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June 20, 2023

Vitiligo

The chronic skin condition that affects people’s social lives

Dr. Lana du Plessis

Vitiligo is a chronic skin condition caused by the death of melanocytes leading to patches of discolored skin. In a patient with vitiligo, the immune system attacks melanocytes (the cells that produce melanin or skin pigment) and destroys them. As a result, vitiligo patients regularly show recurrent flare-ups, and the affected areas progressively enlarge. Vitiligo affects all races across the globe and sometimes leads to social aversion as in some communities. The disease becomes stigmatised in many communities. The condition can have a severe impact on self-esteem and self-image.  In addition, the affected areas may be prone to painful sunburns, as they have lost the protection offered by melanin. Vitiligo is neither contagious or deadly. The two main culprits believed to underly the cause of the disease; namely, autoimmunity and oxidative stress.

There are no current approved medical treatments that offer a permanent solution to vitiligo. If surgical solutions are chosen, often skin grafts leave scars and do not provide assurance of an even skin tone. In this respect, mesenchymal stem cells are considered an ideal type of cell for the treatment of vitiligo owing to their low immunogenicity, lower rates of transplant rejection, and ability to secrete numerous growth factors, exosomes, and cytokines in vivo. Therefore, a potential treatment for vitiligo is using mesenchymal stromal cells (MSCs) to help restore melanocytes in the affected areas by turning off an existing immune response against involved areas in the skin. Various MSCs from bone marrow, fat, amniotic fluid, and umbilical cord blood, have been studied. In the USA there are currently 3 ongoing trials studying the effect of MSC treatment in vitiligo. It has been shown that MSCs can not only regulate immunity but induce anti-inflammatory effects, treatment with MSCs can both prevent a patient’s immune system from attacking melanocytes, halt the progression of the condition and allow regeneration of the patient’s damaged skin (1, 2).

Why is World Vitiligo Day on June 25th?

The inaugural World Vitiligo Day was first celebrated in 2011 in Lagos, Nigeria. Micheal Jackson was one of the most well-known celebrities who suffered from this condition. He passed away on June 25, 2009, thus World Vitiligo Day is observed on June 25 in his honor.

This extraordinary day commemorates the lives and community of individuals living with vitiligo while casting light on the challenges they face.

Facts about Vitiligo:

  • Vitiligo is not a “cosmetic” problem but an autoimmune disorder.
  • Vitiligo affects the immune system and thereby affects the skin, ensuing in white patches on the skin.
  • 70 million people across the world have vitiligo.
  • There are no boundaries of race, ethnicity or gender.

References

  1. Zhu L, et al. Mesenchymal stem cells promote human melanocytes proliferation and resistance to apoptosis through PTEN pathway in vitiligo. Stem Cell Res Ther. 2020 Jan 15;11(1):26. doi: 10.1186/s13287-019-1543-z.
  2. Zhou MN, et al.Dermal mesenchymal stem cells (DMSCs) inhibit skin-homing CD8+ T cell activity, a determining factor of vitiligo patients’ autologous melanocytes transplantation efficiency. PLoS One. 2013;8(4):e60254. doi: 10.1371/journal.pone.0060254. Epub 2013 Apr 5.

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