Vitiligo

Vitiligo is a refractory skin disease, usually local or generalized depigmentation, can occur in various parts of the body, such as eyes, ears pigment cells may also be involved; therefore Vitiligo is a skin pigment-based violations, but also to violations of other systemic diseases pigment cells. The main performance, local skin milky white spots, the affected area of ​​the hair may be normal, but also white; but generally superficial, if the white area is larger in the summer after exposure, occasionally burning sensation. Vitiligo induced by many factors, such as mental predisposing factors, genetics, trauma, chemical exposure frequent cause endocrine disorders, autoimmune factors, and environmental factors. Our incidence rate is about 0.05 to 0.2%, with the acceleration and air pollution aggravation rhythm of life, the incidence of vitiligo increased year by year.
Vitiligo disease etiology
     (A) causes
The disease causes clearly outstanding. Recent studies have considered the following factors:
       1. genetics
 Studies suggest that Vitiligo may be an autosomal dominant genetic skin disease. Study abroad statistics 30% of patients had a positive family history, found in two monozygotic twins are sick. China reported a positive family history of 3% to 12%, lower than the foreign reports.

2. The autoimmune theory
  Pathogenesis of autoimmune theory of vitiligo and more attention. Many scholars have noted that patients and their family members in a higher combined ratio of autoimmune disease, a common thyroiditis, hyperthyroidism or hypothyroidism, diabetes, chronic adrenal hypofunction, pernicious anemia, rheumatoid arthritis, malignant melanoma . The serum of patients with vitiligo, it was detected in a variety of organ-specific antibodies such as anti-thyroid antibodies, anti-parietal cell antibodies, anti-adrenal antibodies, anti-parathyroid antibody, anti-smooth muscle antibodies, and significantly higher detection rate. Also suffering from autoimmune diseases, the incidence of vitiligo than the general population of 10 to 15 times. Recently discovered vitiligo patients with anti-melanocyte surface antigens, known as vitiligo antibody titers and the degree of skin pigmentation depigmentation patients about the titer increased with the expansion of the lesion area, also found that animals suffer from vitiligo have similar phenomenon, the disease is an autoimmune disease melanocytes. Behl (1977) found that during the white edge of monocyte aggregates penetrated the dermal-epidermal junction, by the destruction of the basement membrane into the epidermis, so where melanocytes and melanosomes absent, that the disease may be delayed hypersensitivity autoimmune diseases. In addition, oral or topical corticosteroids, especially the effect is not by skin lesions better distribution section, the immune mechanism of the disease is also indirect evidence.
3. Spirit and neurochemical theory
  Many therapists find that psychological factors associated with the pathogenesis of vitiligo, it is estimated that about two-thirds of patients with trauma or lesions in the onset stage of development, excessive stress, depression or depressed. Stress can cause increased catecholamines, such as adrenaline can directly affect the decolorization; stress can also increase the secretion of ACTH, leading to increased secretion of corticosteroids, and the mobilization of free fatty acids and sugar, stimulate insulin secretion. Insulin indirectly stimulate the brain L- tryptophan increased the brain serotonin synthesis, and serotonin metabolite of melatonin, pheomelanin overactive receptor plays an important role in the pathogenesis of vitiligo. Melatonin receptor hyperactivity increase theophylline activity of these enzymes to inhibit melanin biochemistry, but later they make Mesozoic activation, resulting in toxic metabolic intermediates melanin accumulation in the melanocyte cells, melanocytes death eventually lead vitiligo. Some scholars have observed that white spot at the degeneration of nerve endings, and the degree of change seems related with the course, this phenomenon is also supported neurochemical theory.
4. melanocytes self-destruction (self-destruction of melanocytes) theory
 The basic vitiligo lesions epidermal melanocytes partial or complete loss of function. Lerner1971年提出这一学说. Vitiligo is considered because of epidermal melanocytes hyperactivity, loss and promote the early recession, and may be due to the accumulation of toxic cells themselves synthesize melanin precursor substances due. Experiments show that certain chemical substances on melanocyte selective destructive effect, skin bleaching, these substances are mostly substituted phenolic chemical bleaching agents such as hydroquinone monomethyl ether, hydroquinone, Syria Ding phenol, hydrogen peroxide, etc. , both on the skin and hair have decolorization. In recent years, the increased incidence of vitiligo may be related to the development of industry, opportunities for contact these chemicals increases related.
5. micronutrient deficiencies doctrine
 It was suggested that the body copper content is reduced and the pathogenesis of vitiligo, but it seems that there was no significant difference in the determination of serum and hair copper content of the general population, the relevant trace element theory for further study.
6. Other factors
Trauma, including trauma, surgery, scratching can be induced vitiligo. Certain endocrine diseases such as hyperthyroidism, diabetes may be associated with vitiligo. Sun exposure prone vitiligo.
Etiology of vitiligo more, and there is a certain basis, but have a certain one-sidedness. Its incidence is currently considered a genetic factor, but also in a variety of internal, under the effect of external factors, immune function, neural and endocrine and metabolic disorders, and many other functions, resulting in inhibition of enzyme systems, or destroy melanocytes or melanin formation obstacles that may cause skin depigmentation.
When the spirit too nervous adrenaline increased consumption, the main synthetic dopa epinephrine, thus reducing the synthesis of melanin.
Reduce blood and skin of copper or ceruloplasmin levels in patients with vitiligo, resulting in reduced activity of tyrosinase, thus affecting the metabolism of melanin.
In addition to certain chemicals and drugs can also induce light sensitivity of the disease.
Chinese medicine treatment of vitiligo
(1) law should Shufeng blood, and blood. Side with white split pill Decoction: Angelica 10g, Millettia 15g, wind 10g, Tribulus terrestris 30g, psoralen 10g, red peony 10g, safflower 10g, tangerine peel 10g, Health Qi 15g, Chuan Xiong 10g, 15g black hull , Polygonum vine 15g. Also take Tribulus terrestris son, born pound for the end of each 6g, boiled water, 2 times a day. White split or taking pills, vitiligo pill.
(2) Compound Coke sexual gallic acid tincture :( Tar gallic acid 5.0 ichthyol 10.0, 84.0% alcohol glycerol 1.0,75) or 10,000 / 20,000 mustard ointment.
(3) Tusi grass: fresh Tusi grass, frequency paint the affected area several times a day, or with 25% alcohol Waicha after coating according to ultraviolet rays. Or 15% with traditional Chinese medicine Angelica tincture, Waicha.
(4) Chinese medicine litharge powder 6g, sulfur 6g, realgar 6g, orpiment 1.5g, Baiji 9g, musk 0.9g, cinnabar 6g, white tuber 15g, borneol 0.9g. Total research fine flour, with a balsamic tone paint.