Vitiligo is not just an aesthetic problem, but a real disease (which weighs on the psyche) – time.news

2023-06-24 15:14:53

by Vera Martinella

Although it is considered by many to be an aesthetic problem, there are psychological repercussions, especially when it is very extensive or affects visible areas. It is partly hereditary and linked to other autoimmune diseases

More or less 330,000 Italians have to live with spotted skin, i.e. with lighter patches that are often very evident because they particularly affect the most visible areas: face (especially around the eyes and mouth), elbows, hands, feet and knees. They suffer from vitiligo, a disease which fortunately is not lethal or painful, but which can have important consequences on a psychological level, as demonstrated by the data of a recent study presented on the occasion of World Vitiligo Day, celebrated internationally on June 25th. In summer, then, the problem worsens because while healthy skin tans naturally, the white areas become even more evident and are exposed to a very high risk of burns.

Anxiety and depression

At the basis of this disease there is an intrinsic defect of the epidermis cells responsible for the production of melanin (melanocytes), which gives color to the skin, hair and hair and has the important function of protecting the skin from ultraviolet solar rays – he explains Giuseppe Argenziano, president of the Italian Society of Dermatology SIDeMaST -. Often unknown or considered a simple skin imperfection, vitiligo is a chronic autoimmune disease that manifests itself with white spots on the body that can create a lot of discomfort for patients, especially in the most visible or most intimate areas. So much so that many suffer from anxiety and depression. In fact, from a survey recently conducted by the consulting firm Kearney for the awareness campaign promoted by the biopharmaceutical company Incyte (with the sponsorship of SIDeMaST and the Italian Association of Dermatologists, Venereologists and Hospitals, Adoi) with the intention of increasing awareness on this pathology, anxiety is 72% more common in those suffering from vitiligo than in the rest of the population and symptoms related to depression are 32% more frequent. And the psychological impact is particularly felt in women and adolescents.

Causes and diagnosis

The disease can occur at any age, but appears more frequently between the ages of 20 and 40, and 40% of patients have other cases of vitiligo or other autoimmune diseases in the family. The association with other autoimmune pathologies, in particular hypothyroidism, is quite frequent – says Francesco Cusano, president of Adoi -, but rheumatoid arthritis and lupus also have a higher incidence. The causes are not yet entirely clear, but to arrive at a certain diagnosis, a visit to a specialist is needed, who will use a special ultraviolet lamp (Wood’s light), which allows you to highlight lesions that are not visible with normal light and to distinguish them from other dermatological conditions with which they could be confused (for example mycosis, eczema, etc.). The course is difficult to predict: generally, after a rapid appearance of the lesions, an arrest of the progression is observed.

Therapy

The goal of the therapy is precisely to stop the advance of the spots and then try to re-pigment them. Current treatments are based, on the one hand, on the use of topical (i.e. to be applied to the skin) or systemic cortisone, in relation to the state of activity and the spread of the lesions to block their spread; on the other, on the use of topical immuno-modulators and above all of phototherapy with narrow band UVB rays to try to induce re-pigmentation. Until today, vitiligo has been without effective treatments, it cannot be cured for now – concludes Ugo Viora, National Association of Friends for the Skin -. Lately targeted therapies are about to become available which seem to offer new hope for patients: they are based on drugs which, by acting in a specific way on the processes which cause the onset of vitiligo, allow a re-pigmentation of the skin. Encouraging results have been obtained with the so-called JAK-inhibitors, drugs already successfully used orally in atopic dermatitis. A cream formulation has been developed for vitiligo which has recently been approved by the American Medicines Agency (Fda) and by the European one (Ema): the molecule has anti-inflammatory properties, but other trials are underway both with various drugs of the same category, administered by mouth, or with biological molecules.

June 24, 2023 (change June 24, 2023 | 3:14 pm)

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