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MagazineDecember 2010 (Vol. 21 Issue 9)Vitiligo

Vitiligo is a puzzling, often progressive, condition that causes de-pigmentation (whiten-ing) of the skin in patches

Vitiligo is a puzzling, often progressive, condition that causes de-pigmentation (whiten-ing) of the skin in patches. It arises when melanocytes, the cells responsible for the pigments that give colour to the skin, die or are unable to function normally. An estimated 100 million people are affected worldwide.

Although, medically speaking, vitiligo is usually not harmful and causes no physical pain, its emotional and psychological effects can be devastating. In fact, 16 to 35 per cent of sufferers experience significant psychiatric problems, such as chronic depression, sleep disturbances, suicidal thoughts and anxiety. Vitiligo can also lead to difficulties in forming relation-ships and avoidance of certain social situations (BMC Dermatol, 2008; 8: 2; doi: 10.1186/1471-5945-8-2).

Precisely what causes vitiligo is still a mystery, but the leading theory is that it's an autoimmune disease in which the immune system targets the body's own pigment cells and tissues (Autoimmun Rev, 2010; 9: 516-20). Gaining in popularity, however, is the idea that vitiligo is caused by the body's reduced ability to fight free radicals such as hydrogen peroxide, which can accumulate in the skin and damage melanocytes. Our cells are normally able to defend themselves against free-radical damage through the actions of antioxidant enzymes, such as super-oxide dismutase (SOD), glutathione peroxidase and catalase. But several studies have shown that this defence system is impaired in vitiligo sufferers, leading to a state of 'oxidative stress' (Indian J Dermatol Venereol Leprol, 2009; 75: 268-71). Oxidative stress is now thought to play an important role in vitiligo development.

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