A. What is Vitiligo?
Vitiligo is a confined white patch that occurs later in life due to loss of skin pigmentation. So what is skin pigmentation? And what about pigment loss? The so-called skin pigment is skin melanin. Skin melanin is found in melanocytes within the skin and hair follicles. Melanin produced by melanocytes is converted from tyrosinase to dopa (DoPa) by a series of complex biochemical processes. When this process occurs obstacles (such as the melanocyte tyrosinase copper (cu++) decrease or sulfhydryl (----SH increase) lead to a decrease in tyrosinase activity, or even disappeared, and then make the melanin production decreased, disappeared, the medical usually called this lesion pigmentation loss, loss of the results of the local skin white spot-like.
So why is this disease called vitiligo? The original in our country in ancient times called this disease called purpura, but also because of its onset of "no fixed place", with the characteristics of wind evil, the wind line to which part of which part of the white, so named "vitiligo".
Second, vitiligo is the world's skin disease?
Yes, vitiligo is one of the world's three major dermatologic diseases. It not only harms the Chinese people, but also harms the people of the world, and is a common disease and frequent disease. All colors of people on the earth, all kinds of nationalities can get the disease. The incidence of the disease in the world population is about 1-2%. If the world population is calculated according to 5 billion, the incidence rate is calculated according to 1%, then the number of people suffering from the disease is as high as more than 50 million. China's population of 1.2 billion people have more than 12 million people suffering from this disease, which is an alarming number! Moreover, the incidence rate is reported to continue to rise everywhere.
After the investigation of medical scientists found such a phenomenon: both the incidence seems to be yellow, black, and darker skin color of the white people incidence of lighter skin color is higher. The United States, France and other white people in the incidence of vitiligo in less than 1%, while South India up to 4%, Japan for 2%, and our country is about 1%. Some scholars believe that the reason for the difference in the incidence of ethnicity is: due to the darker pigmentation once the white spot is easier to recognize than the white people.
Three, what is the cause of vitiligo?
The cause of vitiligo so far is not very clear, summarized in nine factors: genetic factors; psycho-neurological factors; chemical factors; tyrosinase, copper ions, relative lack of factors; infectious factors; traumatic factors and so on. It can be seen that the pathogenesis of vitiligo is multi-faceted factors, but a considerable number of patients can not find any triggering factors. Our research found that vitiligo patients, regardless of what part of the onset of vitiligo, are related to microcirculation disorders. We are researching therapeutic drugs, focusing on improving microcirculation.
Four, vitiligo and mental factors have a relationship?
The answer is yes. The spirit has a vital role in human health. Have you ever heard of the allusion to "the bow of the cup and the shadow of the snake"? This allusion fully illustrates the influence of psychoneurological factors on people's emotions and health.
The phrase "cup and bow, snake and shadow" comes from the Book of Jin. Le Guang's biography". Le Guang once invited a guest to draw wine, he hung a bow on the wall, due to the light, the shadow of the bow was exactly reflected in the wine cup and swayed in it. One of the guests mistook the bow's shadow in the wine cup for a snake. After drinking the wine, the bow shadow disappeared, and the guest thought he had swallowed the snake, so he became sick with fright and could not be cured for a long time. When Le Guang realized this, he told him that the "snake" in the cup was the projection of the bow hanging on the wall, and that you had not swallowed any snake. After hearing this, the guest's doubts were dispelled and he was cured.
Medicine to the "cup bow snake shadow" caused by the disease, called the spiritual factors both the role of human emotions. People's emotions are diverse, the motherland medicine will be divided into joy, anger, worry, thoughts, sadness, fear, shock seven, referred to as the "seven emotions", is an important factor in causing disease. For example, "joy hurts the heart", "anger hurts the liver", "thinking hurts the spleen", "worry hurts the lungs", "The first thing you need to do is to get rid of all the stuff that you've got to do.
Then we clinic thousands of cases of vitiligo cases, by the mental factors induced by the case accounted for about 35%, some of the spirit of the stimulation, some of the spirit of excessive tension, but also the thought of excessive repression.
Let's put a real-life true story.
In 1994, a Henan woman brought her son to my department to see a doctor, a beautiful young man's face, but there is a walnut size of a white spot. We asked the doctor to understand: the woman's family lives in the countryside, in order to let her son jump "agricultural" door, bent on letting her son go to college, academic performance has always been among the top. However, fate can really play tricks on people, the college entrance examination only because of the 6-point difference in name, no chance to cross into the university door, and from then on he was sad, depressed into a disease. One day look in the mirror he suddenly found a millet large white spots on the face, and then gradually expanded into the present appearance. This is a typical case of vitiligo induced by mental factors.
So why can mental factors induce vitiligo?
We know that melanocytes originate from the neural crest of the embryo, and it has been found that the central nervous system (mainly the pineal gland) contains a substance that inhibits melanin production-Melatonin. Under normal conditions, it is in dynamic balance with the pituitary gland's secretion of melanin (MSH), and when there is an excess of Melatonin, it can inhibit melanin formation. Apparently, when a person's spirit is malignantly stimulated, highly tense and overly repressed, McLatanin will increase, leading to vitiligo.
About neurological factors triggered by neurological vitiligo, there are several points of view:
1, ganglion theory. In the clinic, we also observed that many patients' lesions are distributed according to the nerve segments, that is, according to the nerve direction of a section of a section of the onset of the disease, some along the corner of the mouth to the jaw, some from the corner of the eye to the jaw, and some from the jaw to the neck. It has been observed that a patient with transverse myelitis lost sensation below the waist, while vitiligo occurred on the face and upper body above the waist, which suggests that there is a close relationship between leukoplakia and localized nerves.
2, peripheral nerve theory. Some people have done experiments: melatonin ethyl choline, noradrenaline, adrenaline in vitro can make amphibians and fish pigment cells white. Rejecting this person proposed that the diminished ability of melanocytes to produce melanin is due to an increase in their peripheral nerve chemicals, which interferes with tyrosinase activity. Normally, the inhibitory state of the peripheral nerves, so there is no change in skin pigmentation. However, patients with vitiligo skin peripheral nerve endings function actively, thus increasing the release of melatonin and other substances, resulting in reduced ability of melanocytes to synthesize melanin, thus the onset of disease].
3, local nerve theory. Some people think that vitiligo hair in local nerve damage, because of a variety of local stimulation directly injured nerves and cause disease.
4, mechanical stimulation theory. Vitiligo in the face and easy to friction part (such as lumbosacral, bra, belt, buttons, hernia bracket and other direct pressure part), which may be related to these parts of the skin nerves by a long time of mechanical stimulation.
5, plant nerve theory. Many patients with vitiligo is often accompanied by vegetative nerve dysfunction, such as white spots with abnormal sweating, vitiligo accompanied by baldness and skin scratches disease rate is relatively high.
Fifth, vitiligo will be hereditary?
Vitiligo has a certain relationship with heredity. In the clinical father and daughter, mother and son, mother and daughter, twin siblings onset is not uncommon.
According to domestic and foreign reports, about 3.9-4% of patients have a family history. It has been reported abroad that 18 out of 96 patients have family history (Qrtonne,1976). The dermatology department of Shanxi Linfen Regional Hospital (1978) reported 200 cases with family history out of 5230 cases, accounting for 4%. Family history was found in 7.20% of the patients we observed, of which first-degree relatives accounted for 55.4%, which suggests that there is a relationship between the disease and heredity.
This involves a serious problem: can you have children with vitiligo and pass it on? This is many patients and friends and relatives are very concerned about the problem, especially in the adolescent young men and women. Because of the prejudice and discrimination against vitiligo, many young patients carry a heavy burden.
Although vitiligo has a certain relationship with heredity, and there are monozygotic twins with two simultaneous onset of the report, thus proposing that vitiligo may be an autosomal dominant gene abnormality due to, but clusters of heredity point of view, heredity is only one of the factors in the onset of vitiligo. In addition, environmental factors, such as: lifestyle, working life environment, dietary habits, mental state, etc., also plays an important role, generally must be in the genetic factors and environmental factors are available before the onset of conditions. Therefore, even if there are genetic factors, as long as the influence of environmental factors is eliminated, the disease may not develop. Besides, genetic factors and environmental factors are different from person to person. From this point of view, the chance of vitiligo being passed on to the next generation is far less than that of other genetic diseases. Therefore, vitiligo patients can get married and have children.
It is important to note that vitiligo patients should not look for the same vitiligo objects. If parents have a history of vitiligo, children should pay attention to the influence of environmental factors, life should be regular, avoid exposure to the sun, avoid mental stimulation, and actively participate in physical exercise. If you find abnormal skin white spots, you should immediately seek medical attention, to do: early prevention, early treatment, early recovery.
Six, vitiligo and autoimmune function has no relationship?
Currently, most of the etiology of this disease tends to autoimmune theory. According to our research in recent years, found that the patient's serum autoantibody positive rate is higher than normal, mainly anti-thyroid antibodies, anti-gastric wall cell antibodies and anti-nuclear antibodies. Peripheral blood T-cells decreased significantly, and the number of Langerhans cells within the epidermis at the edge of the lesion white spot, both at the active site of the lesion, increased significantly and showed morphological abnormalities.
The pathogenic triggers of local skin injury occupies an important position, 15.5% of patients with positive homoeomorphic reaction (both in the normal skin trauma site of white spot injury); 11.9% of patients with other autoimmune diseases, higher than the general skin patients (3.6%) significantly; funduscopic examination found that nearly half of the patients (48.1%) abnormal. This proves that vitiligo and autoimmune function has a close relationship.
Seven, vitiligo will recur after the cure?
The recurrence rate of vitiligo after cure is about 15-35%, usually within one year after cure. The site of recurrence can also be in the original site, or in the original spot neighboring out, or far away from the original lesion. The recurrence of white spots may be 1-2 pieces or several pieces, and the white spots may be large or small.
So, vitiligo should not be taken lightly after the cure, should continue to treat for a period of time. If cured for more than a year, usually will not recur.
Eight, what is called microcirculation? Microcirculation and vitiligo related?
1, the human body's blood vessels are pipes that carry blood, he is like a big river, gradually branching out, irrigating the surrounding land, but also nourish the tissue cells around the blood vessels. When the blood passes through the large blood vessels to reach the tiny fine arteries, it flows through the widely distributed capillary network, and then converges into the fine veins. Because the caliber of this part of the blood vessels is so small that it is invisible to the naked eye and can only be seen under a microscope, it is called microcirculation.
In recent years, some people put forward the concept of broad microcirculation, in addition to the blood microcirculation, but also includes the lymphatic fluid and tissue fluid microcirculation. However, the microcirculation is usually referred to as the microcirculation that has been studied in greater depth.
The study of microcirculation has begun since the 1920s, but the term microcirculation was formalized and used at the first American Microcirculation Conference in 1954. Five world congresses on microcirculation have been held in more than half a century. Currently, the study of microcirculation has gone from direct observation of blood flow under the microscope to the cellular and molecular level.
The basic function of the microcirculation is to transport oxygen and nutrients to the tissues and carry away the products of metabolism. The tiny blood vessels in the microcirculation have only one layer of endothelial cells, and the tubes are thin enough to allow small molecules to move freely in and out, plus the capillaries are intertwined into a network with enough site and area for material exchange. In this way, the higher oxygen and nutrients in the blood will be transmitted from the capillaries to the surrounding tissue cells; and the carbon dioxide and other wastes produced by the metabolism of the tissue cells will be taken away by the blood and discharged from the body's excretory organs. Therefore, microcirculation has an important role in the life activities of the human body.
2, above we understand the microcirculation, microcirculation and vitiligo has a close relationship. We clinic with advanced means to observe: vitiligo parts of the microcirculation obstacles exist, so that the nutrients can not be sent to all parts of the skin, melanocytes can not get normal nourishment and affect the growth and development, metabolism. The day long, melanin loss, so that the local skin discoloration white, appear vitiligo lesions. Vitiligo patients for trace element measurement will find that the vast majority of patients in the body does not lack of trace elements, only the lack of localized white spots; microcirculation measurement of the white spots will find that the same area of skin, vitiligo parts of the number of capillaries is far less than the normal skin parts. This is also in a side proved that vitiligo and microcirculation between the existence of some kind of inevitable connection.
3, it is because we grasp the microcirculation and vitiligo of this inevitable connection, from the improvement and adjustment of microcirculation to start, the traditional Chinese medicine and modern medicine identification theory, the traditional understanding of Chinese medicine and modern pharmacology, selected natural precious Chinese medicine, the use of modern advanced preparation process, made the treatment of vitiligo, the special effect of the internal medicine! The "strong white powder" and external medicine "vitiligo tincture", both internal and external, the symptomatic treatment, achieved a high therapeutic effect.
Nine, facial or exposed parts of vitiligo affect the appearance of the moment difficult to cure there is no way to hide the white spots?
In the long-term treatment of vitiligo medical practice, some people have successfully developed a vitiligo patient-specific cover-type supplies --- gold beauty cream. This kind of supplies on vitiligo no treatment effect, only play a cosmetic role. Its main ingredient DHA has artificial tanning effect, can and vitiligo most surface protein amino acid on the free radical combination, condensation after the formation of deeper than the white spots, similar to the normal skin color of the protein melanin, uniformly covered in the white patches of the skin, can effectively play a role in masking the role of white patches. If you stop the role, with the skin surface metabolism, the affected pigment will also fall off, so the supplies of this kind of vitiligo has no treatment and control role, only "stopgap measures".
The use of beauty cream is generally used twice a day in the morning and evening, a few days after the effect, continuous use of 2-3 months, can achieve satisfactory coverage, beauty effect.
Ten, what is called melanin? How is it produced?
Melanin is widely found in human skin, mucous membranes, retina, soft meninges and gallbladder and ovaries. Melanin is synthesized by melanocytes. The melanocytes of the skin are mainly distributed in the basal layer of the epidermis, but also in the hair root and outer hair sheath. The human epidermis has about 2 billion melanocytes, weighing about one gram, with an average of 1,560 per square millimeter distributed symmetrically throughout the body.
Melanocytes synthesize and secrete melanin and are therefore glandular cells. However the biosynthesis of melanin is very complex and is formed through a tyrosine-tyrosinase reaction within the chromatophore (immature melanin).
XI. What are the factors that affect melanin anabolism?
In the process of melanin production, transfer and degradation, any one of the obstacles can affect its metabolism, resulting in skin color changes. After our research, there are mainly the following situations:
1. Tyrosine-tyrosinase reaction is disturbed. Ascorbic acid (vitamin C) as an example, such as the addition of ascorbic acid in this reaction, will prevent dopa & lt; further oxidation to dopa pigment, and make the synthesized dopa enzyme is reduced to dopa, so that melanin can not be synthesized.
2, the black body from the melanocytes to the adjacent angle far cell migration process is blocked. After years of observation, we found that the human skin color is mainly due to differences in melanocyte activity, but the skin color is not necessarily with the melanocyte black body increase and deepen, but mainly depends on the black body from the melanocyte to the proximity of the process of angular remote cell migration is smooth. Such as skin inflammation pigment loss is due to epidermal cell damage, the black body can not pass through the epidermal cells smooth excretion, and lead to the black body blocked in the melanocytes, so that the secondary melanocyte hypomelanosis.
3, black body generation, degradation of slow. Clinically seen green pigmentation abnormalities such as nevus, Mongolian spots, Nevus of Ota and Nevus of Iten, etc., are due to the dermal melanocytes within the black body of the generation, degradation of slow causes.
What we need to understand is that tyrosinase plays an extremely important role in the production of black bodies and their melanization process, and tyrosinase activity is affected by a variety of factors, it is necessary for the majority of patients to understand:
(1), ultraviolet light. In general, ultraviolet light can make the melanocyte tyrosinase activity enhancement, so that the melanocyte increase, the black body generation exuberant, move faster.
(2), base. The human epidermis has an organic compound - based compounds, especially the glutathione, can inhibit tyrosinase activity through the complexation of copper ions, some people determine the skin based on the content of vitiligo patients found in the damaged skin based on the content of the content of the skin (157 mg molecular weight / 100 grams of wet weight) than the normal person (1.55x0.01 mg molecular weight / 100 grams of wet weight) high and have a lower copper/glutathione ratio in the blood.
(3), Tryptophan pyrrolase. Increased tryptophan pyrrolase activity inhibits tyrosinase activity.
(4), Copper ions. Tyrosinase is using copper ions as a cofactor, and its activity is closely related to copper ions. Studies have shown that vitiligo patients with blood and skin copper or copper blue protein value is lower than the healthy control group, as for the copper, copper blue protein value may be reduced with nutritional disorders, or copper metabolism in the body dysregulation and genetic defects and other factors.
Twelve, sun exposure why easy to occur vitiligo?
We statistically analyzed 830 cases of vitiligo, and found that 95.54% of the seasonal factors, especially in late spring and early summer this time is more likely to occur or increase the new white spots. Among them, 6.8% developed after exposure to sunlight, what is the reason for this?
We believe that after sun exposure, melanocytes are hyperfunctional, and their tyrosinase and dopa oxidation intermediates are destroyed, and the intermediates are an important protective mechanism, and once this protective mechanism is consumed and declines, the melanin may be destroyed; secondly, the intermediates that can be synthesized by the cells may be overproduced or accumulated, and the melanocytes may be damaged. White spots occur.
Thirteen, vitiligo and endocrine have no relationship?
The relationship between vitiligo and endocrine is relatively close. From our statistical analysis of 2060 cases of clinical data, there are endocrine factors accounted for 23.6%. Among them are hyperthyroidism, suffering from diabetes, menstrual disorders in women of childbearing age half breast lobular hyperplasia or breast fibroma .........
So what is the impact of endocrine on pigment metabolism? Experimental studies have shown that: melanocyte stimulating hormone, dermatotropin, sex hormones can promote melanin synthesis and metabolism, while corticosteroids, adrenaline and noradrenaline, thyroxine and melatonin can inhibit melanin synthesis and metabolism. In order to make patients understand, we briefly introduce:
1, melanocyte stimulating hormone. In recent years, studies have shown that: human melanocyte stimulating hormone may be secreted by the anterior pituitary gland cells that secrete dermatogonadotropin. Melanocyte-stimulating hormone is divided into two kinds of a and β. When the patient receives a large number of melanin-stimulating hormone treatment, local short-term hyperpigmentation will occur.
2, dermatotropin. Dermatotropin is secreted by the anterior pituitary gland. Clinical use of dermatogonin after many patients with Addison's disease-like hyperpigmentation, the original pigmented nevus color deepening, and produce a new pigmented nevus, which may be due to the dermatogonin contains melanin-stimulating hormone, but also the use of dermatogonin treatment of vitiligo reports.
3, sex hormones. Sex hormones include male hormones and female hormones, male hormones represented by testosterone, such as testosterone propionate; female hormones such as flavonoids and estrogen. Sex hormones have the effect of deepening skin color, for example, pregnant women are often accompanied by facial chloasma and nipples, areolas and other places to deepen the color, which is due to the increase of female hormones in pregnant women. Again, such as liver disease patients with skin pigmentation, facial chloasma (also known as liver spots), this is due to liver disease patients inactivate the function of the hormone is reduced, so that the concentration of estrogen in the blood to increase due.
4, corticosteroids. Corticosteroid hormone: prednisone, dexamethasone and cyanide cortisone secreted by the adrenal cortex, its role in melanin metabolism is mainly related to melanocyte stimulation. Then under normal circumstances, the blood melanin stimulating hormone and corticosteroid hormone levels are relatively balanced, once dysregulation, affecting skin color. We have found that vitiligo patients taking cortisone treatment for arthritis after the white spots expanded and increased. From case analysis to animal experiments, skin experts speculate that: corticosteroids can make the skin whitening mechanism mainly lies in the inhibition of the pituitary gland secretion of melanocyte stimulating hormone, while the direct effect on melanocytes is slight.
5, adrenaline and noradrenaline. Adrenaline and norepinephrine are hormones secreted by the adrenal medulla, and they are secreted in a quiet state in a very small amount, when encountered in cold, pain, emotional factors make the body is a "state of tension", in the sympathetic excitation at the same time, the adrenal medulla secretion increased, so the two hormones increased. Trace amounts of adrenaline can inhibit both melanocyte stimulation of isolated frog skin melanocytes.
6, thyroxine. Thyroxine is secreted by the thyroid gland. Thyroid preparations of thyroxine, diiodothyronine system of inorganic iodide complexes, can make the skin color light, but the frog melanocytes have no effect. In addition, cases of hyperthyroidism with vitiligo are not uncommon, and when they remove the thyroid gland individual patients with vitiligo will change.
7, melatonin. Melatonin is mainly secreted by the pineal gland. The secretory function of the pineal gland and light has a close relationship, prolonged light can inhibit melatonin and secretion.
Fourteen, immune and vitiligo relationship is how?
After years of research, it can be affirmed that leucoderma lucidum has a close relationship with abnormal immune function. The main performance is as follows:
1, humoral immune changes. We measured 104 cases of vitiligo patients blood immunoglobulin, found that before treatment immunoglobulin white A, G, M value than the healthy people control group increased significantly; many patients complement (C3), the total body complement (CH50) decreased; and immune circulating complexes (C1C) determination is increased. In addition, many patients were positive for serum antithyroglobulin antibodies and antithyroglobulin antibodies. Some patients also had leukopenia, low hemoglobin, and thrombocytopenia. We performed direct fluorescence examination of 22 cases of leukoplakic tissues and found immunoglobulin G deposits at the basement membrane in 6 cases.
Also, as we talked about in question 6 of this booklet, auto-antibodies can be detected in the blood of patients with leukoepidemias that are higher than normal, which will not be discussed here.
2. Changes in cellular immunity. We to 400 cases of leukocalypse patients with 1:10,000 old tuberculin for skin test, the results of 194 cases were negative; for more than 180 cases of patients with phytohaemagglutinin with intradermal injection method of skin test, showing that the intensity of the skin test reaction at the leukoplakia before the treatment is significantly lower than its own normal skin color, as well as the intensity of the phytohaemagglutinin skin test reaction at the normal skin color, the treatment is significantly more than the treatment before the enhancement. In addition, the lymphocyte transformation test, natural petal formation test in patients with leukocoria showed hypoplasia.
Fifteen, what are the typical damage characteristics of leukapheresis?
Leucoderma occurs on the skin of any part of the body. Most of the white spots occur in the exposed parts of the body that are susceptible to friction and sunlight, especially the face (such as between the eyebrows, the inner side of the eyebrows, the root of the nose and the inner side of the cheeks, in front of the ears and the upper part of the ears, the frontal hairline, and the red part of the lips), the neck, the lower back, the abdomen, the sacral tail, and the extensor surfaces of the forearms and backs of the fingers, and other places.
The typical white spots are mostly nail to coin size, nearly round, oval, and later although expanding or fused with each other into an irregular large-scale shape, but no matter how its shape changes, the edge of the white spots are always visible, and there are islands of pigmentation spots in the white spots; another typical white spot is a band-like or striated depigmented spot distributed along the nerves, and the edges of the white spots are as neat as a knife cut.
Sixteen, leukoplakia and environmental pollution has no relationship?
There is a relationship between leprosy and environmental pollution. From our large number of cases, it is easy to see that the incidence of rural areas is lower than urban areas, and industrial weak areas are lower than industrially developed areas, and vice versa. Proof from known occupational diseases: exposure to certain alkylphenol compounds (such as p-tert-butylphenol, etc.) can induce leukapenia. If more and more phenolic compounds are produced and applied in industry, the incidence of leukapalpia will also increase. In addition, pollution of water, air, vegetables, food, etc., can also lead to vitiligo from life.
Therefore, environmental protection is very important. Our government attaches great importance to environmental protection work, over the years to do a lot of people praised by the control of pollution of the big things, so that our living environment has been improved to a certain extent. We are also pleased to see that many people consciously protect the environment and learn to protect themselves. I believe that the chance of vitiligo caused by environmental pollution will gradually reduce.
Seventeen, why the dark-colored skin type of people prone to vitiligo?
This question we have talked about in this booklet in the second lecture, now further discussed.
World survey data on vitiligo, the incidence of vitiligo in dark-skinned people can be as high as 4% (such as India), while light-colored people less than 1% (such as the United States of America, Britain), the incidence of both the difference is significant. The reason for this is not well understood. However, it may be related to the synthesis of mature melanosomes (i.e., stage IV melanin) morphologically different, as shown in the following aspects.
1, light-colored skin species of the black body color is relatively light, small size, oval, into a collection of distribution, that is, a few melanosomes wrapped together; dark-colored skin species of the melanosomes is the opposite, dark brown color, larger size, spherical, a single-type distribution, that is, the presence of melanosomes alone.
2, melanosomes are transferred from melanocytes to the adjacent keratocytes, light-colored skin species melanosomes are mainly found in the epidermis of the basal low layer and the echinocyte layer, while dark-colored skin species of the epidermis can be seen in all layers of melanosomes.
3, melanosomes in the keratocyte degradation (melting, disappearance) process is also different. Light-colored skin species, most of the melanosomes in the keratinocytes are degraded by the direct action of lysosomes in the keratinocytes; and in the black race, keratinocytes melanosomes are mainly the latter degradation pathway, both diffuse to the epidermis in all layers, the last with the shedding of the stratum corneum and epidermal separation, which is why the darker skin species darker skin color.
4, dark skin species of melanin anabolism may be more vigorous, if once given the activation factors such as ultraviolet light, melanin anabolism will be extremely vigorous, and therefore will accelerate the depletion of melanocytes; due to the exuberant metabolism of melanin, the excessive accumulation of intermediate products in turn can kill the melanocytes, which impedes the synthesis of the melanocytes and decoloration of the lesions occurred.
Eighteen, halo nevus and vitiligo what is the relationship?
Halo nevus and vitiligo clinical manifestations are white pigmentation, in histopathology and ultrastructural changes are similar, often seen when the halo nevus central nevus disappeared, its white halo expansion, followed by other parts of the body successively issued a new case of white spots, therefore, we believe that the halo nevus is a type of vitiligo.
In addition, halo nevus and vitiligo in the same patient can occur at the same time, that is to say, halo nevus patients at the same time vitiligo, vitiligo patients at the same time accompanied by the halo nevus, especially the incidence of halo nevus in patients with generalized vitiligo is higher.
nineteen, vitiligo and visceral diseases what is the relationship?
Many internal diseases related to the immune system, also belongs to the category of visceral diseases, vitiligo and autoimmune diseases related to this booklet, the 6th and 37th lecture have been talked about. In addition, some patients with vitiligo are accompanied by gastric and duodenal ulcers, chronic gastritis, gastro-sinusitis, glomerulonephritis, hepatitis, hypertension, tuberculosis, diabetes mellitus ...... then vitiligo and what exactly is the relationship between these diseases is not yet clear. However, from the point of view of concomitant diseases, gastrointestinal diseases are more common, especially ulcer disease. Ulcer disease is related to mental factors, and mental factors are also one of the pathogenesis of vitiligo.
Twenty, vitiligo patients need blood test?
In recent years, we found that many vitiligo patients with anemia, leukocytes and thrombocytopenia, and many patients can detect a variety of autoantibodies in the blood (such as this booklet, the 6th talk about). These conditions tell us that before or during treatment to do some blood tests is necessary, can be found in the abnormal, or find potential internal lesions, identify the causes, symptomatic treatment, can improve the cure rate, conducive to the recovery of vitiligo disease.
Twenty-one, how to recognize the white spots appearing on the body of middle-aged and elderly people?
Clinically, we commonly see some people over 45 years of age begin to appear a kind of degenerative spots without self-conscious symptoms, medically known as senile white spots. There is no difference in the incidence rate between men and women.
White spots often occur on the trunk, limbs, especially thighs, while the face does not occur.
This kind of white spots are distinctive, mostly pin head to bean size, individual can also reach the size of fingernail, round or oval. The number can be a few, or dozens of hundreds of different. The skin at the white spot is slightly sunken, the border is clear, and there is no increase in pigmentation. The disease is a senile degenerative phenomenon, due to the decrease in the number of dopa-positive melanocytes in the skin. So white spots on middle-aged and elderly people are not necessarily vitiligo.
Twenty-two, how to distinguish between sweat patches and vitiligo?
Sweat patches, also known as lichen planus, is a superficial fungal disease, the skin damage is mainly pale white, round or ovoid spots, fuzzy edges, the surface is often a lot of microscopic scales, refractive, can be directly through the microscope to find the fungus, the onset of the part of the sebaceous glands developed parts of the common, such as the neck, the upper chest, the back and upper limbs.
We need to remind you that young children cases can be seen in the cheeks, forehead and between the eyebrows, due to frequent scrubbing, the surface is not easy to adhere to the scales, so it is very easy to confuse with early vitiligo.
The skin pigmentation of vitiligo patients is white in patches, the edge can have pigmentation, the surface is not scaly, excessive sweating does not aggravate, of course, in the microscope can not find fungi. Knowledge of these can help identify the two diseases.
Twenty-three, STDs and vitiligo have a relationship?
It can be said with certainty that venereal disease has nothing to do with vitiligo. But some people think that syphilis patients with depigmented white patches on the skin seems to be vitiligo. This is a wrong understanding, because the syphilis white spots is the second stage of syphilis rash characteristics, manifested as multiple, the size of the nail discoloration, border is not clear; white spots confined to the neck and shoulder nails, the degree of depigmentation is not as obvious as the vitiligo, tone is not bright, combined with the history of unclean sexual intercourse and other symptoms of syphilis can be differentiated from the vitiligo.
There are two different kinds of illnesses that are not necessarily related to syphilis and vitiligo.
Twenty-four, simple furfur and vitiligo how to distinguish?
Furfury simplex, commonly known as worm spots, is a common skin disease in children, can also occur in young adults. The pigmentation is round or oval, clear boundaries, the edge of the slightly high, covered with a small amount of small scales, more than no self-conscious symptoms as a characteristic, the size of the patch varies, the diameter of about 1 centimeter several centimeters, the early red, soon to be light white, this time if you do not pay attention to identify, easy to vitiligo confuse. However, the depigmentation of worm spots is not complete, the surface is rough, sometimes with scales, these are helpful with limited vitiligo identification.
Twenty-five, transfer factor, thymine, levitra treatment of vitiligo effect?
The use of these immune drugs can improve the patient's cellular immunity to varying degrees, some patients with vitiligo due to the immune mechanism of pathogenesis and accompanied by cellular immune dysfunction, the application of these drugs is of some benefit (this booklet 29