Human skin color vary. Different races have different skin color. The same race in different shades of skin color is not the same individual, even the same individual, different parts of the skin there are differences.
---- These differences is Those factors determine it? Hospital ---- Vitiligo Vitiligo Vitiligo skin color under normal conditions is mainly determined by two factors:
----( 1) skin pigment contents:
---- 4 biological skin pigment melanin is brown, red, oxygenated hemoglobin, deoxygenated hemoglobin blue and yellow carotene. carotene can not be synthesized by the body's own needs from the diet, said exogenous pigment, and the remaining 3 synthesized by the body itself, said endogenous pigment.
---- were from outside to inside the skin epidermis, dermis and subcutaneous tissue (subcutaneous fat layer). the 4 kinds of biological pigments in different parts of the skin, melanin distributed in the epidermal keratinocytes, the carotenoids found in the stratum corneum and the subcutaneous fat layer, hemoglobin is distributed in the dermis. (Figure 1-1)
- - of which melanin is the main determinant of skin color. melanocytes mainly depends on the amount of melanocyte tyrosinase activity in the strength, the stronger the activity of tyrosinase, the amount to the synthesis of melanin more.
----( 2) differences in skin anatomy:
---- mainly refers to the terms of the thickness of the skin. light in the scattering of the skin of varying thickness, the skin color change. skin blood vessels as the number, the amount of blood flow, and whether there telangiectasia also affect skin color.
Vitiligo Vitiligo Vitiligo Hospital
2. What is the formation of melanin and metabolism? It is what features?
---- the surface of the skin by the two types of cells. One is the keratinocytes and keratinocytes, in its evolution to the skin cells can generally be divided into four : basal layer, spinous cells layer, granular layer and stratum corneum (in the palm of your hand and paw, the stratum corneum and the granular layer there between the transparent layer); the other is the dendritic cell.
---- Black melanocytes is a dendritic cell. It embedded in the epidermal basal cells, with an average of every 10 cells in a basal melanocytes, it is a highly differentiated cell, the cytoplasm has a special organelles called melanosomes. melanocyte melanin is synthesized in the body.
---- melanin is a polymer of biological pigments. The formation process is as follows: in the melanocytes in vivo, the tyrosine enzyme in the tyrosine and the formation of dopa, dopa quinone dehydrogenase to form dopa, and re-arranged in 5,6 - quinone indole, aggregated melanosomes in vivo with the combination of the structural proteins that form the black melanin protein Su.
---- melanocytes to the epidermis layers of cells distribution is to determine the skin color of the main factors. melanocytes more undoubtedly to prevent ultraviolet damage to skin the main barrier. melanin can protect the important folic acid and similar material from the decomposition of light. In addition, melanin is a stable free radical, may participate in a number of redox reactions in the body.
3. The formation of melanin which factors affected?
--- - In the process of melanin formation plays a crucial role of tyrosinase, which is a copper-bearing aerobic activity, who can affect the activity of tyrosinase factors affect the formation of melanin. which is more clearly and important factors are the following:
---- (1) genetic factors: The most important factor.
---- (2) endocrine factors: multiple endocrine factors can affect the black pigment formation.
---- (3) Neural factors: nerve impulses on the formation of melanin also have some impact. Some animals (such as certain fish, frogs, lizards, etc.) has confirmed that rapid changes in skin color and nerve control of the.
---- (4) mercapto factors: thiol biochemical reactions in the melanogenesis is an inhibitor of.
---- (5) trace: trace element metabolism in the black enzyme plays a major role in promoting, in particular copper ions, the higher its content, the stronger the activity of tyrosinase, melanin synthesis of the more.
---- (6) amino acids and vitamins : Animal experiments show that tyrosine, tryptophan and lysine in the formation of melanin is required. pantothenic acid, folic acid, biotin, on the ammonia acid, also can participate in the formation of melanin. but note that vitamin C as a reducing agent, make color fades, and less.
---- (7) UV: Ultraviolet radiation in the glutathione content of the skin by reducing the activation of tyrosinase activity, and finally to black increase in prime form.
4. melanocyte skin barriers What?
---- black skin disease is the prime obstacle to melanocytes and melanin quantity and quality differences, or functional disorders skin diseases caused by.
---- (1) Class hyperpigmentation (dark spots of): is hyperpigmentation of the skin contains more melanin. black pigmentation in the skin, the skin layers due to the depth at different, it will cause visual differences, such as melasma.
---- (2) reduce pigment class (white of): The decrease of the skin pigment melanin contained less than the normal white or color color is light (white light). skin was completely white, who often lack the melanocytes, or melanin metabolic process of a part of the defect, so that the black pigment melanin formation ability of cells affected, mostly hereditary, diseases such as vitiligo and albinism.
---- Vitiligo and skin beauty is closely related to, will cause serious psychological burden of patients and great mental pressure, and even affect people's normal life, work and study.
5. What causes vitiligo?
---- 1, .2 genetic factors, immune factors .3 .4 neuropsychiatric factors, factors influencing the destruction of melanocytes .5 trace elements and their radical changes. < br >---- several aspects of the above scholars have put forward different theories, known as genetics, immune abnormalities theory, neurochemistry factor theory of self-destruction of the melanin theory, trace element and radical changes in doctrine and so on. but each a theory can not fully explain vitiligo, but not mutually exclusive, it could be a combination of many factors.
Vitiligo Vitiligo Vitiligo Hospital
6. vitiligo hereditary you?
--- - Many studies have noted a number of vitiligo have a family history and family aggregation, and gradually formed a genetics of vitiligo can be said of genetic factors on the incidence of vitiligo has a certain role.
7. How to treat vitiligo?
---- Vitiligo occurs in face and other exposed, the disease clearly marked, noticeable, especially in underdeveloped areas of science and culture often criticized by some people, and even discriminated against in society, coupled with the treatment of vitiligo difficult, if patients suffering from vitiligo will cause great mental pain, many patients with end sleepless nights, depression and even suicidal thoughts. The recovery of the disease is detrimental. In addition, vitiligo is a chronic disease, treatment must have patience, impatience should not have, in fact, most patients through the correct treatment of the disease can be controlled, and with varying degrees of efficacy, is still very large chance of cure.
8. Why to timely treatment of vitiligo?
---- Vitiligo course of varying lengths, often in the exposure, trauma, acute illness or surgery, the rapid spread under severe stress. Progress can be slow or intermittent development, but also long-term stability remain unchanged, although now off to see the individual pigment patch small spontaneous regression of the patients, but more is to see a white tend to expand, increase, develop into a pan-hair, so that vitiligo is a chronic nature disease and therefore requires the discovery of vitiligo patients with vitiligo after timely treatment for early control of the disease.
9. Why should adhere to the treatment of vitiligo?
---- number of vitiligo patients, especially those longer course, stable disease, skin lesions in patients with non-exposed parts of their spot in the winter since that will not stop the development of the treatment, in fact, this is their kind of illusion. in winter because of less exposure by the Yang Guan, normal skin color will fade , and the white of the color reduction, improved easily mistaken for white; to the spring and early summer, the sun strong, the chance of receiving more sunlight, and with normal skin color deepened, and the color white is also added big, hot days combined with a small dressing, easy to make clothes sheltered spot originally exposed, which in turn is easily mistaken for exacerbations. Therefore, winter casual interruption of treatment approach is not hate appropriate. not only delay the damage recovery of melanoma cells, but also may cause the spot into a full-type, so the more the more white, increasing the difficulty of treatment. the correct approach is to treat not subject to seasonal factors, both seasons are a result of the treatment, and because of the perseverance, not free to terminate treatment or to abandon the treatment.
10, what is vitiligo? how its incidence?
---- Vitiligo is a common multiple of the acquired pigmented skin, showed limited or generalized pigment loss. is generally believed that the disease was mainly due to the skin and hair follicles caused by melanin depigmentation.
---- but in recent years some studies have shown that vitiligo is not just skin depigmentation disease, other parts of the body such as eyes, ears pigment cells could change, combined with the existence of the disease changes in immunological abnormalities, indicating that vitiligo is a skin pigment-based violations, but also may invade the body pigment cells of other systemic diseases.
---- Vitiligo is a common disease. It's incidence rate in the world 0.5% m4%. in the pathogenesis of age, vitiligo can occur at any age, but for many young adults. 95% of patients recorded before the age of onset 40, age of onset account for about one 11m30 60% of the total number of patients.
Vitiligo Vitiligo Vitiligo Hospital
11, clinical symptoms vitiligo what?
---- Vitiligo is an acquired skin damage occurs, the typical damage is scattered, or the realm of clear white patches. leukoplakia can was gray, white or milky white porcelain, of various shapes can be round, fan-shaped, line-shaped or irregular shaped, jagged edges from mild to quite clear, from a few millimeters to several centimeters in diameter or even tens of centimeters, the surface generally smooth, without shrinking or scaling and other changes.
- - When the initial issuance of the white pigment faded mostly pale spots, one or a few pieces, pigment is not completely disappear, it is unclear demarcation with normal skin, and some when the disease began to decline as the point-like pigment spots.
---- expansion of the progressive development of skin lesions can be integrated with each other, stable spot to stop development, resulting in complete depigmentation of the white pigment spots, and its borders become more clear, and white pigmentation often better edge. leukoplakia of the number of variable. its distribution area vary in size or number can be a focal piece for the small area of skin lesions, but also extensive involvement of almost the whole body while the remaining part of the normal skin.
---- The disease of the skin in any part of the body happen, but vulnerable to sunlight occurs in the sun and other parts of the friction damage, especially facial (such as eyebrows, eyebrows inside of the cheek inside the bridge of the nose associated with the site, and the upper front of the ear, the forehead hairline and the vermilion border), neck, waist and abdomen (waist belt Department), President chest, sacral, forearm and hand back the other side of the stretch. torso perineum also involved. leukoplakia most symmetrical distribution. The disease usually no symptoms . depigmentation lesions of the limitations of spot, white, rounded, oval or irregular in shape, white spot at the hair can also be white, white hair is often refractory to extensive signs. some cases, when the onset of mixed with the proliferation of hair follicles of pigmented spots.
---- premature gray hair is considered a harbinger of occurrence of vitiligo.
12, how to diagnose vitiligo?
---- Vitiligo under typical The clinical manifestations generally can be diagnosed, patients often symmetrical limbs occurred, back and facial depigmentation. If the simultaneous observation of the lips, buccal mucosa, palms and soles, and scalp depigmentation spots will further support the diagnosis.
---- filtration ultraviolet examination (Wood lamp examination) can be used as auxiliary diagnostic methods. for unilateral asymmetry in the diagnosis of segmental vitiligo usually more easily, the patient usually presents the face, trunk or limbs, unilateral de-pigmentation loss of spots, skin lesions occur, the development of dominance by nerve segment. However, patients are often clinically mild hypopigmentation emerging spots that come to treatment, early diagnosis and treatment by doctors. this time is often difficult to diagnose, with the exception of vitiligo hypopigmentation often spot early, but also can occur in many other skin diseases such performance, it requires careful differential diagnosis to rule out these diseases before making the diagnosis of vitiligo.
---- Even so there are some patients can not be confirmed , which requires further observation the disease progresses, lesions of the area if there hair follicles, hair, white pigment loss, vitiligo is more likely to suggest. In addition, if a child appears gray hair, hair, often prompt-based disease (except adult).
---- First Affiliated Hospital of Nanjing Medical University, one of Professor Zhu Wenyuan propose a clinical diagnostic points:
---- �� acquired depigmentation occurred in spots or pigment faded spots. < br >---- �� circumscribed lesions and irregular.
---- �� edge of pigment skin lesions better.
---- �� lesions may be white or can be seen within the hair follicles around the mouth complex color phenomenon.
---- �� Wood lamp white porcelain was white.
---- if the above five in the establishment of three diagnosed with vitiligo can, if two are suspected as the establishment of Vitiligo, need further exclusion of other skin disease vitiligo. But the first of which is a necessary condition �� article.
13, how the course of vitiligo? the factors affecting the progression of the disease what?
---- the natural history of vitiligo is usually slow, carried out. shortest number of weeks duration, the longest up to several decades. This may be associated with treatment of the age. in the disease process may be due to exposure, trauma, severe acute illness or surgery the rapid spread of the stress state. individual cases, vitiligo rapid progress in a few days or weeks to form extensive bleaching, known as the outbreak of vitiligo. of the disease can be expanded integration of the original lesions, but also the emergence of new the skin lesions. Some data indicate that 70% of vitiligo patients with advanced disease is, that the majority of patients with active disease. On the other hand, the slow progress of vitiligo can be developed or intermittent, or constant long-term stability .
---- Many factors can influence the development of the disease and prognosis of vitiligo, there are �� without family history. vitiligo occurrence and genetic factors, the genetic relationship between melanocytes are more susceptible due to destruction of leaving the disease tend to develop. �� lesion type. early onset of segmental vitiligo, the condition is relatively stubborn, often within two years after onset, the rapid development in the affected area, then become stationary, white often remain unchanged for life. a few cases can be Still later came the development of the lesions. segmental vitiligo affected skin, usually along the nerve segment development, and therefore, more predictable trends in its development. rather than segmental vitiligo can affect any part of the body, there is no specific trends, so the bad prediction. the hands of patients as the primary site, easy to develop to the facial skin lesions; after the back, hand or foot as the primary site were, to other parts of the development of vitiligo is easy; the primary site for the face, upper or lower extremities are, the progress of vitiligo is not easy; ��, age, origin; ��, other factors. The disease usually developed rapidly in summer, and winter often slow down or stop the spread of development. In addition, emotional trauma, sun, cosmetics allergy, other disease and pregnancy of staff may make the disease increased.
14. vitiligo and other body related diseases
----( 1) Alopecia areata: alopecia areata vitiligo is not uncommon complicated. Some studies have shown that vitiligo can be associated with alopecia totalis or in the scalp or beard hair of alopecia areata occurring at a single, the accompanying rate of 16%, mainly seen in the progress and the Pan onset of vitiligo, vitiligo patients in the early years of the family who has more gray hair.
- --- (2) Psoriasis: psoriasis and vitiligo patients also occurred in the same clinical cases is not uncommon. concurrency and they are both autoimmune and genetic factors related to not unrelated.
---- (3) thyroid disease: information, vitiligo, thyroid disease, the incidence of 1.28% to 38%. For two concurrent mechanisms, most scholars believe that they share a common immunological basis of the genetic, can reinforce each other .
---- (4) Diabetes: The incidence of vitiligo, diabetes mellitus% ~ 7.1%, mainly insulin-dependent diabetes mellitus, and vitiligo patients, islet cell antibody positive rate is higher than the general population, associated with vitiligo patients with diabetes often have autoimmune disease susceptibility, or there is the phenomenon of familial aggregation of disease.
---- (5) Cancer: Malignant melanoma associated with vitiligo. In addition, concurrent squamous vitiligo cell carcinoma, basal cell carcinoma and gastric cancer reported.
---- (6) Other: including Addison disease (Addison), pernicious anemia, bullous pemphigoid, scleroderma and sclerosis atrophy of lichen, etc..
15. vitiligo what harm the human body? the treatment of vitiligo to what end?
---- vitiligo patients generally will not cause any physical discomfort, but not life-threatening, it harm the human body is mainly mental, to patients can lead to serious psychological stress and social problems, thus reducing the quality of life of patients.
---- Therefore, clinicians, we must first achieve the treatment of vitiligo purpose is to make patients the disease has a more correct understanding.
---- Vitiligo is an easy to diagnose and difficult to treat skin diseases, its pathogenesis is unknown, so far, treatment is still difficult, the domestic outside of a therapy can not yet completely healed in all patients. physicians should recognize that patients with vitiligo do not have any impact on life, it will not infect others, to eliminate their fear of normal social activities, there is no need to look around for the so-called effect radical approach, but should be based on their specific circumstances, a medical practitioner to develop their own viable treatment options, and actively cooperate with the physician adherence to treatment.
---- of treatment of this disease is generally more long, from effect is slow, a course of at least 2-3 months, the general courses required to adhere to treatment 2m3, so the patient should be fully aware of the difficulty of treating this disease.
---- aim is to pigment loss back to normal , white is not obvious as possible.
Vitiligo Vitiligo Vitiligo Hospital
16. vitiligo, stability and progress of patients with lesions of
---- are under development or stability, can be divided into stable and progress of the period. in advanced, off to the normal skin pigmentation development, and may appear with the form of reaction, pressure, friction, trauma, secondary vitiligo can be formed. In stable spot to stop development, state clearly that ring the edge of pigmentation , duration of chronic persistent. the right to determine the stability of vitiligo and advanced, for the clinical treatment of great significance.
17. Children What are the characteristics of treatment of vitiligo?
---- the treatment of adults generally the same, its efficacy is better than the adults.
---- (a) of the children with vitiligo has the following characteristics:
---- 1, age of onset: the shortest in 3 days after birth, the average age of onset 4.6-4.8 years; 2, girls more common; 3 to segmental more common, localized second; 4, 11.2% had a family history of -17.32%; 5, the eyes easily affected; 6, the occurrence of halo nevus rate of 8.5%; 7 after trauma can lead to the same type reaction; 8, gastrointestinal disorders significantly.
---- (b) the special treatment of children with vitiligo
---- not the routine treatment of children used have:
---- 1, the system of oral corticosteroids, there will be system or local side effects; 2, the body light therapy is not appropriate for children under 12 years of age; local light therapy is not appropriate for children under 5 years of age; 3, transplant surgery, difficult for children with, should not be used.
---- can be used with:
---- 1, the effect of topical corticosteroids low; 2, immune enhancer; 3, trace elements; 4, oral Chinese medicine, the dose by half.
---- (c) is generally believed that the best treatment for child patients with vitiligo is a stable condition on time, which is the white area is no longer the situation continues to expand 3-6 months.
18. Some common clinical classification
---- Vitiligo Vitiligo generally unified into two types, II, II:
---- (1) II: �� unusual type. can be divided into limited, sporadic, pan-onset and limb off of 4. limitations are as single or clusters of white, sizes, restricted to a particular site; those for the scattered sporadic, multiple leukoplakia, usually symmetrical; pan-onset are more evolved from the sporadic, irregular white spots and more mutual integration into a large and involved more than 50% body surface area, sometimes only a small piece of residual islands of normal skin equipment; extremities of those white At the beginning of the body's extremities, such as face, hand, foot and other parts Zhi Zhi; �� section end type. white as a sheet or several along the broken section of a nerve to dominate the regional distribution of the skin, usually unilateral.
---- (2) Category II: 1. full of spots. white porcelain for pure white or white, there is no white pigment regeneration, vitiligo melanocytes disappear within the organization, on the negative reaction is not phenylalanine. 2. leukoplakia incomplete. leukoplakia bleaching is not complete, white pigment in the visible point.
---- (3) Phase II: 1. during the progress. leukoplakia increased gradually to the normal 2, the original spot. stable. spot to stop development, state clearly that white pigment to enhance the edge.
---- Four Mistakes treatment of vitiligo?
---- 1, becoming a sick, mistakenly believed earth, recipe, casually wiping medicine.
---- 2, quickly, demand will be misled into believing that Western steroid injection.
---- 3, skin grafting, a temporary solution, resulting in white spread.
---- 4, enhanced immunotherapy, the use of intramuscular injection of a number of immunostimulants such as: thymosin, transfer factor, these pins serve water only enhance the immune effect on vitiligo is not relevant, would not achieve therapeutic effect.
---- Expert Tip: The above symptoms refractory to this treatment are considered easy to relapse, the majority of patients to the adverse psychological pressure and severe economic burden on the patient missed the best timing of treatment.
---- white spot is not terrible, select the correct drug treatment to prevent recurrence is the key.
Vitiligo Vitiligo Vitiligo Hospital
No comments:
Post a Comment