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Vita fläckar, fjärilar och PSEUDOCATALASE. Vitiligo är en kronisk hudsjukdom som kännetecknas av depigmenterade (vita) hudområden på kroppen. Sjukdomen är vanlig och drabbar 1–2 procent av befolkningen globalt. Statistiskt sett kan det finnas många fler eftersom de flesta inte söker vård för pigmentförändringar i huden.
Vitiligo vulgaris (generalised vitiligo) is the most common form of vitiligo. Vitiligo vulgaris is characterised by white patches that appear symmetrically on both halves of the body.
Vitiligo segmentalis is the second variant, vitiligo segmentalis (segmental vitiligo), appearing as patches on only one side of the body.
Vitiligo focalis is called the third variant and is characterised by small patches on one or a few parts of the body.
Scientists currently disagree on the reason why vitiligo occurs. Some say it's caused by autoimmunity, which is when your immune system attacks the pigment cells. Others claim that a high concentration of oxidative stress destroys the pigment cells. Most likely, it's a combination of both. Patients with vitiligo (especially with vitiligo vulgaris) have antibodies against the pigment cells along with a high concentration of hydrogen peroxide which is an oxidative marker. Which came first the chicken or the egg? We don't know.
For a long time it was assumed that white patches contained no melanocytes (pigment cells), but research has now shown that melanocytes are still present in white patches, only that they have lost their ability to form pigment (1).
As depigmentation can occur in visible areas of the skin, the disease can be socially stigmatising and cause psychosocial distress, including a decline in well-being (2).
Att diagnostisera vitiligo är ofta en enkel process. Hos ljushyade patienter kan dock en så kallad hudlampa (Woods lampa) behövas för att säkerställa att det är vitiligo. Professorn Karin Schallreuter och ett team av amerikanska och tyska forskare upptäckte att det bildas ämnen i den vita huden som avger fluorescens när de belyses med lampan. Dessa ämnen tillhör familjen bioteriner och det är också dessa som ger vissa fjärilar dess fluorescerande färg (3).
The discovery of vitiligo's ability to fluoresce was published in the prestigious journal Science in 1994 (3).
A: Vitiligo på ögonlocken i visuellt ljus. B: Samma ögonlock under Woods lampa ger ett vitt fluorescerande ljus. (4).
Det finns inga enhetliga nationella riktlinjer för behandling av vitiligo idag. Oftast erbjuds ingen ytterligare medicinsk behandling utan fokus ligger på patientinformation om sjukdomsförloppet.
However, some dermatologists prescribe cortisone or tacrolimus, a substance developed for the treatment of atopic eczema, which you are advised to apply to the affected areas. After 6 months, there is an evaluation. A few patients see some effect due to the immunomodulatory effect. A UVB light treatment is recommended in some regions with variable efficacy
Professor Karin Schallreuter har studerat vitiligo de senaste 25 åren och har varit arbetande hudläkare och specialist vid Mayo Clinic, Minnesota. Hon är en av grundarna av Center for Skin Science vid University of Bradford samt grundare av institutet för Pigmentary Disorders i Greifswald, Tyskland. Hon har skrivit mer än 170 vetenskapliga artiklar inom experimentell och klinisk dermatologi och har behandlat mer än 6000 patienter med vitiligo. I den här intervjun berättar hon mer om behandlingen hon har utvecklat.
Om professor Schallreuter's behandling som har bidragit till att minska hans vitiligo.
I have had vitiligo since childhood. I visited many dermatologists and tried everything from cortisone, tacrolimus and UVB treatment to transplanting healthy pigmented skin cells to the affected areas. Nothing worked and the vitiligo actually got worse from all the treatments.
I studied pharmacy in Uppsala and graduated in 2002. During my years at university, I came into contact with the German dermatologist and skin researcher Karin Schallreuter, who was a professor at the University of Bradford and an expert on vitiligo (see video clip). This contact gave me the opportunity to carry out PhD studies in clinical and experimental dermatology with Schallreuter's team.
Based on the discovery of the "butterfly bioterins" in the vitiligo patches, Karin Schallreuter and her team developed a treatment to reduce oxidative stress in the skin. When the treatment was used, the melanocytes faded and started producing pigment again. Today I use NB-UVB activated pseudocatalase PC-KUS with very good effect, my face and legs have got 90% repigmentation. However, hands and feet are still difficult to treat.
This treatment was developed by Professor Schallreuter in 1995 and has since helped thousands of patients at three different locations: the Medical Clinic-The Dead Sea, the Institute for Pigmentation Disorders of V. Greifswald, Germany and at the University of Bradford, England. In 2006 I defended my thesis on vitiligo and obtained a PhD in experimental dermatology. Today I feel happy about my vitiligo and enjoy the white patches, although several of them have now completely disappeared. If I didn't have them, I probably wouldn't have the motivation I have, nor would I have experienced everything I have or met all the amazing people and researchers I have met over the years.
Om du är intresserad, läs gärna de vetenskapliga publikationerna om behandlingen här.
/Johanna Gillbro
