2. VITILIGO April 26th, 1999 Chemistry 412 Rick Helgemo

3. What is vitiligo?  Autoimmune disorder  Genetic link  Affects 1-2% of population  Difficult to cure  Harmful effects

5. “Untreated” Vitiligo

6. Autoimmune disorder  Melanocytes destroyed *Melanocyte-specific differentiation antigens *Tyrosinase, Dopachrome isomerase (TRP-2), gp100, MART-1  Immunoglobulin G recognizes TRP-2, causing immune response  Possible link to curing melanoma?

7. Genetic Links  Two types-Segmental and nonsegmental  Polygenic nature, multifactorial inheritance  Autosomal and not linked to race or sex  Linked to other autoimmune diseases  Weakly heritable

8. Curing Vitiligo Effects  Long and difficult process, rarely 100% effective on individual  Always involves sunlight or ultraviolet light  Physical and chemical methods  Cosmetics  Depigmentation  Psychological counseling

9. Chemical Treatment Options for Vitiligo  Corticoids  Psoralens (PUVA)  Phenylalanine  P-aminobenzoic acid (PABA)  Cantharidin, a blister beetle secretion

10. Physical Treatment Options for Vitiligo  Tattooing (micropigmentation)  Autologous skin grafts  Skin grafting using blisters  Autologous melanocyte transplantation  Combination of Sun and Sunscreen

11. References: §“Anti-tyrosinase-related protein-2 immune response in vitiligo patients…;” Okamoto T, Irie RF, Fujii S, etal.; The Journal of Investigative Dermatology; Dec 1998; 111:1034-1039. §“Autoantibodies to Tyrosinase-related protein-1 detected in the sera… ;” Kemp EH, Waterman EA, Gawkrodger DJ, et al.; British Journal of Dermatology 1998; 139:798-805. §“A systematic review of autologous transplantation methods in vitiligo;” Njoo MD,Westerhof W, Bos JD, Bossuyt PMM; Archives of Dermatology, Dec 1998 134:1543-1549. §“The genetics of vitiligo in Korean patients;” Kim SM, Chung HS, Hann SK; International Journal of Dermatology 1998; 38:908-910. §“On the association between vitiligo and malignant melanoma;” Lindelof B, Hedblad MA, Sigurgeirsson B; Acta Dermatologica Venereologica; 1998 78:483-484. §“Tyrosinase as an autoantigen in patients with vitiligo;” Baharav E, Merimsky O, Shoenfeld Y, et al.; Clinical Experimental Immunology; 1996 105:84-88. §“Nonsurgical repigmentation therapies in vitiligo;” Njoo MD,Westerhof W, Bos JD, Bossuyt PMM; Archives of Dermatology; Dec 1998 134:1532-1540. §“Spontaneous repigmentation of vitiligo patches distant from the autologous skin…;” Malakar S, Dhar S; Dermatology; 1998 197:274.

12. More References §“Treatment of vitiligo with oral and topical phenylalanine: 6 years of experience;” Camacho F, Mazuecos J; Archives of Dermatology; Feb 1999 135:216-217. §“UV-dependent melanocyte plasticity-The structure-function relationship;” Iyengar B; Indian Journal of Pathological Microbiology; 1996 39(2):105-109. §“Topical application of a melanotropin analogue to vulgar vitiligo dermo-epidermal minigrafts;” Schwartzmann-Solon AM, Visconti MA, Castrucci AML; Brazilian Journal of Medical and Biological Research; 1998 31:1557-1564. §“Repigmentation of vitiligo lesion after beetle dermatitis;” Parsad D, Saini R, Nagpal R; Dermatology; 1998 197:398.