Skip to main content

Vitiligo

A Manifestation of Apoptosis?

Abstract

Vitiligo is a common cutaneous disorder that has significant biological and social consequences for those affected. It is characterized by a loss of melanocytes from the epidermis, which results in the absence of melanin, i.e. depigmentation. There are numerous hypotheses about the etiology of vitiligo, but no data to definitively prove one theory over another. It is likely that there are numerous causes for the loss of these melanocytes.

One way to approach the identification of the etiology is to determine the mechanism by which the melanocytes are destroyed. The two known mechanisms for the destruction of cells are necrosis and apoptosis. One purpose of this paper is to review the extant data that might suggest which of the two mechanisms is operative against melanocytes in patients with vitiligo. The histological data, and some laboratory data, support apoptosis, rather than necrosis, as the mechanism for removal of melanocytes. Apoptosis can be induced by a variety of factors, including immune cytokines, some environmental chemicals (for example substituted hydroquinones such as monobenzone) or other molecular mechanisms. Current therapies, such as corticosteroids and ultraviolet light, do affect apoptosis in a variety of ways.

Confirmation of apoptosis as a mechanism, and identification of how apoptosis is initiated to produce vitiligo, can serve as a basis for devising medications that might stop the progression of the disorder. The problem of vitiligo would be essentially solved if there was a medication that is well tolerated in children, adults and pregnant women, and that would halt the progression of the depigmentation. The study of apoptosis, mechanisms of its induction, and the ways to block apoptosis, is one possible way to find both the causes of depigmentation and medications to prevent its progression.

This is a preview of subscription content, access via your institution.

References

  1. Nordlund J., Ortonne J. Mechanisms that cause abnormal skin color. In: Nordlund J., Boissy R., King R., et al., editors. The pigmentary system: physiology and pathophysiology. Oxford: Oxford University Press, 1998: 489–502

    Google Scholar 

  2. Boissy R., Nordlund J. Albinism. Dermatology in eMedicine [online]. James W., Elston D., editors. eMedicine Corporation, St. Petersburg. Available from URL: http://www.emedicine.com/derm/index/shtml [Accessed 2002 May 02]

  3. Boissy R.E., Nordlund J.J. Molecular basis of congenital hypopigmentary disorders in humans: a review. Pigment Cell Res 1997; 10 (1-2): 12–24

    PubMed  CAS  Article  Google Scholar 

  4. Spritz R.A. Piebaldism, Waardenburg syndrome and related genetic disorders of melanocyte development: clinical aspects. In: Nordlund J.J., Boissy R., Hearing V., et al., editors. The pigmentary system: physiology and pathophysiology. New York: Oxford University Press, 1998: 997

    Google Scholar 

  5. Nordlund J., Ortonne J. Disorders of hypopigmentation and depigmentation. In: Nordlund J., Boissy R., King R., et al., editors. Pigmentary system: physiology and pathophysiology. Oxford: Oxford University Press, 1998: 503–707

    Google Scholar 

  6. Sheth P. The differential diagnosis of vitiligo vulgaris. In: Hann S.K., Nordlund J., editors. Vitiligo: monograph on the basic and clinical science. Oxford: Blackwell Science Ltd, 2000: 101–122

    Google Scholar 

  7. Tobin D., Swanson N., Pittelkow M.R., et al. Melanocytes are not absent in lesional skin of long duration vitiligo. J Pathol 2000; 191: 407–416

    PubMed  CAS  Article  Google Scholar 

  8. Birbeck M.S., Breathnach A.S., Everall J.D. An electron microscope study of basal melanocytes and high-level clears cells (Langerhans cells) in vitiligo. J Invest Dermatol 1961; 37: 51–64

    Google Scholar 

  9. Koh H.K., Sober A.J., Nakagawa H., et al. Malignant melanoma and vitiligo-like leukoderma: an electron microscopic study. J Am Acad Dermatol 1983; 9 (5): 696–708

    PubMed  CAS  Article  Google Scholar 

  10. Le Poole I.C., van den Wijngaard R.M., Westerhof W., et al. Presence or absence of melanocytes in vitiligo lesions: an immunohistochemical investigation. J Invest Dermatol 1993; 100 (6): 816–822

    PubMed  Article  Google Scholar 

  11. Dippel E., Haas N., Grabbe J., et al. Expression of the c-kit receptor in hypomelanosis: a comparative study between piebaldism, naevus depigmentosus and vitiligo. Br J Dermatol 1995; 132 (2): 182–189

    PubMed  CAS  Article  Google Scholar 

  12. Ito K. Ultrastructural observations of dendritic cells in the repigmented area of vitiligo: electron microscopic studies on dopa oxidase in melanocytes which are present between the epidermal basal cells in the repigmented area of vitiligo. Jap J Dermatol 1975; 85 (6): 333–349

    CAS  Google Scholar 

  13. Bleehen S.S. The treatment of vitiligo with topical corticosteroids: light and electronmicroscopic studies. Br J Dermatol 1976; 94 Suppl. 12: 43–50

    PubMed  Article  Google Scholar 

  14. Morohashi M., Hashimoto K., Goodman Jr T.F., et al. Ultrastructural studies of vitiligo, Vogt-Koyanagi syndrome, and incontinentia pigmenti achromians. Arch Dermatol 1977; 13 (6): 755–766

    Article  Google Scholar 

  15. Moellmann G., Klein-Angerer S., Scollay D.A., et al. Extracellular granular material and degeneration of keratinocytes in the normally pigmented epidermis of patients with vitiligo. J Invest Dermatol 1982; 79 (5): 321–330

    PubMed  CAS  Article  Google Scholar 

  16. Boissy R.E., Beato K.E., Nordlund J.J., et al. Dilated rough endoplasmic reticulum and premature death in melanocytes cultured from the vitiligo mouse. Am J Pathol 1991; 138 (6): 1511–1525

    PubMed  CAS  Google Scholar 

  17. Boissy R.E., Liu Y.Y., Medrano E.E., et al. Structural aberration of the rough endoplasmic reticulum and melanosome compartmentalization in long-term cultures of melanocytes from vitiligo patients. J Invest Dermatol 1991; 97 (3): 395–404

    PubMed  CAS  Article  Google Scholar 

  18. Boissy R. Histology of vitiliginous skin. In: Hann S.K., Nordlund J., editors. Vitiligo: monograph on the basic and clinical science. Oxford: Blackwell Science Ltd, 2000: 23–34

    Google Scholar 

  19. Medrano E.E., Nordlund J.J. Successful culture of adult human melanocytes obtained from normal and vitiligo donors. J Invest Dermatol 1990; 95 (4): 441–445

    PubMed  CAS  Google Scholar 

  20. Cui J., Shen L.Y., Wang G.C., et al. Role of hair follicles in the repigmentation of vitiligo. J Invest Dermatol 1991; 97 (3): 410–416

    PubMed  CAS  Article  Google Scholar 

  21. Cui J. The melanocyte reservoir and its necessity. In: Hann S.K., Nordlund J., editors. Vitiligo: monograph on the basic and clinical science. Oxford: Blackwell Science Ltd, 2000: 163–165

    Google Scholar 

  22. Ortonne J.P., MacDonald D.M., Micoud A., et al. PUVA-induced repigmentation of vitiligo: a histochemical (split-DOPA) and ultrastructural study. Br J Dermatol 1979; 101 (1): 1–12

    PubMed  CAS  Article  Google Scholar 

  23. Ortonne J.P., Schmitt D., Thivolet J., et al. PUVA-induced repigmentation of vitiligo: scanning electron microscopy of hair follicles. J Invest Dermatol 1980; 74 (1): 40–42

    PubMed  CAS  Article  Google Scholar 

  24. Galadari E., Mehregan A.H., Hashimoto K., et al. Ultrastructural study of vitiligo. Int J Dermatol 1993; 32 (4): 269–271

    PubMed  CAS  Google Scholar 

  25. Arrunategui A., Arroyo C., Garcia L., et al. Melanocyte reservoir in vitiligo. Int J Dermatol 1994; 33 (7): 484–487

    PubMed  CAS  Article  Google Scholar 

  26. Nordlund J.J., Ortonne J.P. Vitiligo vulgaris. In: Nordlund J., Boissy R., King R., et al., editors. The pigmentary system: physiology and pathophysiology. Oxford: Oxford University Press, 1998: 513–553

    Google Scholar 

  27. Halder R., Nordlund J. Surgical treatment of pigmentary disorders. In: Nordlund J., Boissy R., King R., et al., editors. The pigmentary system: physiology and pathophysiology. Oxford: Oxford University Press, 1998: 987–994

    Google Scholar 

  28. Falabella R. Surgical therapies for vitiligo. In: Hann S.K., Nordlund J., editors. Vitiligo: monograph on the basic and clinical science. Oxford: Blackwell Science Ltd, 2000: 193–202

    Google Scholar 

  29. Malmusi M., Ackerman A. A critical review of apoptosis in historical perspective. Am J Dermatopathol 2000; 22: 291–293

    PubMed  Article  Google Scholar 

  30. Mishima Y., Kawasaki H., Pinkus H., et al. Dendritic cell dynamics in progressive depigmentations: distinctive cytokinetics of -dendritic cells revealed by electron microscopy. Arch Dermatol Forsch 1972; 243 (2): 67–87

    PubMed  CAS  Google Scholar 

  31. Abdel-Naser M.B., Kruger-Krasagakes S., Krasagakis K., et al. Further evidence for involvement of both cell mediated and humoral immunity in generalized vitiligo. Pigment Cell Res 1994; 7 (1): 1–8

    PubMed  CAS  Article  Google Scholar 

  32. Blois M. Phagocytosis of melanin particles by human epidermal cells in vitro. J Invest Dermatol 1968; 50: 336–337

    PubMed  CAS  Google Scholar 

  33. Wolff K., Konrad K. Melanin pigmentation: an in vivo model for studies of melanosome kinetics within keratinocytes. Science 1971; 174: 1034–1035

    PubMed  CAS  Article  Google Scholar 

  34. Ortonne J.P., Bose S.K. Vitiligo: where do we stand? Pigment Cell Res 1993; 6 (2): 61–72

    PubMed  CAS  Article  Google Scholar 

  35. Cummings M., Nordlund J.J. Chemical leukoderma: fact or fancy. Am J Contact Derm 1995; 6: 122–127

    Article  Google Scholar 

  36. Gellin G.A., Possick P.A., Perone V.B., et al. Depigmentation from 4-tertiary butyl catechol: an experimental study. J Invest Dermatol 1970; 55: 190–197

    PubMed  CAS  Article  Google Scholar 

  37. Lerner A.B. On the etiology of vitiligo and gray hair. Am J Med 1971; 51 (2): 141–147

    PubMed  CAS  Article  Google Scholar 

  38. Oliver E.A., Schwartz L. Occupational leukoderma. Arch Dermatol Syph 1940; 42: 993–1014

    Article  Google Scholar 

  39. Malten K.E., Seutter E. Occupational vitiligo due to paratertiary butylphenol and homologues. Trans St Johns Hosp Dermatol Soc 1971; 57 (1): 115–134

    PubMed  CAS  Google Scholar 

  40. Calnan C.D. Occupational leukoderma from alkyl phenols. Proc R Soc Med 1973; 66 (3): 258–260

    PubMed  CAS  Google Scholar 

  41. Bentley-Phillips R. Occupational leucoderma following misuse of a disinfectant. South Afr Med J 1974; 48 (19): 810

    CAS  Google Scholar 

  42. Goldmann P.J., Thiess A.M. Occupational vitiligo caused by para-tertiary-butylphenol, a trial of vitiligo, hepatosis and struma. Hautarzt 1976; 27 (4): 155–159

    PubMed  CAS  Google Scholar 

  43. Rodermund O.E. Occupational vitiligo caused by paratertiary butylphenol [letter]. Arch Dermatol 1976; 112 (4): 554–555

    PubMed  CAS  Article  Google Scholar 

  44. James O., Mayes R.W., Stevenson C.J., et al. Occupational vitiligo induced by p-tertbutylphenol, a systemic disease? Lancet 1977; II (8050): 1217–1219

    Article  Google Scholar 

  45. Ebner H., Helletzgruber M., Hofer R., et al. Vitiligo from p-tert butylphenol; a contribution to the problem of the internal manifestations of this occupational disease [in German]. Derm Beruf Umwelt 1979; 27 (4): 99–104

    PubMed  CAS  Google Scholar 

  46. Gellin G.A., Maibach H.I., Misiaszek M.H., et al. Detection of environmental depigmenting substances. Contact Dermatitis 1979; 5 (4): 201–213

    PubMed  CAS  Article  Google Scholar 

  47. Arievich A.M., Selisskii G.D. Occupational vitiligo. Vestn Dermatol Venerol 1980; (5): 46–49

    PubMed  Google Scholar 

  48. Frenk E., Loi-Zedda P. Occupational depigmentation due to a hydroquinone-containing photographic developer. Contact Dermatitis 1980; 6 (3): 238–239

    PubMed  CAS  Article  Google Scholar 

  49. Swarbrick P. Vitiligo as an occupational disease. Occup Health (Lond) 1980; 32 (9): 442–448

    CAS  Google Scholar 

  50. O’Sullivan J.J., Stevenson C.J. Screening for occupational vitiligo in workers exposed to hydroquinone monomethyl ether and to paratertiary-amyl-phenol. Br J Ind Med 1981; 38 (4): 381–383

    PubMed  Google Scholar 

  51. Romaguera C., Grimalt F. Occupational leukoderma and contact dermatitis from paratertiary-butylphenol. Contact Dermatitis 1981; 7 (3): 159–160

    PubMed  CAS  Article  Google Scholar 

  52. Stevenson C.J. Occupational vitiligo: clinical and epidemiological aspects. Br J Dermatol 1981; 105 Suppl. 21: 51–56

    PubMed  CAS  Article  Google Scholar 

  53. Goette D.K. Raccoon-like periorbital leukoderma from contact with swim goggles. Contact Dermatitis 1984; 10 (3): 129–131

    PubMed  CAS  Article  Google Scholar 

  54. Das M., Tandon A. Occupational vitiligo. Contact Dermatitis 1988; 19: 184–185

    Article  Google Scholar 

  55. O’Malley M.A., Mathias C.G., Priddy M., et al. Occupational vitiligo due to unsuspected presence of phenolic antioxidant byproducts in commercial bulk rubber. J Occup Med 1988; 30 (6): 512–516

    PubMed  Article  Google Scholar 

  56. Gawkrodger D.J., Cork M.J., Bleehan S.S., et al. Occupational vitiligo and contact sensitivity to para-tertiary butyl catechol. Contact Dermatitis 1991; 25 (3): 200–201

    PubMed  CAS  Article  Google Scholar 

  57. Tosti A., Gaddoni G., Piracinni B.M., et al. Occupational leukoderma due to phenolic compounds in the ceramics industry? Contact Dermatitis 1991; 25 (1): 67–68

    PubMed  CAS  Article  Google Scholar 

  58. Jimbow K., Obata H., Pathak M.A., et al. Mechanism of depigmentation by hydroquinone. J Invest Dermatol 1974; 62 (4): 436–449

    PubMed  CAS  Article  Google Scholar 

  59. Mans D., Lafleur M., Westmijze E.J., et al. Reactions of glutathione with the catechol, the ortho-quinone and semi-quinone free radical of etoposide: consequences for DNA inactivation. Biochem Pharmacol 1992; 43: 1761–1768

    PubMed  CAS  Article  Google Scholar 

  60. Halliwell B., Chirico S. Lipid peroxidation: its mechanism, measurement, and significance. Am J Clin Nutr 1993; 57 Suppl. 5: 715S–724S

    PubMed  CAS  Google Scholar 

  61. Nakagawa Y., Tayama S., Moore G., et al. Cytotoxic effects of biphenyl and hydroxybiphenyls on isolated rat hepatocytes. Biochem Pharmacol 1993; 45: 1959–1965

    PubMed  CAS  Article  Google Scholar 

  62. Yang F., Abdel Malek Z., Boissy R.E., et al. Effects of commonly used mitogens on the cytotoxicity of 4-tertiary-butylphenol to human melanocytes. In Vitro Cell Dev Biol Anim 1999; 35: 566–570

    PubMed  CAS  Article  Google Scholar 

  63. Yang F., Sarangarajan R., Le Poole I.C., et al. The cytotoxicity and apoptosis induced by 4-tertiary butylphenol in human melanocytes are independent of tyrosinase activity. J Invest Dermatol 2000; 114: 157–164

    PubMed  CAS  Article  Google Scholar 

  64. Yang F., Bossy R. Effects of 4-tertiary butylphenol on the tyrosinase activity in human melanocytes. Pigment Cell Res 1999; 12: 237–245

    PubMed  CAS  Article  Google Scholar 

  65. Ros J., Rodrigues-Lopex J., Varon R., et al. Kinetic study of the oxidation of 4-tertbutyl phenol by tyrosinase. Eur J Biochem 1994; 222: 449–452

    PubMed  CAS  Article  Google Scholar 

  66. Jimenez M., Garcia-Carmona G. Hydrogen peroxide-dependent 4 t-butylphenol hydroxylation by tyrosinase: a new catalytic activity. Biochim Biophys Acta 1996; 1287: 33–39

    Article  Google Scholar 

  67. Thorneby-Andersson K., Sterner O., Hansson C.L. Tyrosinase-mediated formation of a reactive quinone from the depigmenting agents, 4-tert butylphenol and 4 tert butylcatechol. Pigment Cell Res 2000; 13: 33–38

    PubMed  CAS  Article  Google Scholar 

  68. Orrechia G. Alternative therapies for vitiligo. In: Hann S.K., Nordlund J., editors. Vitiligo: monograph on the basic and clinical science. Oxford: Blackwell Science Ltd, 2000: 222–242

    Google Scholar 

  69. Schallreuter K., Moore J. Pseudocatalase in the treatment of vitiligo. In: Hann S.K., Nordlund J., editors. Vitiligo: monograph on the basic and clinical science. Oxford: Blackwell Science Ltd, 2000: 182–192

    Google Scholar 

  70. Okamoto H., Mizuno K., Itoh T., et al. Evaluation of apoptotic cells induced by ultraviolet light B radiation in epidermal sheets stained by the TUNEL technique. J Invest Dermatol 1999; 113: 802–807

    PubMed  CAS  Article  Google Scholar 

  71. Van Den Wijngaard R., Aten J., Scheepmaker A., et al. Expression and modulation of apoptosis regulatory molecules in human melanocytes: significance in vitiligo. Br J Dermatol 2000; 143: 573–581

    PubMed  Article  Google Scholar 

  72. Parrish J.A., Fitzpatrick T.B., Shea C., et al. Photochemotherapy of vitiligo: use of orally administered psoralens and a high-intensity long-wave ultraviolet light system. Arch Dermatol 1976; 112 (11): 1531–1534

    PubMed  CAS  Article  Google Scholar 

  73. Theodoridis A., Tsambaos D., Sivenas C. Oral trimethylpsoralen in the treatment of vitiligo. Acta Dermatol Venereol 1976; 56 (3): 253–256

    CAS  Google Scholar 

  74. Gupta A.K., Anderson T.F. Psoralen photochemotherapy. J Am Acad Dermatol 1987; 17 (5 Pt 1): 703–734

    PubMed  CAS  Article  Google Scholar 

  75. Tham S.N., Gange R.W., Parrish J.A. Ultraviolet-B treatment of psoriasis in patients with concomitant vitiligo [letter]. Arch Dermatol 1987; 123 (1): 26–27

    PubMed  CAS  Article  Google Scholar 

  76. Ortel B., Tanew A., Honigsmann H. Treatment of vitiligo with khellin and ultraviolet A. J Am Acad Dermatol 1988; 18 (4 Pt 1): 693–701

    PubMed  CAS  Article  Google Scholar 

  77. Honigsmann H. Phototherapy and photochemotherapy. Sem Dermatol 1990; 9 (1): 84–90

    CAS  Google Scholar 

  78. Antoniou C., Katsambas A. Guidelines for the treatment of vitiligo. Drugs 1992; 43 (4): 490–498

    PubMed  CAS  Article  Google Scholar 

  79. Karppinen L., Lassus A. Treatment of vitiligo with 5-methoxypsoralen and selective ultraviolet phototherapy (SUP). Nouv Dermatol 1992; 11: 709–714

    Google Scholar 

  80. Skouge J.W., Morison W.L., Diwan R.V., et al. Autografting and PUVA: a combination therapy for vitiligo. J Dermatol Surg Oncol 1992; 18 (5): 357–360

    PubMed  CAS  Google Scholar 

  81. Imamura S., Tagami H. Treatment of vitiligo with oral corticosteroids. Dermatologica 1976; 153 (3): 179–185

    PubMed  CAS  Article  Google Scholar 

  82. Kumari J. Vitiligo treated with topical clobetasol propionate. Arch Dermatol 1984; 120 (5): 631–635

    PubMed  CAS  Article  Google Scholar 

  83. Goldstein E., Haberman H.F., Menon I.A., et al. Non-psoralen treatment of vitiligo; part I: cosmetics, systemic coloring agents, and corticosteroids. Int J Dermatol 1992; 31 (4): 229–236

    PubMed  CAS  Article  Google Scholar 

  84. Pasricha J.S., Khaitan B.K. Oral mini-pulse therapy with betamethasone in vitiligo patients having extensive or fast-spreading disease. Int J Dermatol 1993; 32 (10): 753–757

    PubMed  CAS  Article  Google Scholar 

  85. Leffell D. The scientific basis of skin cancer. J Am Acad Dermatol 2000; 42 (1 Pt 2): 18–22

    PubMed  CAS  Article  Google Scholar 

  86. McKay B., Chen F., Perumalswami C.R., et al. The tumor suppressor p53 can both stimulate and inhibit ultraviolet light-induced apoptosis. Mol Biol Cell 2000; 11: 2543–2551

    PubMed  CAS  Google Scholar 

  87. Zhai S., Yaar M., Doyle S.M., et al. Nerve growth factor rescues pigment cells from ultraviolet-induced apoptosis by upregulating BCL-2 levels. Exp Cell Res 1996; 224: 335–343

    PubMed  CAS  Article  Google Scholar 

  88. Petit-Frere C., Capulas E., Lyon D.A., et al. Apoptosis and cytokine release induced by ionizing or ultraviolet B radiation in primary and immortalized human keratinocytes. Carcinogenesis 2000; 21: 1087–1095

    PubMed  CAS  Article  Google Scholar 

  89. Hofs T. Humoral and cellular autoimmunity in genuine vitiligo studied by means of an antigen produced from melanoma cells. Folia Haematol Int Mag Klin Morphol Blutforsch 1982; 109 (2): 244–250

    PubMed  CAS  Google Scholar 

  90. Naughton G.K., Eisinger M., Bystryn J.C. Detection of antibodies to melanocytes in vitiligo by specific immunoprecipitation. J Invest Dermatol 1983; 81 (6): 540–542

    PubMed  CAS  Article  Google Scholar 

  91. Betterle C., Mirakian R., Doniach D., et al. Antibodies to melanocytes in vitiligo [letter]. Lancet 1984; I (8369): 159

    Article  Google Scholar 

  92. Naughton G.K., Lipkin G., Bystryn J.C. Expression of vitiligo antigen on a revertant line of hamster melanoma cells. J Invest Dermatol 1984; 83 (5): 317–319

    PubMed  CAS  Article  Google Scholar 

  93. Bystryn J.C., Naughton G.K. The significance of vitiligo antibodies. J Dermatol 1985; 12 (1): 1–9

    PubMed  CAS  Article  Google Scholar 

  94. Morgan M, Castells A., Ramirez A. Autoantibodies in vitiligo: clinical significance [in Spanish]. Med Cutan Ibero Lat Am 1986; 14 (2): 139–142

    PubMed  CAS  Google Scholar 

  95. Naughton G.K., Mahaffey M., Bystryn J.C. Antibodies to surface antigens of pigmented cells in animals with vitiligo. Proc Soc Exp Biol Med 1986; 181 (3): 423–426

    PubMed  CAS  Google Scholar 

  96. Naughton G.K., Reggiardo D., Bystryn J.C. Correlation between vitiligo antibodies and extent of depigmentation in vitiligo. J Am Acad Dermatol 1986; 15 (5 Pt 1): 978–981

    PubMed  CAS  Article  Google Scholar 

  97. Bystryn J.C., Pfeffer S. Vitiligo and antibodies to melanocytes. Prog Clin Biol Res 1988; 256: 195–206

    PubMed  CAS  Google Scholar 

  98. Norris D.A., Kissinger R.M., Naughton G.M., et al. Evidence for immunologic mechanisms in human vitiligo: patients sera induce damage to human melanocytes in vitro by complement-mediated damage and antibody-dependent cellular cytotoxicity. J Invest Dermatol 1988; 90 (6): 783–789

    PubMed  CAS  Article  Google Scholar 

  99. Bystryn J.C. Serum antibodies in vitiligo patients. Clin Dermatol 1989; 7 (2): 136–145

    PubMed  CAS  Article  Google Scholar 

  100. Cui J., Harning R., Henn M., et al. Identification of pigment cell antigens defined by vitiligo antibodies. J Invest Dermatol 1992; 98 (2): 162–165

    PubMed  CAS  Article  Google Scholar 

  101. Cui J., Arita Y., Bystryn J.C. Cytolytic antibodies to melanocytes in vitiligo. J Invest Dermatol 1993; 100 (6): 812–815

    PubMed  CAS  Article  Google Scholar 

  102. Fishman P., Azizi E., Schoenfeld Y., et al. Vitiligo autoantibodies are effective against melanoma. Cancer 1993; 72 (8): 2365–2369

    PubMed  CAS  Article  Google Scholar 

  103. Merimsky O., Shoenfeld Y., Chaitchik S., et al. Antigens and antibodies in malignant melanoma. Tumour Biol 1994; 15 (4): 188–202

    PubMed  CAS  Article  Google Scholar 

  104. Song Y.H., Connor E., Li Y., et al. The role of tyrosinase in autoimmune vitiligo. Lancet 1994; 344 (8929): 1049–1052

    PubMed  CAS  Article  Google Scholar 

  105. Cui J., Arita Y., Bystryn J.C. Characterization of vitiligo antigens. Pigment Cell Res 1995; 8 (1): 53–59

    PubMed  CAS  Article  Google Scholar 

  106. Cui J., Bystryn J.C. Melanoma and vitiligo are associated with antibody responses to similar antigens on pigment cells. Arch Dermatol 1995; 131 (3): 314–318

    PubMed  CAS  Article  Google Scholar 

  107. Cui J., Chen D., Misfeldt M.L., et al. Antimelanoma antibodies in swine with spontaneously regressing melanoma. Pigment Cell Res 1995; 8 (1): 60–63

    PubMed  CAS  Article  Google Scholar 

  108. Gilhar A., Zelickson B., Ulman Y., et al. In vivo destruction of melanocytes by the IgG fraction of serum from patients with vitiligo. J Invest Dermatol 1995; 105 (5): 683–686

    PubMed  CAS  Article  Google Scholar 

  109. Hara I., Takechi Y., Houghton A.N. Implicating a role for immune recognition of self in tumor rejection: passive immunization against the brown locus protein. J Exp Med 1995; 182 (5): 1609–1614

    PubMed  CAS  Article  Google Scholar 

  110. Kemp E.H., Gawkrodger D.J., Watson P.F., et al. Immunoprecipitation of melanogenic enzyme autoantigens with vitiligo sera: evidence for cross-reactive autoantibodies to tyrosinase and tyrosinase-related protein-2 (TRP-2). Clin Exp Immunol 1997; 109 (3): 495–500

    PubMed  CAS  Article  Google Scholar 

  111. Duvic M., Rapini R., Hoots W.K., et al. Human immunodeficiency virus-associated vitiligo: expression of autoimmunity with immunodeficiency? J Am Acad Dermatol 1987; 17 (4): 656–662

    PubMed  CAS  Article  Google Scholar 

  112. Spickett G., Prentice A.G., Wallington T., et al. Alopecia totalis and vitiligo in common variable immunodeficiency. Postgrad Med J 1991; 67 (785): 291–294

    PubMed  CAS  Article  Google Scholar 

  113. Tojo N., Yoshimura N., Yoshizawa M. Vitiligo and chronic photosensitivity in human immunodeficiency virus infection. Jpn J Med 1991; 30 (3): 255–259

    PubMed  CAS  Article  Google Scholar 

  114. Tanus T., Levinson A.I., Atkins P.C. Polyautoimmune syndrome in common variable immunodeficiency. J Int Med 1993; 234 (5): 525–527

    CAS  Article  Google Scholar 

  115. Garcia-Patos Briones V., Rodriguez Cano L., Capdevila Morell J.A. Vitiligo associated with the acquired immunodeficiency syndrome [letter]. Med Clin 1994; 103 (9): 358

    Google Scholar 

  116. Cho M., Cohen P.R., Duvic M. Vitiligo and alopecia areata in patients with human immunodeficiency virus infection. South Med J 1995; 88 (4): 489–491

    PubMed  CAS  Article  Google Scholar 

Download references

Acknowledgments

The authors declare no conflicts of interest and no funding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James J. Nordlund.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Huang, C.L., Nordlund, J.J. & Boissy, R. Vitiligo. Am J Clin Dermatol 3, 301–308 (2002). https://doi.org/10.2165/00128071-200203050-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00128071-200203050-00001

Keywords

  • Nerve Growth Factor
  • Vitiligo
  • White Skin
  • DTBP
  • Oculocutaneous Albinism