Aspects of etiopathogenesis and therapy of vitiligo/ Aspectos sobre a etiopatogenese e terapeutica do vitiligo

Introduction: Vitiligo is a chronic skin disease characterized by cutaneous depigmentation, being associated with aesthetic disfiguration and considerable psychological discomfort, representing great challenges in terms of dermatological care. Main Objective: To address the etiopathogenic aspects of...

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Veröffentlicht in:Revista de medicina (São Paulo, Brazil) Brazil), 2020-05, Vol.99 (3), p.278
Hauptverfasser: Sobrinho, Herminio Mauricio da Rocha, Mendonca, Ana Elisa Andrade, Aquino, Daniela Dias, Horbilon, Juliana Andrade Mendonca
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Mendonca, Ana Elisa Andrade
Aquino, Daniela Dias
Horbilon, Juliana Andrade Mendonca
description Introduction: Vitiligo is a chronic skin disease characterized by cutaneous depigmentation, being associated with aesthetic disfiguration and considerable psychological discomfort, representing great challenges in terms of dermatological care. Main Objective: To address the etiopathogenic aspects of vitiligo, as well as to present current therapeutic options for disease management. Method: Narrative bibliographic review using the electronic Pubmed database (US National Library of Medicine). The research was carried out in 2018, using the following identifiers in Health Sciences: vitiligo, cosmetic camouflage and vitiligo, treatment and vitiligo, physiopathology and vitiligo, immunopathology and vitiligo. We selected 26 researches published in the period from 2011 to 2018 that presented contents related to the objectives of this study. Result: Vitiligo is developed by the association of a genetic predisposition and exposure to environmental factors. The treatment aims to limit the progression of the disease, promote repigmentation of the affected areas and prevent relapses; It can be divided into clinical, aesthetic and surgical. Topical, systemic, phototherapy and recent immunobiological medicines are clinical treatments. The aesthetic treatment is represented by cosmetic camouflage and the surgical one is indicated for those who present stable disease not responsive to clinical therapy. Conclusion: Treatment is usually performed by the association of techniques, which is why it should be individualized for each patient. Early initiation of treatment is associated with a more favorable prognosis of the disease. It is of extreme importance not to neglect it in addition to knowing therapeutic innovations, considering the potential societal stigmatization of the disease, as a result improving clinical practice and quality of life of patients. Keywords: Vitiligo, Autoimmunity, Repigmentation, Drug Therapy, Phototherapy, Cosmetic, Surgery, Tissue Graft. O vitiligo e uma doenca cutanea cronica caracterizada por despigmentacao da pele, sendo associada com desfiguracao estetica e consideravel desconforto psicologico, representando grandes desafios em termos de cuidados dermatologicos. A partir do conhecimento do impacto psicossocial desta doenca para o paciente e os desafios do seu tratamento pela medicina, este trabalho teve como objetivos destacar os principais aspectos etiopatogenicos do vitiligo, bem como, apresentar as opcoes terapeuticas atuais para o manejo
doi_str_mv 10.11606/issn.1679-9836.v99i3p278-285
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Main Objective: To address the etiopathogenic aspects of vitiligo, as well as to present current therapeutic options for disease management. Method: Narrative bibliographic review using the electronic Pubmed database (US National Library of Medicine). The research was carried out in 2018, using the following identifiers in Health Sciences: vitiligo, cosmetic camouflage and vitiligo, treatment and vitiligo, physiopathology and vitiligo, immunopathology and vitiligo. We selected 26 researches published in the period from 2011 to 2018 that presented contents related to the objectives of this study. Result: Vitiligo is developed by the association of a genetic predisposition and exposure to environmental factors. The treatment aims to limit the progression of the disease, promote repigmentation of the affected areas and prevent relapses; It can be divided into clinical, aesthetic and surgical. Topical, systemic, phototherapy and recent immunobiological medicines are clinical treatments. The aesthetic treatment is represented by cosmetic camouflage and the surgical one is indicated for those who present stable disease not responsive to clinical therapy. Conclusion: Treatment is usually performed by the association of techniques, which is why it should be individualized for each patient. Early initiation of treatment is associated with a more favorable prognosis of the disease. It is of extreme importance not to neglect it in addition to knowing therapeutic innovations, considering the potential societal stigmatization of the disease, as a result improving clinical practice and quality of life of patients. Keywords: Vitiligo, Autoimmunity, Repigmentation, Drug Therapy, Phototherapy, Cosmetic, Surgery, Tissue Graft. O vitiligo e uma doenca cutanea cronica caracterizada por despigmentacao da pele, sendo associada com desfiguracao estetica e consideravel desconforto psicologico, representando grandes desafios em termos de cuidados dermatologicos. A partir do conhecimento do impacto psicossocial desta doenca para o paciente e os desafios do seu tratamento pela medicina, este trabalho teve como objetivos destacar os principais aspectos etiopatogenicos do vitiligo, bem como, apresentar as opcoes terapeuticas atuais para o manejo da doenca. Metodo: Revisao bibliografica narrativa, utilizando-se as bases de dados Pubmed (US National Library of Medicine) e Portal Capes. A busca dos trabalhos foi realizada no ano de 2018, utilizando-se os seguintes Descritores em Ciencias da Saude: Vitiligo; Autoimunidade; Repigmentacao; Tratamento Farmacologico; Fototerapia; Cosmeticos; Cirurgia; Enxerto de tecido. Foram selecionados 26 artigos publicados no periodo de 2011 a 2018 que apresentaram conteudos relacionados aos objetivos deste estudo. Resultados: O vitiligo desenvolve-se pela associacao da predisposicao genetica e exposicao a fatores ambientais. O tratamento tem o objetivo de limitar a progressao da doenca, promover repigmentacao das areas afetadas e prevenir recidivas; podendo ser dividido em clinico, estetico e cirurgico. Os medicamentos topicos, os sistemicos, a fototerapia e os recentes imunobiologicos constituem tratamentos clinicos. O tratamento estetico e representado pela camuflagem cosmetica e o cirurgico e indicado para aqueles que apresentam doenca estavel nao responsiva a terapia clinica. Conclusao: O tratamento em geral e realizado pela associacao de terapias, razao pela qual deve ser individualizado para cada paciente. O inicio precoce do tratamento esta associado a um prognostico mais favoravel. Torna-se de extrema importancia nao negligencialo alem de conhecer inovacoes terapeuticas, tendo em vista o potencial estigmatizante da doenca; melhorando assim a pratica clinica e a qualidade de vida dos pacientes. Descritores: Vitiligo; Autoimunidade; Repigmentacao; Tratamento Farmacologico; Fototerapia; Cosmeticos; Cirurgia; Enxerto de tecido.</description><identifier>ISSN: 0034-8554</identifier><identifier>DOI: 10.11606/issn.1679-9836.v99i3p278-285</identifier><language>por</language><publisher>Universidade de Sao Paulo. Departamento Cientifico da Faculdade de Medicina</publisher><ispartof>Revista de medicina (São Paulo, Brazil), 2020-05, Vol.99 (3), p.278</ispartof><rights>COPYRIGHT 2020 Universidade de Sao Paulo. 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Main Objective: To address the etiopathogenic aspects of vitiligo, as well as to present current therapeutic options for disease management. Method: Narrative bibliographic review using the electronic Pubmed database (US National Library of Medicine). The research was carried out in 2018, using the following identifiers in Health Sciences: vitiligo, cosmetic camouflage and vitiligo, treatment and vitiligo, physiopathology and vitiligo, immunopathology and vitiligo. We selected 26 researches published in the period from 2011 to 2018 that presented contents related to the objectives of this study. Result: Vitiligo is developed by the association of a genetic predisposition and exposure to environmental factors. The treatment aims to limit the progression of the disease, promote repigmentation of the affected areas and prevent relapses; It can be divided into clinical, aesthetic and surgical. Topical, systemic, phototherapy and recent immunobiological medicines are clinical treatments. The aesthetic treatment is represented by cosmetic camouflage and the surgical one is indicated for those who present stable disease not responsive to clinical therapy. Conclusion: Treatment is usually performed by the association of techniques, which is why it should be individualized for each patient. Early initiation of treatment is associated with a more favorable prognosis of the disease. It is of extreme importance not to neglect it in addition to knowing therapeutic innovations, considering the potential societal stigmatization of the disease, as a result improving clinical practice and quality of life of patients. Keywords: Vitiligo, Autoimmunity, Repigmentation, Drug Therapy, Phototherapy, Cosmetic, Surgery, Tissue Graft. O vitiligo e uma doenca cutanea cronica caracterizada por despigmentacao da pele, sendo associada com desfiguracao estetica e consideravel desconforto psicologico, representando grandes desafios em termos de cuidados dermatologicos. A partir do conhecimento do impacto psicossocial desta doenca para o paciente e os desafios do seu tratamento pela medicina, este trabalho teve como objetivos destacar os principais aspectos etiopatogenicos do vitiligo, bem como, apresentar as opcoes terapeuticas atuais para o manejo da doenca. Metodo: Revisao bibliografica narrativa, utilizando-se as bases de dados Pubmed (US National Library of Medicine) e Portal Capes. A busca dos trabalhos foi realizada no ano de 2018, utilizando-se os seguintes Descritores em Ciencias da Saude: Vitiligo; Autoimunidade; Repigmentacao; Tratamento Farmacologico; Fototerapia; Cosmeticos; Cirurgia; Enxerto de tecido. Foram selecionados 26 artigos publicados no periodo de 2011 a 2018 que apresentaram conteudos relacionados aos objetivos deste estudo. Resultados: O vitiligo desenvolve-se pela associacao da predisposicao genetica e exposicao a fatores ambientais. O tratamento tem o objetivo de limitar a progressao da doenca, promover repigmentacao das areas afetadas e prevenir recidivas; podendo ser dividido em clinico, estetico e cirurgico. Os medicamentos topicos, os sistemicos, a fototerapia e os recentes imunobiologicos constituem tratamentos clinicos. O tratamento estetico e representado pela camuflagem cosmetica e o cirurgico e indicado para aqueles que apresentam doenca estavel nao responsiva a terapia clinica. Conclusao: O tratamento em geral e realizado pela associacao de terapias, razao pela qual deve ser individualizado para cada paciente. O inicio precoce do tratamento esta associado a um prognostico mais favoravel. Torna-se de extrema importancia nao negligencialo alem de conhecer inovacoes terapeuticas, tendo em vista o potencial estigmatizante da doenca; melhorando assim a pratica clinica e a qualidade de vida dos pacientes. 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Main Objective: To address the etiopathogenic aspects of vitiligo, as well as to present current therapeutic options for disease management. Method: Narrative bibliographic review using the electronic Pubmed database (US National Library of Medicine). The research was carried out in 2018, using the following identifiers in Health Sciences: vitiligo, cosmetic camouflage and vitiligo, treatment and vitiligo, physiopathology and vitiligo, immunopathology and vitiligo. We selected 26 researches published in the period from 2011 to 2018 that presented contents related to the objectives of this study. Result: Vitiligo is developed by the association of a genetic predisposition and exposure to environmental factors. The treatment aims to limit the progression of the disease, promote repigmentation of the affected areas and prevent relapses; It can be divided into clinical, aesthetic and surgical. Topical, systemic, phototherapy and recent immunobiological medicines are clinical treatments. The aesthetic treatment is represented by cosmetic camouflage and the surgical one is indicated for those who present stable disease not responsive to clinical therapy. Conclusion: Treatment is usually performed by the association of techniques, which is why it should be individualized for each patient. Early initiation of treatment is associated with a more favorable prognosis of the disease. It is of extreme importance not to neglect it in addition to knowing therapeutic innovations, considering the potential societal stigmatization of the disease, as a result improving clinical practice and quality of life of patients. Keywords: Vitiligo, Autoimmunity, Repigmentation, Drug Therapy, Phototherapy, Cosmetic, Surgery, Tissue Graft. O vitiligo e uma doenca cutanea cronica caracterizada por despigmentacao da pele, sendo associada com desfiguracao estetica e consideravel desconforto psicologico, representando grandes desafios em termos de cuidados dermatologicos. A partir do conhecimento do impacto psicossocial desta doenca para o paciente e os desafios do seu tratamento pela medicina, este trabalho teve como objetivos destacar os principais aspectos etiopatogenicos do vitiligo, bem como, apresentar as opcoes terapeuticas atuais para o manejo da doenca. Metodo: Revisao bibliografica narrativa, utilizando-se as bases de dados Pubmed (US National Library of Medicine) e Portal Capes. A busca dos trabalhos foi realizada no ano de 2018, utilizando-se os seguintes Descritores em Ciencias da Saude: Vitiligo; Autoimunidade; Repigmentacao; Tratamento Farmacologico; Fototerapia; Cosmeticos; Cirurgia; Enxerto de tecido. Foram selecionados 26 artigos publicados no periodo de 2011 a 2018 que apresentaram conteudos relacionados aos objetivos deste estudo. Resultados: O vitiligo desenvolve-se pela associacao da predisposicao genetica e exposicao a fatores ambientais. O tratamento tem o objetivo de limitar a progressao da doenca, promover repigmentacao das areas afetadas e prevenir recidivas; podendo ser dividido em clinico, estetico e cirurgico. Os medicamentos topicos, os sistemicos, a fototerapia e os recentes imunobiologicos constituem tratamentos clinicos. O tratamento estetico e representado pela camuflagem cosmetica e o cirurgico e indicado para aqueles que apresentam doenca estavel nao responsiva a terapia clinica. Conclusao: O tratamento em geral e realizado pela associacao de terapias, razao pela qual deve ser individualizado para cada paciente. O inicio precoce do tratamento esta associado a um prognostico mais favoravel. Torna-se de extrema importancia nao negligencialo alem de conhecer inovacoes terapeuticas, tendo em vista o potencial estigmatizante da doenca; melhorando assim a pratica clinica e a qualidade de vida dos pacientes. Descritores: Vitiligo; Autoimunidade; Repigmentacao; Tratamento Farmacologico; Fototerapia; Cosmeticos; Cirurgia; Enxerto de tecido.</abstract><pub>Universidade de Sao Paulo. Departamento Cientifico da Faculdade de Medicina</pub><doi>10.11606/issn.1679-9836.v99i3p278-285</doi></addata></record>
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