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White spots, butterflies and PSEUDOCATALASE. Vitiligo is a chronic skin disease characterized by depigmented (white) skin areas on the body. The disease is common and affects 1–2 percent of the population globally. Statistically, there may be many more because most people do not seek care for pigment changes in the skin.
Vitiligo vulgaris (generalized vitiligo) is the most common form of vitiligo. Vitiligo vulgaris is characterized by white patches that appear symmetrically on both halves of the body.
Vitiligo segmentalis is the other variant, vitiligo segmentalis (segmental vitiligo), appears as spots on only one side of the body.
Vitiligo focalis is called the third variant and is characterized by small spots on one or a few parts of the body.
Scientists today disagree about the reason why vitiligo occurs. Some claim it is caused by autoimmunity, which is when your immune system attacks the pigment cells. Others claim that a high concentration of oxidative stress destroys the pigment cells. Most likely it is a combination of both. Patients with vitiligo (especially with vitiligo vulgaris) have antibodies against the pigment cells along with a high concentration of hydrogen peroxide which is an oxidative marker. What came first the chicken or the egg? We do not know.
For a long time it was assumed that the white spots did not contain any melanocytes (pigment cells), but now research has shown that melanocytes are still present in the white spots only that they have lost their ability to form pigment (1).
As depigmentation can occur in visible areas of the skin, the disease can be socially stigmatizing and cause psychosocial concerns, including impaired well-being (2).
Diagnosing vitiligo is often a simple process. In light-skinned patients, however, a so-called skin lamp (Wood's lamp) may be needed to ensure that it is vitiligo. Professor Karin Schallreuter and a team of American and German researchers discovered that substances are formed in the white skin that emit fluorescence when illuminated with the lamp. These substances belong to the bioterins family and it is also these that give some butterflies their fluorescent color (3).
The discovery of vitiligo's ability to fluoresce was published in the prestigious journal Science in 1994 (3).
A: Vitiligo of the eyelids in visual light. B: The same eyelid under Wood's lamp produces a white fluorescent light. (4).
There are no uniform national guidelines for the treatment of vitiligo today. Most often, no further medical treatment is offered, but the focus is on patient information about the course of the disease.
However, some dermatologists prescribe cortisone or tacrolimus, a substance developed to treat atopic eczema that you are asked to apply to the affected areas. After 6 months, an evaluation takes place. A few patients see some effect due to the immunomodulatory effect. A light treatment with UVB light is recommended in some regions with varying effect
Professor Karin Schallreuter has studied vitiligo for the past 25 years and has been a working dermatologist and specialist at the Mayo Clinic, Minnesota. She is one of the founders of the Center for Skin Science at the University of Bradford and founder of the Institute for Pigmentary Disorders in Greifswald, Germany. She has written more than 170 scientific articles in experimental and clinical dermatology and has treated more than 6000 patients with vitiligo. In this interview, she tells us more about the treatment she has developed.
About Professor Schallreuter's treatment that has helped reduce his vitiligo.
I have had vitiligo since my childhood. I visited many dermatologists and tried everything from cortisone, tacrolimus and UVB treatment to transplanting healthy pigmented skin cells to the affected areas. Nothing worked and the vitiligo actually got worse with all the treatments.
I studied in Uppsala to become a pharmacist and graduated in 2002. During my years at the university, I got in touch with the German dermatologist and skin researcher Karin Schallreuter, who was a professor at the University of Bradford and an expert on vitiligo (see video clip). This contact gave me the opportunity to undertake doctoral studies in clinical and experimental dermatology with Schallreuter's team.
Based on the discovery of the "butterfly bioterins" in the vitiligo patches, Karin Schallreuter and her team developed a treatment to reduce oxidative stress in the skin. When the treatment was used, the melanocytes faded and started producing pigment again. Today I use NB-UVB-activated pseudocatalase PC-KUS with very good effect, my face and legs have received 90% repigmentation. However, hands and feet are still difficult to treat.
This treatment was developed by Professor Schallreuter in 1995 and has since helped thousands of patients at three different locations: Medical Clinic-The Dead Sea, Institute for Pigmentation Disorders by V. Greifswald, Germany and at the University of Bradford, England. In 2006, I defended my thesis on vitiligo and obtained a doctorate in experimental dermatology. Today I feel happy about my vitiligo and enjoy the white spots, although several of them have now completely disappeared. If I hadn't had them, I probably wouldn't have had the motivation I have, nor would I have experienced everything I've experienced or met all these amazing people and scientists I've met over the years.
If you are interested, please read the scientific publications about the treatment here .
/Johanna Gillbro
