الفهرس 
A general view on vitiligoOnly 14 pages are availabe for public view
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Abstract
Vitiligo is a multifactorial disease with a complex pathogenesis; its precise cause remains unknown. Old theories suggested complete destruction of melanocytes due to either the presence of autoantibodies; the ’self destruction’ theory; the participation of cytotoxic T cells.More recent studies suggested intrinsic and extrinsic defects of melanocytes rendering them as nonfunctioning cells.
Although vitiligo is categorized as a systemic disease and many studies are interested in vitiligenous skin, studies directed towards perilesional and apparently normal distant skin remain few and controversial. The degree of involvement of these areas and size of surface area affected influence strategies of therapeutics options.
The present study was conducted on 40 vitiligo patients with different clinical types, aiming at comparing both skin color and histological changes in lesional, perilesional and apparently normal distant skin.Taking into consideration the possible influence of disease duration, we included two groups of patients: G1 included 20 cases with disease duration less than 1year and G2, included 20 cases with disease duration more than 1year and less than 5 years.
In this study; we combined analysis of clinical photos with analysis of H&E and F-M stained slides to correlate both color changes and histopathological changes in vitiligo patients.Digital photos were used as reference visualdocumentsto diminish as much as possible errorsof naked eye examinationand Computer Assisted Digital Image Analysis was used to evaluate color changes in digital photos and to assess histopathological changes in biopsies stained by H&E and F-M stains.
Statistical analysis of clinical photos revealed that skin color luminance decreases significantly in relation to increasing distance from the vitiligo spot in contrast to skin pigmentation that gradually increases from lesional to distant skin.
Statistical analysis of histological changes revealed that there is a significant involvement of both perilesional skin and distant skin in the pathological process of vitiligo. Lesional skin showed scanty pigmentation in short disease duration cases while there was no melanin reaction in long duration cases. In both groups perilesional skin showed more pigmentation ratio than that of lesional skin and less pigmentation ratio than that of distant skin.
To conclude, whether assessed histopathologically or by measurement of color indices, perilesional skin and apparently normal distant skin in vitiligo patients show the same morphological and histopathological changes detected in lesional skin of vitiligo but with different degrees. Perilesional skin shows a moderate degree of these changes between lesional and distant skin. Therefore, it differs greatly when we consider vitiligo as a generalized disease not merely as a skin disorder.