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Vitiligo: Truth, Hope and Change  (full-length)
Vitiligo: Truth, Hope and Change (full-length)
Published: 2016/03/03
Channel: Vitiligo Video Channel
Vitiligo: Cause and Solution
Vitiligo: Cause and Solution
Published: 2016/07/30
Channel: Dr. John Bergman
My VITILIGO STORY
My VITILIGO STORY
Published: 2017/06/28
Channel: 10kJB
What Is Vitiligo?
What Is Vitiligo?
Published: 2014/12/05
Channel: OnisionSpeaks
I Have Vitiligo | MannyMua
I Have Vitiligo | MannyMua
Published: 2016/11/13
Channel: Manny Mua
My Vitiligo Story
My Vitiligo Story
Published: 2015/09/11
Channel: Mark & Brian
Opening Up About My Vitiligo... | Tess Florio
Opening Up About My Vitiligo... | Tess Florio
Published: 2016/11/08
Channel: Tess Florio
Michael Jackson talks about Vitiligo with Oprah
Michael Jackson talks about Vitiligo with Oprah
Published: 2009/10/12
Channel: Lan Nguyen
Girl with vitiligo talks about Michael Jackson
Girl with vitiligo talks about Michael Jackson
Published: 2012/01/29
Channel: LunaJo67
Dermablend Professional: Cheri
Dermablend Professional: Cheri's Camo Confession
Published: 2014/03/07
Channel: Dermablend Professional
Vitiligo Queen Is Comfortable In Her Own Skin
Vitiligo Queen Is Comfortable In Her Own Skin
Published: 2016/08/11
Channel: Barcroft TV
8-Year-Old Boy Embarrassed Of Vitiligo Meets Dog With Same Skin Condition
8-Year-Old Boy Embarrassed Of Vitiligo Meets Dog With Same Skin Condition
Published: 2017/03/21
Channel: Inside Edition
Dean Edwards Reveals His Vitiligo to Lorraine | Lorraine
Dean Edwards Reveals His Vitiligo to Lorraine | Lorraine
Published: 2017/07/04
Channel: Lorraine
Astro fala pela primeira vez sobre o vitiligo
Astro fala pela primeira vez sobre o vitiligo
Published: 2009/07/28
Channel: vejapontocom
Top 10  Celebrities with Vitiligo  In The World 2017
Top 10 Celebrities with Vitiligo In The World 2017
Published: 2016/11/27
Channel: Vitiligo Treatment
One Student Won
One Student Won't Be Bullied For Vitiligo | Dispelling Beauty Myths | Allure
Published: 2017/01/04
Channel: Allure
Vitiligo Treatment At Home - Cure Vitiligo Naturally & Permanently Within 8 weeks
Vitiligo Treatment At Home - Cure Vitiligo Naturally & Permanently Within 8 weeks
Published: 2017/01/14
Channel: Dimagrisci In 3 Settimane
Dr. Max Gomez: Vitiligo Treatment
Dr. Max Gomez: Vitiligo Treatment
Published: 2015/12/10
Channel: CBS New York
vitiligo antes y despues 2016
vitiligo antes y despues 2016
Published: 2016/11/03
Channel: Diego Arias
How a Model with Vitiligo Ignored Bullies and Became an Inspiration to All
How a Model with Vitiligo Ignored Bullies and Became an Inspiration to All
Published: 2015/09/04
Channel: Inside Edition
सफेद दाग के  घरेलु उपाय │Vitiligo/Leucoderma Treatment │Sfed Daag Ka Desi Ilaj in Hindi │ Life Care
सफेद दाग के घरेलु उपाय │Vitiligo/Leucoderma Treatment │Sfed Daag Ka Desi Ilaj in Hindi │ Life Care
Published: 2016/09/23
Channel: Life Care
How to cure vitiligo l Foods to Eat l That Contains Quick Melanin My Skin
How to cure vitiligo l Foods to Eat l That Contains Quick Melanin My Skin
Published: 2016/08/11
Channel: Vitiligo Treatment
Vitiligo: A Skin Condition not a Life Changer
Vitiligo: A Skin Condition not a Life Changer
Published: 2011/07/08
Channel: thosegirlsarewild
Vitiligo: Understanding its Causes and Treatments
Vitiligo: Understanding its Causes and Treatments
Published: 2015/12/03
Channel: Consumer Health Digest
3 Fáciles Remedios Para El Vitiligo Tratamiento Natural - Vitiligo La Cura Permanente En 2 Meses
3 Fáciles Remedios Para El Vitiligo Tratamiento Natural - Vitiligo La Cura Permanente En 2 Meses
Published: 2015/06/18
Channel: David Paltrow - Investigador Médico
Bullied For Her Vitiligo, This Inspirational Young Woman Turned Her Condition Into Art
Bullied For Her Vitiligo, This Inspirational Young Woman Turned Her Condition Into Art
Published: 2017/03/21
Channel: nollygrio
Vitiligo treatments- what works!
Vitiligo treatments- what works!
Published: 2017/06/17
Channel: Lasers and Lifts by Dr Davin Lim
Vitiligo 2017
Vitiligo 2017
Published: 2017/07/15
Channel: Imdat Dalga
Por que tenho manchas no rosto? | Meu Vitiligo
Por que tenho manchas no rosto? | Meu Vitiligo
Published: 2017/03/29
Channel: pandangelica
Understanding Vitiligo - Causes & Theories, April 2011
Understanding Vitiligo - Causes & Theories, April 2011
Published: 2011/04/19
Channel: photoprotection
Beautiful People With Vitiligo
Beautiful People With Vitiligo
Published: 2016/05/22
Channel: Terry Swoope
Vitiligo Cream - Best Vitiligo Treatment That Works 100%
Vitiligo Cream - Best Vitiligo Treatment That Works 100%
Published: 2016/12/22
Channel: Vitiligo Treatment
Vitiligo Girl | Diana, el Vitiligo y la inspiración vuelve poco a poco | Diana Díaz
Vitiligo Girl | Diana, el Vitiligo y la inspiración vuelve poco a poco | Diana Díaz
Published: 2017/04/11
Channel: Diana Diaz
Vivre avec le vitiligo au quotidien, la vie de Nadia Bouchikhi - Mille et une vies
Vivre avec le vitiligo au quotidien, la vie de Nadia Bouchikhi - Mille et une vies
Published: 2016/12/02
Channel: Mille et une vies - Officiel
leucoderma vitiligo treatment by homeopathic medicine?? explain!
leucoderma vitiligo treatment by homeopathic medicine?? explain!
Published: 2017/04/29
Channel: Drkirti vikram singh
Vitiligo: A day in Lee Thomas
Vitiligo: A day in Lee Thomas' shoes
Published: 2013/02/26
Channel: LunaJo67
Vitiligo – causas, diagnóstico e tratamento
Vitiligo – causas, diagnóstico e tratamento
Published: 2015/12/02
Channel: Sua Saúde na Rede - SPDM
Vitiligo: ¿Como detener el vitiligo? ¿Se cura? DR. TV - Entrevista al Dr. Aparcana
Vitiligo: ¿Como detener el vitiligo? ¿Se cura? DR. TV - Entrevista al Dr. Aparcana
Published: 2015/08/05
Channel: Dermaperu.com
Vitiligo Hunk: Aspiring Model Embraces His Skin Condition
Vitiligo Hunk: Aspiring Model Embraces His Skin Condition
Published: 2016/03/03
Channel: Barcroft TV
VITILIGO TRANSFORMATION | CRAZY BEAUTY
VITILIGO TRANSFORMATION | CRAZY BEAUTY
Published: 2016/12/30
Channel: Crazy Beauty
Vitiligo e a doença afetiva sazonal podem ser tratados com a Vitamina D
Vitiligo e a doença afetiva sazonal podem ser tratados com a Vitamina D
Published: 2016/08/10
Channel: Kits Completos com Extra Saude Zap 11 94822-0979
Vitiligo Hastalığına Karşı Kür - TRT DİYANET
Vitiligo Hastalığına Karşı Kür - TRT DİYANET
Published: 2015/05/27
Channel: DiyanetTV
O vitiligo e Eu. No stress e muito suco!
O vitiligo e Eu. No stress e muito suco!
Published: 2015/08/23
Channel: Carla Schulz
Pesquisadores de Goiás desenvolvem nova medicação para o vitiligo - Jornal Futura - Canal Futura
Pesquisadores de Goiás desenvolvem nova medicação para o vitiligo - Jornal Futura - Canal Futura
Published: 2015/06/17
Channel: Canal Futura
Vitiligo - Chá, Tratamento para a Pele e Alimentação Adequada.
Vitiligo - Chá, Tratamento para a Pele e Alimentação Adequada.
Published: 2016/12/18
Channel: Marilene Sarah Fialho
Santa Receita | Vitiligo: saiba mais sobre a doença! - 21 de Agosto de 2014
Santa Receita | Vitiligo: saiba mais sobre a doença! - 21 de Agosto de 2014
Published: 2014/08/21
Channel: TV Aparecida
Talkshow Dunia Sehat "Mengenal Penyakit Vitiligo" | Melisa Gandasari | DAAI TV
Talkshow Dunia Sehat "Mengenal Penyakit Vitiligo" | Melisa Gandasari | DAAI TV
Published: 2016/05/18
Channel: Dunia Sehat
Dog With Vitiligo Becomes Face Of Kids Charity
Dog With Vitiligo Becomes Face Of Kids Charity
Published: 2016/07/25
Channel: Caters TV
Essa Mulher Descobriu Acidentalmente a Receita que CURA DO VITILIGO e Calou Todos
Essa Mulher Descobriu Acidentalmente a Receita que CURA DO VITILIGO e Calou Todos
Published: 2017/04/29
Channel: Dieta Detox Fácil
EU E O MEU VITILIGO
EU E O MEU VITILIGO
Published: 2017/02/09
Channel: Pedro Reclama
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WIKIPEDIA ARTICLE

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Vitiligo
Vitiligo2.JPG
Non-segmental vitiligo of the hand.
Pronunciation
Specialty Dermatology
Symptoms Patches of white skin[1]
Duration Long term[1]
Causes Unknown[1]
Risk factors Family history, other autoimmune diseases[2]
Diagnostic method Tissue biopsy[2]
Treatment Sunscreen and makeup[1]
Frequency 1% of people[3]

Vitiligo is a long term skin condition characterized by patches of the skin losing their pigment.[1] The patches of skin affected become white and usually have sharp margins. The hair from the skin may also become white.[1] Inside the mouth and nose may also be involved.[2] Typically both sides of the body are affected.[1] Often the patches begin on areas of skin that are exposed to the sun. It is more noticeable in people with dark skin.[2] Vitiligo may result in psychological stress and those affected may be stigmatized.[1]

The cause is typically unknown.[1] It is believed to be due to genetic susceptibility that is triggered by an environmental factor such that an autoimmune disease occurs.[1][2] This results in the destruction of skin pigment cells. Risk factors include a family history of the condition or other autoimmune diseases, such as hyperthyroidism, alopecia areata, and pernicious anemia.[2] It is not contagious.[4] Vitiligo is classified into two main types: segmental and non-segmental. Most cases are non-segmental, meaning they affect both sides; and these cases typically get worse with time. About 10% of cases are segmental, meaning they mostly involve one side of the body; and these cases do not typically worsen with time.[1] Diagnosis can be confirmed by tissue biopsy.[2]

There is no known cure for vitiligo. For those with light skin, sunscreen and makeup are all that is typically recommended.[1] Other treatment options may include steroid creams or phototherapy to darken the light patches. Alternatively, efforts to lighten the unaffected skin, such as with hydroquinone, may be tried. A number of surgical options are available for those who do not improve with other measures.[2] A combination of treatments generally has better outcomes.[3] Counselling to provide emotional support may be useful.[1]

Globally about 1% of people are affected by vitiligo.[3] Some populations have rates as high as 2–3%.[5] Males and females are equally affected. About half show the disorder before age 20 and most develop it before age 40. Vitiligo has been described since ancient history.[1]

Signs and symptoms[edit]

Vitiligo on lighter skin
Vitiligo on darker skin

The only sign of vitiligo is the presence of pale patchy areas of depigmented skin which tend to occur on the extremities.[6][7] The patches are initially small, but often grow and change shape.[6][8] When skin lesions occur, they are most prominent on the face, hands and wrists.[6][7] The loss of skin pigmentation is particularly noticeable around body orifices, such as the mouth, eyes, nostrils, genitalia and umbilicus.[6][7] Some lesions have increased skin pigment around the edges.[9] Those affected by vitiligo who are stigmatized for their condition may experience depression and similar mood disorders.[10]

Causes[edit]

Although multiple hypotheses have been suggested as potential triggers that cause vitiligo, studies strongly imply that changes in the immune system are responsible for the condition.[1][11] Vitiligo has been proposed to be a multifactorial disease with genetic susceptibility and environmental factors both thought to play a role.[1]

The TYR gene encodes the protein tyrosinase, which is not a component of the immune system, but is an enzyme of the melanocyte that catalyzes melanin biosynthesis, and a major autoantigen in generalized vitiligo.[1] The NIH states that sunburns can cause the disease but there is not good evidence to support this.[12]

Preliminary evidence suggests a possible association with eating gluten.[13]

Immune[edit]

Variations in genes that are part of the immune system or part of melanocytes have both been associated with vitiligo.[1] It is also thought to be caused by the immune system attacking and destroying the melanocytes of the skin.[14] A genomewide association study found approximately 36 independent susceptibility loci for generalized vitiligo.[15]

Autoimmune associations[edit]

Vitiligo is sometimes associated with autoimmune and inflammatory diseases such as Hashimoto's thyroiditis, scleroderma, rheumatoid arthritis, type 1 diabetes mellitus, psoriasis, Addison's disease, pernicious anemia, alopecia areata, systemic lupus erythematosus, and celiac disease.[1][16]

Among the inflammatory products of NALP1 are caspase 1 and caspase 7, which activate the inflammatory cytokine interleukin-1β. Interleukin-1β and interleukin-18 are expressed at high levels in patients with vitiligo.[17] In one of the mutations, the amino acid leucine in the NALP1 protein was replaced by histidine (Leu155->His). The original protein and sequence is highly conserved in evolution, and is found in humans, chimpanzee, rhesus monkey, and the bush baby. Addison's disease (typically an autoimmune destruction of the adrenal glands) may also be seen in individuals with vitiligo.[18][19]

Diagnosis[edit]

UV photograph of a hand with vitiligo
UV photograph of a foot with vitiligo

An ultraviolet light can be used in the early phase of this disease for identification and to determine the effectiveness of treatment. Skin with vitiligo, when exposed to a blacklight, will glow blue. In contrast, healthy skin will have no reaction.

Classification[edit]

Classification attempts to quantify vitiligo have been analyzed as being somewhat inconsistent,[20] while recent consensus have agreed to a system of segmental vitiligo (SV) and non-segmental vitiligo (NSV). NSV is the most common type of vitiligo.[1]

Non-segmental[edit]

Eyelid vitiligo

In non-segmental vitiligo (NSV), there is usually some form of symmetry in the location of the patches of depigmentation. New patches also appear over time and can be generalized over large portions of the body or localized to a particular area. Extreme cases of vitiligo, to the extent that little pigmented skin remains, are referred to as vitiligo universalis. NSV can come about at any age (unlike segmental vitiligo, which is far more prevalent in teenage years).[9]

Classes of non-segmental vitiligo include the following:

  • Generalized Vitiligo: the most common pattern, wide and randomly distributed areas of depigmentation[21]
  • Universal Vitiligo: depigmentation encompasses most of the body[21]
  • Focal Vitiligo: one or a few scattered macules in one area, most common in children[21]
  • Acrofacial Vitiligo: fingers and periorificial areas[21]
  • Mucosal Vitiligo: depigmentation of only the mucous membranes[21]

Segmental[edit]

Segmental vitiligo (SV) differs in appearance, cause, and frequency of associated illnesses. Its treatment is different from that of NSV. It tends to affect areas of skin that are associated with dorsal roots from the spinal cord and is most often unilateral.[1][22] It is much more stable/static in course and its association with autoimmune diseases appears to be weaker than that of generalized vitiligo.[22] SV does not improve with topical therapies or UV light, however surgical treatments such as cellular grafting can be effective.[9]

Differential diagnosis[edit]

Chemical leukoderma is a similar condition due to multiple exposures to chemicals.[23] Vitiligo however is a risk factor.[23] Triggers may include inflammatory skin conditions, burns, intralesional steroid injections and abrasions.[24]

Other conditions with similar symptoms include the following:

Treatment[edit]

There is no cure for vitiligo but several treatment options are available.[1] The best evidence is for applied steroids and the combination of ultraviolet light in combination with creams.[25] Due to the higher risks of skin cancer, the United Kingdom's National Health Service suggests phototherapy only be used if primary treatments are ineffective.[26] Lesions located on the hands, feet, and joints are the most difficult to repigment; those on the face are easiest to return to the natural skin color as the skin is thinner in nature. [1]

Immune mediators[edit]

Topical preparations of immune suppressing medications including glucocorticoids (such as 0.05% clobetasol or 0.10% betamethasone) and calcineurin inhibitors (such as tacrolimus or pimecrolimus) are considered to be first-line vitiligo treatments.[1]

Phototherapy[edit]

Phototherapy is considered a second-line treatment for vitiligo.[1] Exposing the skin to light from UVB lamps is the most common treatment for vitiligo. The treatments can be done at home with an UVB lamp or in a clinic. The exposure time is managed so that the skin does not suffer overexposure. Treatment can take a few weeks if the spots are on the neck and face and if they existed not more than 3 years. If the spots are on the hands and legs and have been there more than 3 years, it can take a few months. Phototherapy sessions are done 2–3 times a week. Spots on a large area of the body may require full body treatment in a clinic or hospital. UVB broadband and narrowband lamps can be used,[27][28] but narrowband ultraviolet picked around 311 nm is the choice. It has been constitutively reported that combination of UVB phototherapy with other topical treatments improves re-pigmentation. However, some vitiligo patients may not see any changes to skin or re-pigmentation occurring. A serious potential side effect involves the risk of developing skin cancer, the same risk as an over-exposure to natural sunlight.

Ultraviolet light (UVA) treatments are normally carried out in a hospital clinic. Psoralen and ultraviolet A light (PUVA) treatment involves taking a drug that increases the skin's sensitivity to ultraviolet light, then exposing the skin to high doses of UVA light. Treatment is required twice a week for 6–12 months or longer. Because of the high doses of UVA and psoralen, PUVA may cause side effects such as sunburn-type reactions or skin freckling.[26]

Narrowband ultraviolet B (NBUVB) phototherapy lacks the side-effects caused by psoralens and is as effective as PUVA.[1] As with PUVA, treatment is carried out twice weekly in a clinic or every day at home, and there is no need to use psoralen.[26]

Skin camouflage[edit]

In mild cases, vitiligo patches can be hidden with makeup or other cosmetic camouflage solutions. If the affected person is pale-skinned, the patches can be made less visible by avoiding tanning of unaffected skin.[21]

De-pigmenting[edit]

In cases of extensive vitiligo the option to de-pigment the unaffected skin with topical drugs like monobenzone, mequinol, or hydroquinone may be considered to render the skin an even colour. The removal of all the skin pigment with monobenzone is permanent and vigorous. Sun-safety must be adhered to for life to avoid severe sun burn and melanomas. Depigmentation takes about a year to complete.[26]

History[edit]

Descriptions of a disease believed to be vitiligo date back to a passage in the medical text Ebers Papyrus circa 1500 BC in ancient Egypt. Mentions of whitening of the skin was also present circa 1400 BC in sacred Indian texts such as Atharvaveda as well as Shinto prayers in East Asia circa 1200 BC. The Hebrew word "Zora'at" from the Old Testament book of Leviticus[29] dating to 1280 BCE[30] (or 1312 BCE[31]) described a group of skin disease associated with white spots, and a subsequent translation to Greek led to continued conflation of those with vitiligo with leprosy and spiritual uncleanliness.[29] Medical sources in the ancient world such as Hippocrates often did not differentiate between vitiligo and leprosy, often grouping these diseases together. In Arabic literature, the word "alabras" has been associated with vitiligo, with this word found in the Quran. The name "vitiligo" was first used by the Roman physician Aulus Cornelius Celsus in his classic medical text De Medicina.[29]

Etymology[edit]

The etymology of the term "vitiligo" is believed to be derived from "vitium", meaning "defect" or "blemish".[29]

Notable cases[edit]

Research[edit]

Afamelanotide is in phase II and III clinical trials for vitiligo and other skin diseases.[40]

A medication for rheumatoid arthritis, tofacitinib, has been tested for the treatment of vitiligo.[41]

In October 1992, a scientific report was published of successfully transplanting melanocytes to vitiligo affected areas, effectively re- pigmenting the region.[42] The procedure involved taking a thin layer of pigmented skin from the patient's gluteal region. Melanocytes were then separated out to a cellular suspension that was expanded in culture. The area to be treated was then denuded with a dermabrader and the melanocytes graft applied. Between 70 and 85 percent of patients experienced nearly complete repigmentation of their skin. The longevity of the repigmentation differed from person to person.[43] By now, several transplantation techniques have been developed, including transplantation of melanocyte precursors derived from hair follicles. Transplantation procedures are frequently used to treat segmental vitiligo which is poorly responsive to other types of treatment. In non-segmental vitiligo, success is achieved when treating patches that are not expanding (so called stable vitiligo).

Society and culture[edit]

The change in appearance caused by vitiligo can affect a person's emotional and psychological well-being and may create difficulty in getting or keeping a job. People with this disorder can experience emotional stress, particularly if vitiligo develops on visible areas of the body, such as the face, hands, arms, feet, or on the genitals. Participating in a vitiligo support group may improve social coping skills and emotional fortitude.

See also[edit]

References[edit]

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z Ezzedine, K; Eleftheriadou, V; Whitton, M; van Geel, N (4 July 2015). "Vitiligo.". Lancet. 386 (9988): 74–84. PMID 25596811. doi:10.1016/s0140-6736(14)60763-7. 
  2. ^ a b c d e f g h "Questions and Answers about Vitiligo". NIAMS. June 2014. Retrieved 11 August 2016. 
  3. ^ a b c Whitton, M; Pinart, M; Batchelor, JM; et al. (May 2016). "Evidence-based management of vitiligo: summary of a Cochrane systematic review.". The British journal of dermatology. 174 (5): 962–9. PMID 26686510. doi:10.1111/bjd.14356. 
  4. ^ Chopra, Parul; Niyogi, Rageshree; Katyal, Gauri (2009). Skin and Hair Care: Your Questions Answered. Byword Books Private Limited. p. 2. ISBN 9788181930378. 
  5. ^ Krüger C, Schallreuter KU (October 2012). "A review of the worldwide prevalence of vitiligo in children/adolescents and adults". Int J Dermatol. 51 (10): 1206–12. PMID 22458952. doi:10.1111/j.1365-4632.2011.05377.x. 
  6. ^ a b c d National Institute of Arthritis and Musculoskeletal and Skin Diseases (March 2007). "What Is Vitiligo? Fast Facts: An Easy-to-Read Series of Publications for the Public Additional". Retrieved 2010-07-18. 
  7. ^ a b c Halder RM, et al. (2007). "72. Vitiligo". In Wolff K, Freedberg IM, Fitzpatrick TB. Fitzpatrick's dermatology in general medicine (7th ed.). New York: McGraw-Hill Professional. ISBN 978-0-07-146690-5. OCLC 154751587. 
  8. ^ Halder, RM; Chappell, JL (2009). "Vitiligo update". Seminars in cutaneous medicine and surgery. 28 (2): 86–92. PMID 19608058. doi:10.1016/j.sder.2009.04.008. 
  9. ^ a b c Huggins RH, Schwartz RA, Janniger CK (2005). "Vitiligo" (PDF). Acta Dermatovenerologica Alpina, Pannonica et Adriatica. 14 (4): 137–42, 144–5. PMID 16435042. 
  10. ^ Picardi A, Pasquini P, Cattaruzza MS, et al. (2003). "Stressful life events, social support, attachment security and alexithymia in vitiligo. A case-control study". Psychotherapy and Psychosomatics. 72 (3): 150–8. PMID 12707482. doi:10.1159/000069731. 
  11. ^ Ongenae, Katia; Van Geel, Nanny; Naeyaert, Jean-Marie (Apr 2003). "Evidence for an Autoimmune Pathogenesis of Vitiligo". Pigment Cell Research. 16 (2): 90–100. doi:10.1034/j.1600-0749.2003.00023.x. 
  12. ^ "Questions and Answers about Vitiligo". June 2014. Retrieved 4 October 2015. 
  13. ^ Grimes PE, Nashawati R (2017). "The Role of Diet and Supplements in Vitiligo Management.". Dermatol Clin (Review). 35 (2): 235–243. PMID 28317532. doi:10.1016/j.det.2016.11.012. 
  14. ^ Staff, Mayo Clinic (May 15, 2014). "Vitiligo Causes". Mayoclinic. Retrieved April 22, 2015. 
  15. ^ Spritz, Richard A. (May 2013). "Modern vitiligo genetics sheds new light on an ancient disease". The Journal of Dermatology. 40 (5): 310–318. doi:10.1111/1346-8138.12147. 
  16. ^ Van Driessche F, Silverberg N (2015). "Current Management of Pediatric Vitiligo". Paediatr Drugs (Review). 17 (4): 303–13. PMID 26022363. doi:10.1007/s40272-015-0135-3. 
  17. ^ Lamkanfi M, Vande Walle L, Kanneganti TD (2011). "Deregulated inflammasome signaling in disease.". Immunol Rev (Review). 243 (1): 163–73. PMC 3170132Freely accessible. PMID 21884175. doi:10.1111/j.1600-065X.2011.01042.x. 
  18. ^ Gregersen PK (2007). "Modern genetics, ancient defenses, and potential therapies". The New England Journal of Medicine. 356 (12): 1263–6. PMID 17377166. doi:10.1056/NEJMe078017. 
  19. ^ Jin Y, Mailloux CM, Gowan K, et al. (2007). "NALP1 in vitiligo-associated multiple autoimmune disease". The New England Journal of Medicine. 356 (12): 1216–25. PMID 17377159. doi:10.1056/NEJMoa061592. 
  20. ^ Picardo, Mauro; Taïeb, Alain, eds. (2009). "Introduction". Vitiligo. Berlin: Springer. ISBN 978-3-540-69360-4. 
  21. ^ a b c d e f g h i j Halder, R. M.; et al. (2007). "Vitiligo". In Wolff, K.; et al. Fitzpatrick's Dermatology in General Medicine (7th ed.). New York: McGraw-Hill Professional. ISBN 978-0-07-146690-5. 
  22. ^ a b van Geel N, Mollet I, Brochez L, et al. (February 2012). "New insights in segmental vitiligo: case report and review of theories". British Journal of Dermatology. 166 (2): 240–6. PMID 21936857. doi:10.1111/j.1365-2133.2011.10650.x. 
  23. ^ a b "Disturbances of Pigmentation". [978-0-323-31967-6 Andrews' diseases of the skin : clinical dermatology] Check |url= value (help). 2016. pp. Ebook. ISBN 9780323319676. 
  24. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. p. 864. ISBN 0-7216-2921-0. 
  25. ^ Whitton, ME; Ashcroft, DM; González, U (Oct 2008). "Therapeutic interventions for vitiligo.". Journal of the American Academy of Dermatology. 59 (4): 713–7. PMID 18793940. doi:10.1016/j.jaad.2008.06.023. 
  26. ^ a b c d Anon. "Vitiligo -Treatment". Patient UK. NHS. Retrieved 2013-06-03. 
  27. ^ Scherschun, L; Kim, JJ; Lim, HW (2001). "Narrow-band ultraviolet B is a useful and well-tolerated treatment for vitiligo". Journal of the American Academy of Dermatology. 44 (6): 999–1003. PMID 11369913. doi:10.1067/mjd.2001.114752. 
  28. ^ Don, Philip; Iuga, Aurel; Dacko, Anne; Hardick, Kathleen (2006). "Treatment of vitiligo with broadband ultraviolet B and vitamins". International Journal of Dermatology. 45 (1): 63–5. PMID 16426381. doi:10.1111/j.1365-4632.2005.02447.x. 
  29. ^ a b c d Gauthier, Yvon; Benzekri, Laila (2009). "Historical Aspects". In Picardo, Mauro; Taïeb, Alain. Vitiligo (Online-Ausg. ed.). Berlin: Springer. ISBN 978-3-540-69360-4. 
  30. ^ Kurzweil, Arthur (2008). The Torah For Dummies (PDF). For Dummies. p. 11. ISBN 978-0-470-28306-6. Retrieved 2010-08-19. 
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