Vitiligo
Palabras clave:
Vitiligo, trastornos de la pigmentación, hipopigmentaciónResumen
El vitiligo se define como un trastorno de la pigmentación, adquirido, crónico, caracterizado por máculas blancas, que usualmente aumentan de tamaño con el tiempo y que corresponden a una pérdida de la función de los melanocitos epidérmicos y, en algunas ocasiones, a los del folículo piloso. La prevalencia mundial es de 0,5% a 2% y afecta todas las razas y en igual proporción a hombres y mujeres. Se han propuesto múltiples teorías para explicar la patogénesis de la enfermedad y, entre ellas, han resaltado la hipótesis bioquímica, la neural y la autoinmune; esta última es la más popular. Las diferentes teorías pueden contribuir a explicar la pérdida de los melanocitos, apoyando una etiología multifactorial, lo que se conoce como la teoría de convergencia.
El diagnóstico es clínico y puede ayudar la lámpara de Wood. Existe una gran cantidad de tratamientos disponibles en nuestro medio, con ventajas y desventajas, pero ninguno de ellos es 100% efectivo en todos los pacientes.
Biografía del autor/a
María Cristina Trujillo Correa
Médica, residente II de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
Luz Marina Gómez Vargas
Médica dermatóloga, Coordinadora del Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia.
Referencias bibliográficas
1. Sehgal VN, Srivastava G. Vitiligo: compendium of clinicoepidemiological features. Indian J Dermatol Venereol Leprol. 2007;73:149-56.
2. Carter RL. A dictionary of dermatologic terms. 4th edition. Baltimore: Williams and Wilkins; 1992.
3. Hann Sk, Chung Hs. Historic view of vitiligo in Korea. Int J Dermatol. 1997;36:313-5.
4. Le Poole, C. van den Wijngaard R, Westerhof, W, Dutrieux R, Das P. Presence or absence of melonocytes in vitiligo lesions: An inmunohistochemical investigation. J Invest Dermatol. 1993;100:816-22.
5. Taïeb A, Picardo M, other VETF members. The definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force. Pigment Cell Res. 2007;20:27-35.
6. Fitzpatrick T, Wolff K, Goldsmith L, Katz S, Gilchrest B, Paller A, et al. Dermatology in general medicine. 7th edition. United States of America: Editorial McGraw-Hill; 2008. p. 616-1.
7. Westerhof W, D´Ischia M. Vitiligo puzzle: the piece fall in place. Pigment Cell Res. 2007;20:345-59.
8. Das SK, Majumder PP, Chakraborty R, Majumdar TK, Haldar B. Studies on vitiligo. Epidemiological profile in Calcutta, India. Genet Epidemiol. 1985;2:71-8.
9. Majumder PP, Nordlund JJ, Nath SK. Pattern of familial aggregation of vitiligo. Arch Dermatol. 1993;129:994-8.
10. Passeron T, Ortonne JP. Physiopathology and genetics of vitiligo. Journal of Autoimmunity. 2005;25:63-8.
11. Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res. 2003;16:208-14.
12. De Vijlder H, Westerhof W, Schreuder G, De lange P, Claas FHJ. Difference in pathogenesis between vitiligo vulgaris and halo nevi associated with vitiligo is supported by an HLA association study. Pigment Cell Res. 2004;17:270-4.
13. Hartmann A, Bröker EB, Becker JC. Hipopigmentary skin disorders. Drugs. 2004;64):89-107.
14. Rezaei N, Gavalas NG, Weetman AP. Kemp EH. Autoimmunity as an aetiological factor in vitiligo. JEADV. 2007;21:865-76.
15. Harning R, Cui J, Bystryn JC. Relation between the incidence and level of pigment cell antibodies and disease activity in vitiligo. J Invest Dermatol. 1991;97:1078-80.
16. Naughton GK, Reggiardo D, Bystryn JC. Correlation between vitiligo antibodies and extent of depigmentation in vitiligo. J Am Acad Dermatol. 1986;15:978-81.
17. Bessou S, Gauthier Y, Surleve-Bazeille J, Pain C. Taieb A. Epidermal reconstruct in vitiligo: an extrinsic factor is needed to trigger the disease. Br J Dermatol. 1997;137:8909-17.
18. Baharav E, Merimski O, Shoenfeld Y, Zigelman R, Gilbrud B, Yecheskel G, et al. Tyrosinase as an autoantigen in patients with vitiligo. Clin Exp Immunol. 1996;105:84-8.
19. Xie Z, Chen D, Jiao D, Bystryn JC. Vitiligo antibodies are not directed to tyrosinase. Arch Dermatol. 1999;135:417-22.
20. Yu HS, Chang KL, Yu CL, Li HF, Meng-Tse W, Wu; ChiehShan W, Wu CS. Alterations in IL6, IL8, GM-CSF, TNF-a, and IFN-g release by peripheral mononuclear cells in patients with active vitiligo. J Invest Dermatol. 1997;108:527-9.
21. Mandry R, Ortíz LJ, Lugo-Somolinos A, Sánchez J. Organspecific autoantibodies in vitiligo patients and their relatives. Int J Dermatol. 1996;35:18-21.
22. Ogg GS, Dumbar PR, Romero P, Chen JL, Cerundolo V. High frecuency of skin homing melanocyte specific cytotoxic T lymphocites in autoinmune vitiligo. J Exp Med. 1998;188:1203-8.
23. Bystryn JC. Inmune mechanism in vitiligo. Clinics in Dermatology. 1997;15:853-61.
24. Dell´Anna ML, Picardo M. A review and new hypothesis for non-immunological pathogenetic mechanisms in vitiligo. Pigment Cell Res. 2006;19:406-11.
25. Schallreuter KU, Zschiesche M, Moore J, Panske A, Hibberts N, Metelmann H, et al. In vivo evidence for compromised phenylalanina metabolism in vitiligo. Biochem Biophys Res Commun. 1998;243:395-9.
26. Passi S, Grandinetti M, Maggio F, Stancato A, de Luca C. Epidermal oxidative stress in vitiligo. Pigment Cell Res. 1998;11:81-5.
27. Maresca V, Roccella M, Roccella F, Del Porto G, Passi S, Grammatico P, et al. Incresed sensivity to peroxidative agents as a possible pathogenic factor of melanocyte damage in vitiligo. J Invest Dermatol. 1997;109:310-3.
28. Grimes P. New insights and new therapies in vitiligo. JAMA. 2005;293:730-5.
29. Hann SK, Kim YS, Yoo JH, Chun YS. Clinical and histological characteristic of trichrome vitiligo. J Am Acad Dermatol. 2000;42:589-96.
30. Behl PN, Aggarwal A, Srivastava G. Vitiligo. En: Behl PN, Aggarwal A, Srivastava G, editors. Practice of dermatology. 9th edition. New Delhi; CBS Publishers and Distributors: 2003. p. 238-41.
31. Fargnoli MC. Bolognia JL. Pentachrome vitiligo. J Am Acad Dermatol. 1995;33:853-6.
32. Arata J, Abe-Matsuura Y. Generalized vitiligo figurate erythematosquamous eruption. J Dermatol. 1994;21:438-41.
33. Michaelsson G. Vitiligo with raised borders –report of two cases. Acta Derm Venereol. 1968;48:158-61.
34. Ivker R, Goldaber M, Buchness MR. Blue vitiligo. J Am Acad Dermatol. 1994;30:829-31.
35. De Sica AB, Wakelin S. Psoriasis vulgaris confined to vitiligo patches and occurring contemporaneously in the same patients. Clin Exp Dermatol. 2004;29:434-5.
36. Garbelli S, Mantovani S, Palermo B, Giachino C. Melanocyte-specific, cytotoxic T cell responses in vitiligo: The effective variant of melanoma immunity? Pigment Cell Res. 2005;18:234-42.
37. Le Poole C, Boissy R. Vitiligo. Sem Cutan Med Surg. 1997;16:3-14.
38. Kim YC, Kim YJ, Kang HY, Sohn S, Lee ES. Histopathologic features in vitiligo. Am J Dermatopathol. 2008;30:112-6.
39. Ongenae K, Beelaert L, van Geel N, Naeyaert JM. Psychosocial effects of vitiligo. JEADV. 2006;20:1-8.
40. Whitton ME, Ascroft DM, Barret CW, González U. Interventions for vitiligo. The Cochrane Collaboration. 2008:1-40.
41. Kim SM, Lee HS, Han SK. The efficacy of low-dose oral corticosteroids in treatment of vitiligo patients. Internal J Dermatol. 1999;38:546-50.
42. Sehgal VN, Srivastava G. Vitiligo treatment options: An evolving scenario. Journal of Dermatological Treatment. 2006;17:262-75.
43. Whitton M, Ashcroft DM, González U. Therapeutic Interventions for vitiligo. J Am Acad Dermatol. 2008;59:713-7.
44. Passeron T, Ortonne JP. What´s new in hypochromy. Journal of Dermatological Treatment. 2006;17:70-3.
45. Xu Ae W.Topical melagenine for repigmentation in twenty-two child patients with vitiligo on the scalp. Chin Med J. 2004;117:199-201.
46. Njoo WW. Vitiligo. Pathogenesis and treatment. Am J Clin Dermatol. 2001;2:167-81.
47. Mandel AS, Haberman HF, Pawlowski D, Goldstein E. Non PUVA nonsurgical therapies for vitiligo. Clin Dermatol. 1997;15:907-19.
48. Falabella R, Barona MI. Update on skin repigmentation therapies in vitiligo. Pigment Cell Melanoma Res. 2009;22:42-5.
49. Rusfianti M, Wirohadidjodjo YW. Dermatosurgical techniques for repigmentation of vitiligo. Int J Dermatol. 2006;45:411-7.
50. Fallabella R. Surgical approaches for stable vitiligo. Dermatologic Surgery. 2005;31:1277-84.
2. Carter RL. A dictionary of dermatologic terms. 4th edition. Baltimore: Williams and Wilkins; 1992.
3. Hann Sk, Chung Hs. Historic view of vitiligo in Korea. Int J Dermatol. 1997;36:313-5.
4. Le Poole, C. van den Wijngaard R, Westerhof, W, Dutrieux R, Das P. Presence or absence of melonocytes in vitiligo lesions: An inmunohistochemical investigation. J Invest Dermatol. 1993;100:816-22.
5. Taïeb A, Picardo M, other VETF members. The definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force. Pigment Cell Res. 2007;20:27-35.
6. Fitzpatrick T, Wolff K, Goldsmith L, Katz S, Gilchrest B, Paller A, et al. Dermatology in general medicine. 7th edition. United States of America: Editorial McGraw-Hill; 2008. p. 616-1.
7. Westerhof W, D´Ischia M. Vitiligo puzzle: the piece fall in place. Pigment Cell Res. 2007;20:345-59.
8. Das SK, Majumder PP, Chakraborty R, Majumdar TK, Haldar B. Studies on vitiligo. Epidemiological profile in Calcutta, India. Genet Epidemiol. 1985;2:71-8.
9. Majumder PP, Nordlund JJ, Nath SK. Pattern of familial aggregation of vitiligo. Arch Dermatol. 1993;129:994-8.
10. Passeron T, Ortonne JP. Physiopathology and genetics of vitiligo. Journal of Autoimmunity. 2005;25:63-8.
11. Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res. 2003;16:208-14.
12. De Vijlder H, Westerhof W, Schreuder G, De lange P, Claas FHJ. Difference in pathogenesis between vitiligo vulgaris and halo nevi associated with vitiligo is supported by an HLA association study. Pigment Cell Res. 2004;17:270-4.
13. Hartmann A, Bröker EB, Becker JC. Hipopigmentary skin disorders. Drugs. 2004;64):89-107.
14. Rezaei N, Gavalas NG, Weetman AP. Kemp EH. Autoimmunity as an aetiological factor in vitiligo. JEADV. 2007;21:865-76.
15. Harning R, Cui J, Bystryn JC. Relation between the incidence and level of pigment cell antibodies and disease activity in vitiligo. J Invest Dermatol. 1991;97:1078-80.
16. Naughton GK, Reggiardo D, Bystryn JC. Correlation between vitiligo antibodies and extent of depigmentation in vitiligo. J Am Acad Dermatol. 1986;15:978-81.
17. Bessou S, Gauthier Y, Surleve-Bazeille J, Pain C. Taieb A. Epidermal reconstruct in vitiligo: an extrinsic factor is needed to trigger the disease. Br J Dermatol. 1997;137:8909-17.
18. Baharav E, Merimski O, Shoenfeld Y, Zigelman R, Gilbrud B, Yecheskel G, et al. Tyrosinase as an autoantigen in patients with vitiligo. Clin Exp Immunol. 1996;105:84-8.
19. Xie Z, Chen D, Jiao D, Bystryn JC. Vitiligo antibodies are not directed to tyrosinase. Arch Dermatol. 1999;135:417-22.
20. Yu HS, Chang KL, Yu CL, Li HF, Meng-Tse W, Wu; ChiehShan W, Wu CS. Alterations in IL6, IL8, GM-CSF, TNF-a, and IFN-g release by peripheral mononuclear cells in patients with active vitiligo. J Invest Dermatol. 1997;108:527-9.
21. Mandry R, Ortíz LJ, Lugo-Somolinos A, Sánchez J. Organspecific autoantibodies in vitiligo patients and their relatives. Int J Dermatol. 1996;35:18-21.
22. Ogg GS, Dumbar PR, Romero P, Chen JL, Cerundolo V. High frecuency of skin homing melanocyte specific cytotoxic T lymphocites in autoinmune vitiligo. J Exp Med. 1998;188:1203-8.
23. Bystryn JC. Inmune mechanism in vitiligo. Clinics in Dermatology. 1997;15:853-61.
24. Dell´Anna ML, Picardo M. A review and new hypothesis for non-immunological pathogenetic mechanisms in vitiligo. Pigment Cell Res. 2006;19:406-11.
25. Schallreuter KU, Zschiesche M, Moore J, Panske A, Hibberts N, Metelmann H, et al. In vivo evidence for compromised phenylalanina metabolism in vitiligo. Biochem Biophys Res Commun. 1998;243:395-9.
26. Passi S, Grandinetti M, Maggio F, Stancato A, de Luca C. Epidermal oxidative stress in vitiligo. Pigment Cell Res. 1998;11:81-5.
27. Maresca V, Roccella M, Roccella F, Del Porto G, Passi S, Grammatico P, et al. Incresed sensivity to peroxidative agents as a possible pathogenic factor of melanocyte damage in vitiligo. J Invest Dermatol. 1997;109:310-3.
28. Grimes P. New insights and new therapies in vitiligo. JAMA. 2005;293:730-5.
29. Hann SK, Kim YS, Yoo JH, Chun YS. Clinical and histological characteristic of trichrome vitiligo. J Am Acad Dermatol. 2000;42:589-96.
30. Behl PN, Aggarwal A, Srivastava G. Vitiligo. En: Behl PN, Aggarwal A, Srivastava G, editors. Practice of dermatology. 9th edition. New Delhi; CBS Publishers and Distributors: 2003. p. 238-41.
31. Fargnoli MC. Bolognia JL. Pentachrome vitiligo. J Am Acad Dermatol. 1995;33:853-6.
32. Arata J, Abe-Matsuura Y. Generalized vitiligo figurate erythematosquamous eruption. J Dermatol. 1994;21:438-41.
33. Michaelsson G. Vitiligo with raised borders –report of two cases. Acta Derm Venereol. 1968;48:158-61.
34. Ivker R, Goldaber M, Buchness MR. Blue vitiligo. J Am Acad Dermatol. 1994;30:829-31.
35. De Sica AB, Wakelin S. Psoriasis vulgaris confined to vitiligo patches and occurring contemporaneously in the same patients. Clin Exp Dermatol. 2004;29:434-5.
36. Garbelli S, Mantovani S, Palermo B, Giachino C. Melanocyte-specific, cytotoxic T cell responses in vitiligo: The effective variant of melanoma immunity? Pigment Cell Res. 2005;18:234-42.
37. Le Poole C, Boissy R. Vitiligo. Sem Cutan Med Surg. 1997;16:3-14.
38. Kim YC, Kim YJ, Kang HY, Sohn S, Lee ES. Histopathologic features in vitiligo. Am J Dermatopathol. 2008;30:112-6.
39. Ongenae K, Beelaert L, van Geel N, Naeyaert JM. Psychosocial effects of vitiligo. JEADV. 2006;20:1-8.
40. Whitton ME, Ascroft DM, Barret CW, González U. Interventions for vitiligo. The Cochrane Collaboration. 2008:1-40.
41. Kim SM, Lee HS, Han SK. The efficacy of low-dose oral corticosteroids in treatment of vitiligo patients. Internal J Dermatol. 1999;38:546-50.
42. Sehgal VN, Srivastava G. Vitiligo treatment options: An evolving scenario. Journal of Dermatological Treatment. 2006;17:262-75.
43. Whitton M, Ashcroft DM, González U. Therapeutic Interventions for vitiligo. J Am Acad Dermatol. 2008;59:713-7.
44. Passeron T, Ortonne JP. What´s new in hypochromy. Journal of Dermatological Treatment. 2006;17:70-3.
45. Xu Ae W.Topical melagenine for repigmentation in twenty-two child patients with vitiligo on the scalp. Chin Med J. 2004;117:199-201.
46. Njoo WW. Vitiligo. Pathogenesis and treatment. Am J Clin Dermatol. 2001;2:167-81.
47. Mandel AS, Haberman HF, Pawlowski D, Goldstein E. Non PUVA nonsurgical therapies for vitiligo. Clin Dermatol. 1997;15:907-19.
48. Falabella R, Barona MI. Update on skin repigmentation therapies in vitiligo. Pigment Cell Melanoma Res. 2009;22:42-5.
49. Rusfianti M, Wirohadidjodjo YW. Dermatosurgical techniques for repigmentation of vitiligo. Int J Dermatol. 2006;45:411-7.
50. Fallabella R. Surgical approaches for stable vitiligo. Dermatologic Surgery. 2005;31:1277-84.
Cómo citar
1.
Trujillo Correa MC, Gómez Vargas LM. Vitiligo. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 12 de febrero de 2019 [citado 19 de abril de 2024];17(2):76-8. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/155
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2019-02-12
Cómo citar
1.
Trujillo Correa MC, Gómez Vargas LM. Vitiligo. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 12 de febrero de 2019 [citado 19 de abril de 2024];17(2):76-8. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/155
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