Correlation Vitiligo, Food Allergy and Celiac ?
Interestingly, this individual had very noticeable vitiligo. Vitiligo is the name of a skin condition where one looses the pigmentation of the skin. That area then looses color in contrast with the skin around it. The cells that create the pigmentation of the skin are destroyed by what is assumed to be an autoimmune reaction. (Autoimmune reactions are when our immune system attacks our own body.)
Seeing him again this week he noted that his vitiligo had greatly improved, which was apparent upon seeing him. He also noted that his brother, who had the same condition, had also improved when he too had changed his diet and avoided dairy and sugar cane. (As a note, food allergies are usually genetic issues.)
I thought that this was a very interesting case because I had often wondered if there was a relationship between vitiligo and food allergies. There is very little record of this in the medical literature and I do not believe that it has ever been well studied. Hopefully someday it will be. It is certainly worth pursuing.
Vitiligo has been connected to celiac disease also. I had vitiligo as a child but it stopped spreading and I actually had the color come back to the spots on my face. (Interesting to note that I was also taken off dairy as a child.) I wasn’t diagnosed with celiac until age 32. My grandfather, who I also believe had celiac, also had vitiligo.
Children have vitiligo and feel so much better after going off gluten that I didn’t want to go backwards to take the gluten challenge and get tested for Celiac. Now my daughter, 7 months pregnant, has absent EDF in the placenta that is causing low fetal weight. She is the only one of my four kids who also tested positive on the gluten saliva test, and she has been gluten free for a year. Do you know of anything she can do to help her carry the baby longer?
Vitiligo (pronounced /ˌvɪtɨˈlaɪɡoʊ/) is a chronic disorder that causes depigmentation in patches of skin. It occurs when the melanocytes, the cells responsible for skin pigmentation which are derived from the neural crest, die or are unable to function. The precise pathogenesis, or cause, of vitiligo is complex and not yet fully understood. There is some evidence suggesting it is caused by a combination of autoimmune, genetic, and environmental factors. It is also common in people with thyroid disorders. The population incidence worldwide is considered to be less than 1 percent. Non-segmental vitiligo has a greater prevalence than the disorder’s other form(s).
Signs and symptoms
The most notable symptom of vitiligo is depigmentation of patches of skin that occurs on the extremities. Although patches are initially small, they often enlarge and change shape. When skin lesions occur, they are most prominent on the face, hands and wrists. Depigmentation is particularly noticeable around body orifices, such as the mouth, eyes, nostrils, genitalia and umbilicus. Some lesions have hyperpigmentation around the edges. In regards to psychological damage, vitiligo can have a significant effect on the mental health of a patient. Psychological stress may even result in an individual becoming more susceptible to vitiligo. Patients who are stigmatised for their condition may experience depression and similar mood disorders.
In Non-segmental vitiligo (NSV), there is usually some form of symmetry in the location of the patches of depigmentation. New patches also appear over time, and can be generalised over large portions of the body, or localised to a particular area. Vitiligo where little pigmented skin remains is referred to as vitiligo universalis. NSV can come about at any age, unlike segmental vitiligo which is far more prevalent in teenage years.
Segmental vitiligo (SV) differs in appearance, aetiology and prevalence from associated illnesses. Its treatment is also different from that of NSV. It tends to affect areas of skin that are associated with dorsal roots from the spine. It spreads much more rapidly than NSV and, without treatment, patches of depigmented skin remain throughout life.
Vitiligo is a complex, polygenic disorder characterized by patchy loss of skin pigmentation due to abnormal melanocyte function. Both genetic and environmental etiological factors have been proposed for vitiligo and lack of molecular markers renders difficulties to predict development and progression of the disease. Identification of dysregulated genes has the potential to unravel biological pathways involved in vitiligo pathogenesis, facilitating discovery of potential biomarkers and novel therapeutic approaches. The transcriptional profile of melanocytes from vitiligo patients have been studied. Oligonucleotide microarrays containing approximately 16,000 unique genes were used to analyse mRNA expression in melanocytes from vitiligo patients and age-matched healthy controls. In total, 859 genes were identified as differentially expressed.
Vitiligo is sometime associated with autoimmune and inflammatory diseases, commonly thyroid overexpression and underexpression. A study comparing 656 people with and without vitiligo in 114 families found several mutations (single-nucleotide polymorphisms) in the NALP1 gene.The NALP1 gene, which is on chromosome 17 located at 17p13, is on a cascade that regulates inflammation and cell death, including myeloid and lymphoid cells, which are white cells that are part of the immune response. NALP1 is expressed at high levels in T cells and Langerhan cells, white blood cells that are involved in skin autoimmunity.
Among the inflammatory products of NALP1 are caspase 1 and caspase 5, which activate the inflammatory cytokine interleukin-1β. Interleukin-1β is expressed at high levels in patients with vitiligo. There are compounds which inhibit caspase and interleukin-1β, and so might be useful drugs for vitiligo and associated autoimmune diseases. In one of the mutations, the amino acid leucine in the NALP1 protein was replaced by histidine (Leu155->His). The original protein and sequence is highly conserved in evolution, and found in humans, chimpanzee, rhesus monkey, and bush baby, which means that it is an important protein and an alteration is likely to be harmful. Addison’s disease (typically an autoimmune destruction of the adrenal glands) may cause vitiligo.
There is no cure for vitiligo but there are a number of treatments available which can slow down or improve the condition. In fair-skinned people, avoiding tanning of normal skin can make patches of vitiligo much less noticeable. Treatment options generally fall into four groups:
Sunblock and other means to protect the pale skin
A high protection sun-block (factor 20 or above) is applied to areas of vitiligo to prevent sunburn. Affected areas of skin are protected when the sun is strong, especially in the middle of the day by wearing, for example, a wide brimmed hat and long sleeved clothing.
In mild cases, vitiligo patches can be hidden with makeup or other cosmetic camouflage solutions. If the affected person is pale-skinned, the patches can be made less visible by avoiding sunlight and the sun tanning of unaffected skin. However, exposure to sunlight may also cause the melanocytes to regenerate to allow the pigmentation to come back to its original color.
Treatments that aim to reverse the changes in the skin
The traditional treatment used by dermatologists is the application of corticosteroid cream.
Studies have also shown that immunomodulator creams such as Protopic and Elidel also cause repigmentation in some cases, when used with UVB narrowband treatments.
In October 1993, a scientific report was published of successfully transplanting melanocytes to vitiligo affected areas, effectively repigmenting the region. The procedure involved taking a thin layer of pigmented skin from the patient’s gluteal region. Melanocytes were then separated out to a cellular suspension that was expanded in culture. The area to be treated was then denuded with a dermabrader and the melanocytes graft applied. Between 70 and 85 percent of patients experienced nearly complete repigmentation of their skin. The longevity of the repigmentation differed from person to person.
In early 2008 scientists at King’s College London discovered that piperine, a chemical derived from black pepper, can shorten the repigmentation process in skin and reduce the UVB exposures, produces a longer lasting and more even pigmentation.
A limited 2003 study in India of 25 patients with limited and slow-spreading vitiligo given orally-taken Ginkgo biloba found it to be “fairly effective therapy for arresting the progression of the disease”. A 2008 review of natural health products found studies to generally be of poor quality but concluded that L-phenylalanine used with phototherapy, and oral Ginkgo biloba as monotherapy showed promise.
Ulltraviolet light (UVA) treatments are normally carried out in a hospital clinic. Psoralen and Ultra Violet A light (PUVA) treatment involves taking a drug which makes the skin very sensitive to light. The skin is then exposed to ultra violet A light (UVA). Treatment is required twice a week for 6–12 months or longer. PUVA may cause side effects such as ‘sunburn’ type reactions or skin freckling. Narrowband ultaviolet B (UVB) phototherapy is now used more commonly than PUVA as it is less damaging to the skin than PUVA. As with PUVA, treatment is carried out twice weekly but there is no requirement to pre-sensitise the skin and the treatment sessions are much shorter.
The new Melagenina Plus, which is the latest version of the old Melagenina, developed by Dr. Carlos Miyares Cao of PLACENTAL HISTOTHERAPY CENTER in Cuba, is claimed to have positive results in re-pigmentation of vitiligo spots. However, it is still not available in many countries including the USA. The medicine is made from human placenta and Calcium Chloride with refined alcohol as a carrier. Human placenta together with Calcium Chloride is known to have the powers to stimulate melanocytes and, thereby, help repigmentation.
Treatment to completely de-pigment the skin
In cases of extensive vitiligo the option to de-pigment the unaffected skin may be considered to render the skin an even colour. The removal of all the skin pigment is permanent and it takes about a year to complete.
Public figures with vitiligo
- Michael Jackson was diagnosed with vitiligo and lupus in 1986. In a 90-minute interview with Oprah Winfrey in February 1993, Jackson claimed that he didn’t bleach his skin, stating for the first time that he had vitiligo. The admission went on to promote awareness of vitiligo.A friend claimed he started wearing his signature sequin glove to cover the vitiligo that had begun to appear in the early 80s. It is also confirmed on his autopsy report. It is also thought that his eldest child, Prince Michael Jackson I has inherited the disease.
- Amitabh Bachchan, the famous Indian actor, suffers from vitiligo.
- Gautam Singhania, the chairman and managing director of Raymond Group, has chosen the treatment option of complete depigmentation for vitiligo.
- Graham Norton has white patches in his hair as a result of vitiligo.
- Asifa Bhutto Zardari, daughter of Pakistani President Asif Ali Zardari and former Prime Minister of Pakistan Benazir Bhutto.
- Lee Thomas, a news anchor and entertainment reporter for WJBK (Fox) Detroit.
- Krizz Kaliko, singer/rapper of the Strange Music record label. He has even named his debut album after the condition, Vitiligo.
- Thomas Lennon of Reno 911! fame.
- Eduardo Panlilio, Governor of the province of Pampanga in the Philippines.
- Yvette Fielding, British TV presenter, has had vitiligo from age 11; her mother developed it at age 24.
- Mikel Jollett, lead singer and creator of American alternative rock band The Airborne Toxic Event.
- Fez Marie Whatley – The Ron and Fez Show XM 202
- Scott Jorgensen – Former Pac 10 wrestling champ and current mixed martial artist with WEC.
- Charly Garcia, Argentinean rockstar, has vitiligo, and is famous for having a bicolour moustache caused by this condition.
- John Wiley Price, the Dallas County Commissioner, is slowly turning white because of vitiligo.
- Rasheed Wallace an American professional basketball player suffers from vitiligo.
- Tempestt Bledsoe, an American actress, suffers from vitiligo.
- Katelyn d’Estes, International Spokesmodel for the Hollywood Graffiti Gown has used vitiligo to her advantage
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