Plant-Derived Compounds as Promising Therapeutics for Vitiligo

Vitiligo is the most common depigmenting disorder characterized by white patches in the skin. The pathogenetic origin of vitiligo revolves around autoimmune destruction of melanocytes in which, for instance, oxidative stress is responsible for melanocyte molecular, organelle dysfunction and melanocyte specific antigen exposure as well as melanocyte cell death and thus serves as an important contributor for vitiligo progression. In recent years, natural products have shown a wide range of pharmacological bioactivities against many skin diseases, and this review focuses on the effects and mechanisms of natural compounds against vitiligo models. It is showed that some natural compounds such as flavonoids, phenols, glycosides and coumarins have a protective role in melanocytes and thereby arrest the depigmentation, and, additionally, Nrf2/HO-1, MAPK, JAK/STAT, cAMP/PKA, and Wnt/β-catenin signaling pathways were reported to be implicated in these protective effects. This review discusses the great potential of plant derived natural products as anti-vitiligo agents, as well as the future directions to explore.

Ayurvedic Approach for Shwitra- A Case Study

Skin is one of the most important and visible organ of our body. Skin anomalies create physical as well as psychological problems in an individual. Among different variety of Kustha, Shwitra is considered as one of them in the Ayurvedic classics which occur due to vitiation of Tridoshas and Dhatus like Rakta, Mamsa and Meda. Shwitra can be correlated with vitiligo or leucoderma, where it manifest as white patch on the skin due to partial or complete loss of skin pigmentation and causes cosmetic imbalance of the body. Vitiligo is an autoimmune disease and it may be associated with other autoimmune diseases such as pernicious anaemia, addison disease and diabetes mellitus results in destruction of melanocytes thus causing depigmentation. A female patient, aged 36 years suffering from white patches in left forehead region for last 2 years and she was treated with both Sodhan and Shaman Chikitsa for a period of 3 months. Result was assessed from the changes in the size of patch and photographs. Proper written consent was taken from the patient prior to the study. Follow up was done at 1 month interval and after 3 months there was marked improvement seen in patch and colour. The present study indicates different prospective of treatment for Shwitra kustha and it provides cost effective as well as safe treatment of the disease. This study shows a new dimension in the treatment for Shwitra and could be carried out for statistical significant study.

AYURVEDIC MANAGEMENT OF SWITRA ROGA: A CASE STUDY

Skin is the largest organ of human body. Skin complaints affect people of all ages from the neonate to the elderly and cause harm in a number of ways such as discomfort, disfigurement, disability and even death rarely. Vitiligo is the condition presenting with whitish discoloration of the skin. It is an acquired condition in which circumscribed de-pigmented patches can be seen. The destruction of melanocytes, pigment forming cells, causes lack of melanin, coloring pigment which leads to this condition. It affects 1-2% of the population worldwide. Onset is usually in the childhood and females are mostly affected. In Ayurveda, the science of life, the disease called “switra” can be correlated to vitiligo. Aim of the present study is to evaluate the action of Ayurvedic medications on switra roga. Here, am presenting a case of 5 years old girl who came to OPD with c/o white patches over left side of the face. A notable improvement in the condition has been observed in this case. Keywords: Switra roga, Vitiligo, twak vikara.

A child with vitiligo

Vitiligo is a chronic skin condition which affects 0,5-2% of the world’s population, without any sex or ethnical predilection. Clinically it is characterized by the development of well-defined depigmented macules. Although its etiopathogenesis is exquisitely compound and remains not fully anderstood, it is known that it results from the destruction of melanocytes present in the skin. The aim of this paper is to present vitiligo clinical picture in a children population, its etiopathogenesis and available therapeutical methods. There are many therapeutic options for vitiligo, none of which is fully effective, hence appropriate patients education concerning various medical and cosmetic therapies, as well as the psychological aspects of the disease, is extremely important.

Knowledge, attitude and behaviour study of vitiligo among general population

Vitiligo is an acquired skin disorder caused due to destruction of melanocytes which clinically presents with well defined depigmented macules and patches with or without white hairs. The present study is an attempt to document the prevalent knowledge and attitude in the general public regarding this disease and to identify the determinants of good/poor knowledge and attitude. To assess Knowledge, attitude and behaviour study of vitiligo among general population attending skin outpatient department (OPD) of Sree Balaji Medical College and Hospital, Chennai. This was a cross sectional study, which was conducted at dermatology OPD in Sree Balaji Medical College and Hospital, Chennai 2021 after ethical committee approval. About 80 patients attending OPD were included in study to whom questionnaire was asked and data was collected and analysed.

Title- Role of herbal products in curing Vitiligo

Plants produce a wide diversity of secondary metabolites which serve them as defence compounds against herbivores, and other plants and microbes, but also as signal compounds. In general, secondary metabolites exhibit a wide array of biological and pharmacological properties. Because of this, some plants or products isolated from them have been and are still used to treat infections, health disorders or diseases. Vitiligo is a skin disorder that is caused due to oxidative stress in the body resulting in the destruction of melanocytes, which are the cells responsible for the pigmentation of the skin. On their destruction the skin gets depigmented resulting in patches of skin losing their colour. In this review we focus on how plant based herbal products help in curing vitiligo.

Multiple Carcinoma injuries of squamous cells and Queratoacantoma on vitiligo patient

Vitiligo patients undergo a destruction of melanocytes. The melanin reduction inflicts as a risk factor for the development of skin neoplasia. Cases of malignant nonmelanocytic tumors and melanoma within the vitiligo patients is rare and isolated. This study reports the multiple injuries of the squamous cell carcinoma and keratoacanthoma within the intense vitiligo affected areas.

Integrative Analysis of Omics Data Reveals Regulatory Network of CDK10 in Vitiligo Risk

Vitiligo is a multifactorial polygenic disorder, characterized by acquired depigmented skin and overlying hair resulting from the destruction of melanocytes. Genome-wide association studies (GWASs) of vitiligo have identified approximately 100 genetic variants. However, the identification of functional genes and their regulatory elements remains a challenge. To prioritize putative functional genes and DNAm sites, we performed a Summary data-based Mendelian Randomization (SMR) and heterogeneity in dependent instruments (HEIDI) test to integrate omics summary statistics from GWAS, expression quantitative trait locus (eQTL), and methylation quantitative trait loci (meQTL) analysis of large sample size. By integrating omics data, we identified two newly putative functional genes (SPATA2L and CDK10) associated with vitiligo and further validated CDK10 by qRT-PCR in independent samples. We also identified 17 vitiligo-associated DNA methylation (DNAm) sites in Chr16, of which cg05175606 was significantly associated with the expression of CDK10 and vitiligo. Colocalization analyses detected transcript of CDK10 in the blood and skin colocalizing with cg05175606 at single nucleotide polymorphism (SNP) rs77651727. Our findings revealed that a shared genetic variant rs77651727 alters the cg05175606 as well as up-regulates gene expression of CDK10 and further decreases the risk of vitiligo.

EVALUATION OF THE TREATMENT OF SHWITRA WITH AYURVEDA MODALITIES: A CASE STUDY

In Ayurveda most of the skin diseases are explained under the term Kushtha. Shwitra is considered as one of the varieties of Kushtha in the Ayurvedic Classics, caused vitiation of Tridoshas and Dhatus like Rakta, Mamsa and Meda. The references of Shwitra are found in almost all the Samhitas like Bruhatrayees and Laghutrayees. Partial or complete loss of skin pigmentation giving rise to white patch on any part of the body is called as leucoderma or vitiligo and in Ayurveda it is called as Shwitra. This depigmentation results due to destruction of melanocytes, which may be unknown in origin or due to autoimmune endocrinopathies selective IgA deficiency. A female patient, aged 20 year suffering from white patches in neck region since 4 year was treated with both Shaman Chikitsa and Sodhan Chikitsa for a period to 4 months with follow up at every 30 days in between, Relief from the complaints was assessed by noting the changes in the size of patch. After 4 months of treatment the size of patch was reduced. The present case study revealed the efficacy of Ayurveda therapy both internal and external for duration of 4 months in the management of Shwitra.

A Concise Review on the Role of Endoplasmic Reticulum Stress in the Development of Autoimmunity in Vitiligo Pathogenesis

Vitiligo is characterized by circumscribed depigmented macules in the skin resulting due to the autoimmune destruction of melanocytes from the epidermis. Both humoral as well as cell-mediated autoimmune responses are involved in melanocyte destruction. Several studies including ours have established that oxidative stress is involved in vitiligo onset, while autoimmunity contributes to the disease progression. However, the underlying mechanism involved in programing the onset and progression of the disease remains a conundrum. Based on several direct and indirect evidences, we suggested that endoplasmic reticulum (ER) stress might act as a connecting link between oxidative stress and autoimmunity in vitiligo pathogenesis. Oxidative stress disrupts cellular redox potential that extends to the ER causing the accumulation of misfolded proteins, which activates the unfolded protein response (UPR). The primary aim of UPR is to resolve the stress and restore cellular homeostasis for cell survival. Growing evidences suggest a vital role of UPR in immune regulation. Moreover, defective UPR has been implicated in the development of autoimmunity in several autoimmune disorders. ER stress-activated UPR plays an essential role in the regulation and maintenance of innate as well as adaptive immunity, and a defective UPR may result in systemic/tissue level/organ-specific autoimmunity. This review emphasizes on understanding the role of ER stress-induced UPR in the development of systemic and tissue level autoimmunity in vitiligo pathogenesis and its therapeutics.