigmentation disorder characterised by white skin patches. The prevalence is around 1% in Europe and the United States, and more than 8% in parts of India. Vitiligo usually occurs after birth and the average age of onset is around 20 years. Vitiligo commonly affects the face and extremities and is often immediately visible to others hence evokes high levels distress associated with appearance concern. Both sexes are affected equally, although women are more likely to seek treatment [1]. Disease progression is unpredictable and response to treatment is highly variable.

Association of various red cell, plasma protein markers based on qualitative studies in psoriasis and vitiligo

Psoriasis and Vitiligo are the skin disorders which are mediated by immunologically and inherited genetically. These are most predominant in the cases where the immune system sends faulty signals and by which the body produces an immune response against some of its own cells. Psoriasis occurs when skin cells grow too quickly. Where as in Vitiligo the immune system destroys pigmented making cells called melanocytes. This results in lesions formation and white patches of skin on different parts of the body. The present study undergone to determine whether the biochemical genetic marker phenotypes are predictive of Psoriasis and Vitiligo. Using biochemical techniques the association between Psoriasis and Vitiligo with Red cell enzymes like ESD, SOD, ACP1, GLO1 and Plasma proteins like HP, CP, ALB, GC, and TF have been extensively studied on 40 individuals of each disorder and 80 healthy controls. The results were compared with the healthy population series investigated for the same genetic markers. There was no significant association with any of the marker systems.

Modern vitiligo genetics sheds new light on an ancient disease

Vitiligo is a complex disorder in which autoimmune destruction of melanocytes results in white patches of skin and overlying hair. Over the past several years, extensive genetic studies have outlined a biological framework of vitiligo pathobiology that underscores its relationship to other autoimmune diseases. This biological framework offers insight into both vitiligo pathogenesis and perhaps avenues towards more effective approaches to treatment and even disease prevention.

Genomic inbreeding and relationships among Holsteins, Jerseys, and Brown Swiss

Genomic measures of relationship and inbreeding within and across breeds were compared with pedigree measures using genotypes for 43,385 loci of 25,219 Holsteins, 3,068 Jerseys, and 872 Brown Swiss. Adjustment factors allow genomic and pedigree relationships to match more closely within breeds and in multibreed populations and were estimated using means and regressions of genomic on pedigree relationships and allele frequencies in base populations. Correlations of genomic relationships with pedigree inbreeding were higher within each breed when an allele frequency of 0.5, rather than base population frequencies, was used, whereas correlations of average genomic relationships with average pedigree relationships and also reliabilities of genomic evaluations were higher using base population frequencies. Allele frequencies differed in the 3 breeds and were correlated by 0.65 to 0.67 when estimated from genotyped animals compared with 0.72 to 0.74 when estimated from breed base populations. The largest difference in allele frequency was between Holstein and the other breeds on chromosome Bos taurus autosome 4 near a gene affecting appearance of white skin patches (vitiligo) in humans. Each animal's breed composition was predicted very accurately with a standard deviation of <3% using regressions on genotypes at all loci or less accurately with a standard deviation of <6% using subsets of loci. Genomic future inbreeding (half an animal's mean genomic relationship to current animals of the same breed) was correlated by 0.75 to 0.94 with expected future inbreeding (half the average pedigree relationship). Correlations of both were slightly higher with parent averages than with genomic evaluations for net merit of young Holstein bulls. Thus, rates of increase in genomic and pedigree inbreeding per generation should be slightly reduced with genomic selection, in agreement with previous simulations. Genomic inbreeding and future inbreeding have been provided with individual genomic predictions since 2008. New methods to adjust pedigree and genomic relationship matrices so that they match may provide an improved basis for multibreed genomic evaluation. Positive definite matrices can be obtained by adjusting pedigree relationships for covariances among base animals within breed, whereas adjusting genomic relationships to match pedigree relationships can introduce negative eigenvalues. Pedigree relationship matrices ignore common ancestry shared by base animals within breed and may not approximate genomic relationships well in multibreed populations.

New Results on the Photochemistry of Biopterin and Neopterin in Aqueous Solution

New photochemical studies of the reactivity of biopterin (BPT) and neopterin (NPT) in acidic (pH = 5.5) and alkaline (pH = 10.5) aqueous solutions at 350 nm and room temperature were performed. The photochemical properties of BPT are of particular interest because the photolysis of this compound takes place in the white skin patches of patients affected by vitiligo. The photochemical reactions were followed by UV/VIS spectrophotometry, HPLC, electrochemical measurement of dissolved O(2) and enzymatic methods for hydrogen peroxide (H(2)O(2)) and superoxide anion (O(2)(-)) determinations. When BPT or NPT are exposed to UVA radiation, a red intermediate, very likely 6-formyl-5,8-dihydropterin, is generated in an O(2)-independent process. That product is rapidly oxidized on admission of O(2) to yield 6-formylpterin and H(2)O(2). When the photolysis takes place in aerobic conditions, no additional pathways exist. On the other hand, in the absence of O(2), the intermediate generated is not stable and leads to the formation of many products. O(2)(-) is also generated during photo-oxidation of BPT and NPT. The quantum yields of reactant consumption depends on the O(2) concentration: the higher the O(2) concentration, the lower the quantum yields. This behavior is discussed in connection with the excited state of the pterins.

White Vesicles in the Skin of Aplysia californica Cooper: A Proposed Excretory Function

White patches of skin that appear early in the development of the shell-less mollusc, Aplysia californica, are composed of aggregations of vase-shaped vesicles, each a single, large cell with an enlarged nucleus. Two layers of collagen, at 908 to each other, surround the vesicle membrane, together with a noncontiguous external layer of muscle. Energy dispersive spectroscopy and electron diffraction of the contents with scanning electron microscopy (SEM) and transmission electron microscopy (TEM) failed to find a signal for halogens (involved with unpalatable skin and, therefore, defence against predation), but did record prominent signals for calcium. Immature vesicles are filled with an homogenous material that appeared to mature progressively, likely by nucleation, into numerous, small spherules, visible by both SEM and TEM. Ultra-thin uranyl acetate stained sections of mature vesicles showed that the spherules had an intracrystalline matrix of radially arranged electron-dense material. The vesicle cell had none of the modifications characteristic of calcium or rhogocyte cell-types, which serve as calcium reservoirs for the movement of this element to sites of shell formation and regeneration. These vesicles are likely involved with the excretion of excess calcium and not, as originally hypothesized, with either defence against predators or calcium flux. In addition, the spherules that fill the vesicles are possibly composed of the less common polymorphs of calcium carbonate, vaterite and amorphous calcium carbonate. Excretion of the vesicle contents appeared to be passive, since vesicles lacked an abundant contiguous layer of muscle or a muscular release valve in the vesicle neck, but did have organized layers of collagen just outside the vesicle membrane. We propose that release of vesicle contents probably occurs when the neck of the vesicle is broken.

Photoinduced Generation of H2O2 and O2•- by 6-formylpterin in Aqueous Solutions

Abstract 6-Formylpterin is one of the oxidized pterins that accumulate in the white skin patches of patients affected by vitiligo. Studies of photoinduced generation of hydrogen peroxide (H2O2 ) and superoxide anion radical (O2• ) by formylpterin in acidic and alkaline aqueous solutions at 350 nm and room temperature have been performed. The photochemical processes were followed by UV-V1S spectrophotometry and enzymatic methods for H2O2 and O2•- determination. When formylpterin is irradiated a red intermediate, that has been proposed to be 6-carboxy- 5,8-dihydropterin, is generated in an O2 -independent process. In the presence of air that intermediate reacts with O2 to yield H2O2 and 6-carboxyptcrin. In anaerobic conditions it undergoes a thermal O2-independent reaction which leads to a non-identified product without generation of H202 . The rate constants of such a process were determined to be 0.011 min 1 and 0.044 min1 at pH 5.4 and 10.5, respectively. (O2 · ), is also generated during photooxidation of formylpterin, probably as a consequence of the electron transfer from the red intermediate to O2 . The biomedical importance of photoinduced generation of H2O2 and O2• is discussed.

HLA class II haplotype DRB1*04–DQB1*0301 contributes to risk of familial generalized vitiligo and early disease onset

Generalized vitiligo is a common autoimmune disorder characterized by white patches of skin and overlying hair caused by loss of pigment-forming melanocytes from involved areas. Familial clustering of vitiligo is not uncommon, and patients and their relatives are at increased risk for a specific complex of other autoimmune diseases. Compared with sporadic vitiligo, familial vitiligo is characterized by earlier disease onset and greater risk and broader repertoire of autoimmunity, suggesting a stronger genetic component, and perhaps stronger associations with specific alleles. To determine whether the major histocompatibility complex (MHC) contributes to the familial clustering of vitiligo and vitiligo-associated autoimmune/autoinflammatory diseases, we performed case-control and family-based association analyses of HLA class II-DRB1 and -DQB1 alleles and haplotypes in affected probands and their parents from 76 European-American Caucasian families with familial vitiligo. Affected probands showed a significantly increased frequency of DRB1*04-DQB1*0301 and a significantly decreased frequency of DRB1*15-DQB1*0602 compared with a large sample of reference chromosomes. Family-based association analyses confirmed these results. Probands with DRB1*04-DQB1*0301 developed vitiligo an average of 13.32 yr earlier than probands with DRB1*15-DQB1*0602. Overall, our results indicate that specific MHC-linked genetic variation contributes to risk of familial vitiligo, although HLA does not completely explain familial clustering of vitiligo-associated autoimmune/autoinflammatory diseases.