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   Vitiligo  Causes   The exact cause for the pigment disorder remains unknown. In most cases there are multiple causes responsible for vitiligo. However, there are theories suggesting a. Autoimmune links: The cells fighting among themselves leading to destruction of the melanin, is one of the reasons. There are other immunological factors as well. One of the studies has suggested role of some neuropeptide (NYP) which may damage melanin. Such neuropeptide may be released in response to skin injury or emotional stress; again suggesting a combination of causative factors. b. Hormonal connections: Affection of certain hormones such as Thyroid hormones or Melanocyte Stimulating hormone may be responsible for vitiligo. c. Genetic tendencies d. Neural theory e. Autocytotoxic theory etc.: As per this theory, there is self-destruction of melanocytes and hence the melanin. This could be a result of genetic, immunological, neural or stress factors. There are factors, internal and external, which either predispose or trigger or maintain the process which leads to development of vitiligo. The familial incidence of 20 to 30% is observed in the family members. If one or more of the parents have vitiligo, there are more chances of one developing the same. However, it is not a rule. At the same time, numerous cases of vitiligo do not have a relevant family history of Vitiligo. We have made an important observation through a study that most patients with vitiligo has one of the family members (father, mother, grand parents on either side, uncle, aunt or siblings) suffering from one or more of the following diseases: a. Vitiligo b. Hypothyroid c, Diabetes d. Alopecia areata d. Cancer or e. Other auto-immune disease. A study at our center also shows that the patients who have either extensive vitiligo or those developing vitiligo spots on both sides of body (bilateral symmetrical) have a strong genetic element.  Vitiligo and Hypothyroidism: Research suggests that Vitiligo and Hypothyroidism (Under active thyroid) often are predisposed by the same gene (NALP1 gene). All patients of Vitiligo are suggested to get Thyroid profile done every six months. Thyroid profile entails blood sample study for T3, T4 and TSH hormones at a small cost. Other factors: The precipitating factors have been identified as due to pressure of tight clothes (such as on the waist) or certain occupational hazards such as wearing certain rubber hand gloves. Long term intake of certain drugs is found to produce this pigment disorder. In many cases, especially in children, we often have no clue why one develops vitiligo. All said and done, there is definitely an abnormal process of melanocyte destruction and defective melanocyte formation, governed by known or unknown factors. It may be noted that some of the above remarks are based on our study of over 4500 cases and they may not be found in the standard dermatological text books. Like many disease conditions, the exact causation yet remains a mystery! |
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