Vitiligo - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

VITILIGO A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. P...

Author: ICON Health Publications

41 downloads 1069 Views 3MB Size Report

This content was uploaded by our users and we assume good faith they have the permission to share this book. If you own the copyright to this book and it is wrongfully on our website, we offer a simple DMCA procedure to remove your content from our site. Start by pressing the button below!

Report copyright / DMCA form

DOWNLOAD PDF

VITILIGO A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

ii

ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Vitiligo: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84236-1 1. Vitiligo-Popular works. I. Title.

iii

Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

iv

Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on vitiligo. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

v

About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

vi

About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

vii

Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON VITILIGO .................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Vitiligo .......................................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 17 The National Library of Medicine: PubMed ................................................................................ 17 CHAPTER 2. NUTRITION AND VITILIGO .......................................................................................... 61 Overview...................................................................................................................................... 61 Finding Nutrition Studies on Vitiligo......................................................................................... 61 Federal Resources on Nutrition ................................................................................................... 68 Additional Web Resources ........................................................................................................... 68 CHAPTER 3. ALTERNATIVE MEDICINE AND VITILIGO.................................................................... 71 Overview...................................................................................................................................... 71 National Center for Complementary and Alternative Medicine.................................................. 71 Additional Web Resources ........................................................................................................... 75 General References ....................................................................................................................... 77 CHAPTER 4. PATENTS ON VITILIGO ................................................................................................ 79 Overview...................................................................................................................................... 79 Patents on Vitiligo ....................................................................................................................... 79 Patent Applications on Vitiligo ................................................................................................... 85 Keeping Current .......................................................................................................................... 93 CHAPTER 5. BOOKS ON VITILIGO .................................................................................................... 95 Overview...................................................................................................................................... 95 Book Summaries: Online Booksellers........................................................................................... 95 The National Library of Medicine Book Index ............................................................................. 96 Chapters on Vitiligo..................................................................................................................... 97 CHAPTER 6. PERIODICALS AND NEWS ON VITILIGO .................................................................... 101 Overview.................................................................................................................................... 101 News Services and Press Releases.............................................................................................. 101 Newsletter Articles .................................................................................................................... 103 Academic Periodicals covering Vitiligo ..................................................................................... 103 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................. 105 Overview.................................................................................................................................... 105 U.S. Pharmacopeia..................................................................................................................... 105 Commercial Databases ............................................................................................................... 107 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 111 Overview.................................................................................................................................... 111 NIH Guidelines.......................................................................................................................... 111 NIH Databases........................................................................................................................... 113 Other Commercial Databases..................................................................................................... 115 The Genome Project and Vitiligo ............................................................................................... 115 APPENDIX B. PATIENT RESOURCES ............................................................................................... 121 Overview.................................................................................................................................... 121 Patient Guideline Sources.......................................................................................................... 121 Associations and Vitiligo ........................................................................................................... 127 Finding Associations.................................................................................................................. 128 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 131 Overview.................................................................................................................................... 131 Preparation................................................................................................................................. 131 Finding a Local Medical Library................................................................................................ 131

viii Contents

Medical Libraries in the U.S. and Canada ................................................................................. 131 ONLINE GLOSSARIES................................................................................................................ 137 Online Dictionary Directories ................................................................................................... 138 VITILIGO DICTIONARY............................................................................................................ 139 INDEX .............................................................................................................................................. 197

1

FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with vitiligo is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about vitiligo, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to vitiligo, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on vitiligo. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to vitiligo, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on vitiligo. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

3

CHAPTER 1. STUDIES ON VITILIGO Overview In this chapter, we will show you how to locate peer-reviewed references and studies on vitiligo.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and vitiligo, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “vitiligo” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Guidelines of Care for Vitiligo Source: Journal of the American Academy of Dermatology. 35(4):620-626; October 1996. Summary: This journal article for health professionals presents guidelines of care for vitiligo. This condition is defined, and the rationale for the guidelines is presented. Diagnostic criteria are outlined, including clinical criteria and physical examination findings. Tests that may be useful in the diagnosis of vitiligo are highlighted. Recommendations concerning the treatment of vitiligo are presented, focusing on topical and oral psoralen photochemotherapy, heliotherapy, topical corticosteroid therapy, depigmentation, adjunctive therapy, surgery, and evolving therapies. 30 references.

4

Vitiligo

•

Cytomegalovirus DNA Identified in Skin Biopsy Specimens of Patients with Vitiligo Source: Journal of the American Academy of Dermatology. 35:21-26; July 1996. Summary: This study determined the presence or absence of viral genomes in the depigmented and uninvolved skin of patients with vitiligo. Researchers used a polymerase chain reaction assay to detect viral genomes in paraffinembedded skin biopsy specimens. Twenty-nine patients with vitiligo and 22 control subjects participated. Biopsy specimens were screened in a blinded fashion for a panel of DNA and RNA viruses included herpes simplex, varicella-zoster, cytomegalovirus (CMV), Epstein-Barr, HIV, and human T-cell lymphotropic virus. Results show that CMV DNA was identified in 38 percent of the patients studied. Twenty-one percent had indeterminate results. Results in all control subjects were negative. Polymerase chain reaction screening for identification of other viral genomes was negative. Although not statistically significant, data trends suggested a correlation between the presence of CMV DNA in biopsy specimens and active vitiligo of relatively brief duration. In addition, CMV-positive patients had a statistically significant increased frequency of other concurrent autoimmune diseases. The results suggest that vitiligo may indeed by triggered by a viral infection in select patients. 3 tables, 52 references. (AA-M).

Federally Funded Research on Vitiligo The U.S. Government supports a variety of research studies relating to vitiligo. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to vitiligo. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore vitiligo. The following is typical of the type of information found when searching the CRISP database for vitiligo: •

Project Title: 2003 CONFERENCE PAN-AMERICAN SOCIETY PIGMENT CELL RESEA Principal Investigator & Institution: Halaban, Ruth; Senior Research Scientist; Dermatology; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2003; Project Start 04-SEP-2003; Project End 07-SEP-2003 Summary: (provided by applicant): The Pan-American Society for Pigment Cell Research (PASPCR) was established in 1987 for scientists and physicians from North, Central and South America who study the normal and abnormal biology of melanogenesis and the melanocyte. The PASPCR was started at the beginning of an

2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

Studies

5

exciting decade in biological research. Molecular biology has become widely applied and the methods and techniques for investigation have changed dramatically. It is now time to expand the horizon of the society by bringing important and new disciplines within its vision. The 2003 11th Annual Meeting has been organized with a focus on the molecular biology and genetics of normal and abnormal melanocytes. This meeting will be held at the Sea Crest Resort Conference Center at Cape Cod, MA on September 4-7, 2003.The theme of this meeting is "Molecular and Genetic Characterization of Melanocytes and Melanoma Cells." The overall objectives of the meeting are to exchange ideas and approaches, and to foster collaborations among members of the society and other investigators by bringing together scientists whose most recent publications advanced the field of pigment cell research and associated diseases such as melanoma, albinism and vitiligo. The Specific Aims of the proposal are: 1. To provide partial support for the travel and meeting expenses for 14 invited speakers for seven sessions during the 11th annual meeting of the PASPCR. These speakers are internationally recognized as leaders in their field, and, except for two, are not members of the PASPCR. 2. To provide partial support for rental room, poster and audiovisual expenses for the 11th annual meeting of the PASPCR. 3. To provide partial support to students and junior faculty to attend the meeting. They request funds for the 2003 meeting as well as for the 2 subsequent PASPCR annual meetings in years 2004 and 2006. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CHEMICAL CHEMOSENSITIVITY

GENETIC

APPROACH

TO

MELANOCYTE

Principal Investigator & Institution: Orlow, Seth J.; Professor; Dermatology; New York University School of Medicine 550 1St Ave New York, Ny 10016 Timing: Fiscal Year 2003; Project Start 25-SEP-2003; Project End 30-JUN-2005 Summary: (provided by applicant): Melanomas are typically resistant to a variety of chemotherapeutic agents. While the basis for chemoresistance of a number of neoplasms is generally understood, the mechanisms leading to melanoma chemoresistance are unclear. Moreover, sensitivity of melanocytes to cytotoxic insult has been implicated in the pathogenesis of vitiligo. Recently, the melanocyte-specific pink-eyed dilution (p) gene product has been implicated in controlling melanocyte sensitivity to cytotoxic compounds including arsenicals and cisplatin. Melanocytes from mice with a deletion of this gene are resistant to these agents and expression of the p gene in yeast leads to increased sensitivity to arsenical compounds and other metalloids. The availability of small molecules to dissect the operative pathways controlling the sensitivity of melanocytic cells to cytotoxic agents would be of value to basic researchers as well as offering potential therapeutic leads. A systems-based "chemical genetics" approach is proposed to further understanding of the pathways controlling these processes. Specific aims of the proposed research are: 1. Screening of a diverse triazine-based tagged library of 10,000 compounds in a simple cytotoxicity assay that will identify those compounds not inherently cytotoxic but capable of overcoming the resistance of melanocytes lacking p gene expression to arsenic and cisplatin. 2. Combinatorial chemistry to maximize the potency of lead compounds and to define structural requirements for activity. 3. Isolation of cellular targets for active compounds by affinity chromatography using immobilized compound. The molecules in this unique library all contain one of several long linkers at one of 3 R positions, allowing the construction of affinity matrices to rapidly isolate the targets of the lead compounds. Microsequencing of affinity-isolated targets will be performed and used to identify targets from protein databases. Findings from the proposed studies will result in a deeper understanding of the cellular

6

Vitiligo

pathways underlying melanocyte chemosensitivity, and in new research tools for cell biologists. The data should provide the basis for future therapeutics to treat metastatic melanoma and for purposes of depigmentation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL COMPONENT Principal Investigator & Institution: Kotzin, Brian L.; Professor and Head; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: The Denver Autoimmunity Center of Excellence encompasses a wide array of clinical investigators involved in studies of autoimmune diseases. The Denver ACE includes groups doing clinical investigation on type 1 diabetes, systemic lupus erythematosus and lupus nephritis, rheumatoid arthritis, systemic sclerosis, multiple sclerosis, autoimmune pulmonary diseases including interstitial lung disease and granulomatous lung disease, celiac disease, inflammatory bowel diseases, autoimmune polyendocrine syndromes and Addison's disease, and autoimmune skin diseases including vitiligo, pemphigus, and lupus-related rashes. These disease groups, involving multiple clinical specialties, departments, and institutions are part of the Denver ACE and have pledged their interest and support. In the original application and this renewal application, diseases being studied in individual clinical projects have included type 1 diabetes, systemic lupus erythematosus, rheumatoid arthritis, Addison's disease and autoimmune polyendocrine syndromes, celiac disease, and vitiligo. Among the different clinical components of the Denver ACE is the Barbara Davis Center for Childhood Diabetes, which is well known for its role in innovative research in the treatment and prevention of type 1 diabetes. The Denver ACE also includes a number of groups interested in the investigation of systemic lupus and two large Centers of multiple sclerosis patients. An important addition to the current renewal application is the addition of the rheumatology group at the University of Nebraska Medical Center and the Rheumatoid Arthritis Investigational Network (RAIN) of clinical rheumatologists and other personnel directed to the study of RA. In the preceding funding period, the Denver ACE has been involved in the design of clinical trials investigating the use of parenteral insulin for the prevention of islet cell autoimmunity and type 1 diabetes in high risk children, the use of a monoclonal antibody to complement component C5 in the treatment of lupus nephritis, and the use of mycophenolate with daclizumab in new onset type 1 diabetes. The Denver Center is also a collaborating site for ACE studies of anti-CD20 in systemic lupus. Two novel Phase II randomized, double-blind, and placebo-controlled protocols are included in the current renewal application. The first investigates the use of an insulin peptide B9-23 altered peptide ligand to prevent development of disease in patients with prediabetes. The second involves the use of a monoclonal antibody to CD20 (rituximab) in the treatment of patients with early (recent-onset) rheumatoid arthritis. Both trials will also involve considerable mechanistic studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: CONFERENCE--PIGMENT CELL RESEARCH Principal Investigator & Institution: King, Richard A.; Professor; Medicine; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2001; Project Start 19-JUL-2001; Project End 18-JUL-2002

Studies

7

Summary: (Taken from the applicant's abstract): The PanAmerican Society for Pigment Cell Research (PASPCR) was established in 1987 for scientists and physicians from North, Central and South America who study the normal and abnormal biology of melanogenesis and the melanocyte. The PASPCR was started at the beginning of a decade in biological research. Molecular biology has become widely applied and the methods and techniques for investigation have changed dramatically. It is now time to expand the horizon of the society, by bringing important and new disciplines within its vision. The 2001 10th Annual Meeting has been organized with symposia to bring new areas and new approaches to the study of the pigment cell. This meeting will be held in Minneapolis on June 14-17, 2001. The theme of this meeting will be New Approaches to the Pigment Cell. The overall objectives of the meeting are to expand ideas, approaches and collaborations for members of the society by bringing together experts from other disciplines of science who work in areas that are or should be relevant to pigment cell research and associated diseases such as melanoma, albinism and vitiligo. The Specific Aims of the proposed efforts are: 1. To provide partial support the travel and meeting expenses for 15 Invited Speakers for five symposia during the 10th annual meeting of the PASPCR. These speakers are internationally recognized as leaders in their field, and, except for two, and not members of the PASPCR.2. To provide partial support for room, poster and audiovisual expenses for the 10th annual meeting of the PASPCR. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CUTANEOUS BIOLOGY OF NITRIC OXIDE Principal Investigator & Institution: Lerner, Ethan A.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114

Associate

Professor;

Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-AUG-2003 Summary: It is proposed that nitric oxide (NO) is a critical messenger and effector molecule in skin physiology and homeostasis and that altered levels of NO in the skin cause disease. The goal of the proposal is to define the role of NO in skin with an emphasis towards determining the functional effects of this gas. Human, but not murine, keratinocytes have been demonstrated to have the capacity to express inducible form of nitric oxide synthase (iNOS) and produce NO. This critical difference between mice and men may explain why mice do not develop cutaneous eruptions analogous to those found in humans. Transgenic mice in which NOS is targeted to the skin mimic are shown here to develop phenotype found in human conditions. In conventional mice, iNOS is expressed in Langerhans cells (LC). NO is also produced by the LC-like cell line XS-52. NO produced in LC may affect LC function and, as NO is freely diffusible across cell membranes, it has the capacity to affect adjacent cells in the epidermis. Toxic effects of NO on melanocytes and keratinocytes suggest that NO may be an effector molecules in a number of skin conditions, including post-inflammatory hypo-pigmentation, vitiligo, graft versus host disease (GVH), scleroderma and the often fatal process, toxic epidermal necrolysis (TEN). In the proposed studies, purified LC will be evaluated for the production of iNOS using RT-PCR and measurement of NO using the Griess reaction and the conversion of radioactive L-arginine to citrulline. The effects of selected cytokines in the regulation of NOS will be examined. The effects of NO on XS-52 cells themselves will be studied. The mechanism of NO- induced killing of melanocytes and keratinocytes will be examined in co- culture experiments with XS-52 cells and via incubation with NO donors. Transgenic mice in which NOS expression is targeted to the epidermis have been produced, phenotypically develop white hair and histopathologically, scleroderma. These animals will be characterized further. Mice expressing NOS under the control of an inducible promoter will be generated. The

8

Vitiligo

transgenic mice will be tested as models for disorders of pigmentation, antigen presentation, scleroderma, TEN and GVH. These results have the potential to lead to novel therapeutic strategies for the treatment of human disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CYTOTOXIC MECHANISMS IN CUTANEOUS DISEASE Principal Investigator & Institution: Norris, David A.; Professor; Dermatology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-JAN-1980; Project End 31-AUG-2003 Summary: This is a request for an additional five years of funding for "Cytotoxic Mechanisms in Cutaneous Disease" which has been funded to sixteen years to study the mechanisms of immunologic damage to keratinocytes and melanocytes, a central component in important skin diseases such as photosensitive lupus erythematosus, vitiligo, erythema multiforme, toxic epidermal necrolysis and lichen planus. We have found that the epidermis is intrinsically resistant to immunologic cytotoxicity, due in large part to resistance of basal keratinocytes and melanocytes to apoptosis induced by immunologic triggers. We hypothesize that this resistance to apoptosis in undifferentiated keratinocytes and melanocytes is maintained by "survival" signals provided by growth factor activation of receptors and by extracellular matrix activating cell surface integrins. We propose to test the effect of growth factor and integrin blockade on the susceptibility of melanocytes and keratinocytes to induction of apoptosis by ultraviolet radiation (UVR), ionophore, anti-Fas, and cytokines. Using combinations of blocking, rescue and transfection experiments, we will verify that survival signals in melanocytes and keratinocytes are transmitted through ras activation, and directly regulate expression of important proteins which control apoptosis, such as bc1-2, and perhaps bc1-x, Bax and Bad. We will also study regulation of these important proteins following nuclear translocation of p53, and important trigger of apoptosis induced by UVR. This proposal addresses the molecular and cellular biology of a fundamental characteristic of the basal layer of the epidermis: its intrinsic resistance to immunologic cytotoxicity. Although these anti- apoptotic defenses protect the skin from unwanted effects of inflammation, they may also allow favor survival melanoma and squamous cell carcinoma. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: DEVELOPMENT NEUROTROPHINS

OF

MECHANORECEPTORS--ROLE

OF

Principal Investigator & Institution: Szeder, Viktor; Cell Biol, Neurobiol/Anatomy; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2001; Project Start 15-AUG-2000 Summary: Merkel cells are slowly adapting sensory receptors in the skin that are innervated by Abeta sensory neurons. Virtually nothing is known about the cellular and molecular mechanisms that control development and innervation of Merkel cells. My advisor, Prof. Grim, and his collaborators have shown that Merkel cells are derived from the neural crest and that their precursors migrate in the ventrolateral migratory pathway in the subectodermal space. The proposed work is designed to elucidate some of the roles growth factors play in the development of quail neural crest cells into Merkel cells. In Aim 1, Merkel cells in culture will be characterized at the ultrastructural level and compared to Merkel cells in the intact organism. In Aim 2, the expression

Studies

9

during embryonic development of pertinent growth factor receptors by Merkel cell precursors and maturing Merkel cells will be elucidated by indirect immunohistochemistry and in situ hybridization. Additionally, the autocrine and/or paracrine expression of the receptor ligands will be determined. Candidate growth factors include stem cell factor (SCF), epidermal growth factor (EGF), nerve growth factor (NGF) and neurotrophin-3 (NT-3). By use of the neural crest cell colony assay that has been developed in Prof. Sieber-Blum's laboratory, I propose in Aim 3 to assess the role of pertinent growth factors (as determined in Aim 2) in the survival, proliferation and differentiation of Merkel cells. The proposed work has relevance to human neurological disease. In individuals with anhidrotic ectodermal dysplasia, and in the corresponding mouse model, Tabby, there are no Merkel cells (Srivastava et al., 1997; Vielkind et al., 1995). This is most likely due to down-regulation of the EGF receptor. In vitiligo, Merkel cells as well as melanocytes are lost (Kumar Bose, 1994). A disrupted neurotrophin-3 gene in mice causes perinatal loss of Merkel cells and other neurodegenerative symptoms (Airaksinen et al., 1996). Merkel cell carcinoma (small, intermediate and trabecular types) is a relatively frequent tumor (Schmidt et al., 1998). Insights into the mechanisms that regulate normal Merkel cell development may prove useful in future approaches for the prevention or treatment of neurological disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENETIC & IMMUNOLOGICAL STUDIES OF VITILIGO Principal Investigator & Institution: Mccormack, Wayne T.; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2001 Summary: The purpose of this study is to understand the nature of vitiligo. This skin disease may be related to the fact that the immune system attacks cells that give the skin its color. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: IDENTIFYING THE VITILIGO RELATED SLE GENE ON 17P13 Principal Investigator & Institution: Nath, Swapan K.; Oklahoma Medical Research Foundation Oklahoma City, Ok 73104 Timing: Fiscal Year 2002; Project Start 05-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): Recently, we published tantalizing evidence locating a gene affecting susceptibility to systemic lupus erythematosus (SLE), and possibly vitiligo, in vitiligo related lupus families on 17p13 (1). Our goal for this proposal is to narrow the susceptibility region and to identify the susceptibility gene. We will achieve this by iterative reduction in the size of the chromosomal region. To improve the power of the study, specific aim 1 is to first augment our current data with new data, identified from our ongoing SLE genetic linkage projects. We will then narrow our previously identified susceptibility region in two steps. First, in specific aim 2, we will choose microsatellite markers to form a 1-2 cM map across the current susceptibility region and analyse these data using genetic linkage methods. Second, in specific aim 3, we will choose single nucleotide polymorphism (SNP) markers to form a 0.5 cM map across the reduced region from specific aim 2 and analyse these data using linkage disequilibrium methods. In the final step, specific aim 4, we will search the public databases for SNPs in genes known to be located in the narrowed susceptibility region established by specific aim 3 and to analyse these using linkage disequilibrium methods. Specific aim 5 is to sequence the gene to find the causal mutations. We ascertained families with European

10

Vitiligo

American ancestry, multiplex for SLE and each family has at least one member afflicted with vitiligo. Since autoimmune diseases are thought to share some of their genetic origins, decreasing sample heterogeneity would increase the power to identify the susceptibility gene(s). As the presence of vitiligo in the family was used as a pedigree ascertainment criterion, and there was significantly higher risk associated with developing vitiligo among the family members affected with SLE compared to non-SLE family members, we postulated the following hypotheses: SLE and vitiligo may share common autoimmune genetic determinant(s) for their pathophysiology. Alternatively, we may assert that there are genes that lead primarily to develop SLE, which may also modify the risk of developing vitiligo, at least among the ascertained families. Our preliminary results support the hypothesis that SLE and vitiligo may share common genetic determinant(s) (1). This project is directly relevant to the goals of NIAMS SMALL GRANT PROGRAM FOR NEW INVESTIGATORS and has the potential to reveal important, previously unappreciated, susceptibility genes, which contribute toward understanding the etiology of SLE and vitiligo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IGF-1 APOPTOTIC DEFENSES IN MELANOCYTES AND VITILIGO Principal Investigator & Institution: Morelli, Joseph G.; Dermatology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2003 Summary: Vitiligo affects 1 percent of the population worldwide. This very common skin affliction is of great significance among dark skinned people in the United States and worldwide. In many countries and societies people with vitiligo are treated as outcasts. We propose that the defenses of melanocytes against cell death are overcome in vitiligo, and must be restored during vitiligo repigmentation. We hypothesize that Insulin-like Growth Factor 1 (IGF-1) is a critical mediator of melanocyte function, stimulating melanocyte movement and proliferation and promoting melanocyte survival by maintaining anti-apoptotic defenses. This proposal will define the IGF-1 anti-apoptotic defenses of melanocytes. Specific Aim 1 will demonstrate that IGF-1 maintains the resistance of human melanocytes to apoptosis and will determine which anti-apoptotic proteins are controlled by IGF-1. Specific Aim 2 will determine which of these IFG-1 effects are mediated through the Ras signaling pathway. Specific Aim 3 will determine whether IGF-1 dependent anti-apoptotic defenses are mediated through PI3K or AKT/PBK. Specific Aim 4 will determine whether intergrin receptors and the IGF-1 receptor act synergistically to control anti-apoptotic defenses in melanocytes. These project is innovative because it: i). Applies modern knowledge of the molecular control of apoptosis and cell death to the study of melanocyte survival, a fundamental biologic feature relevant to human vitiligo, and ii) focuses attention on the role of IGF-1 in melanocyte biology. IGF-1 is a powerful mediator of melanocyte function and mediates crucial survival mechanism in other types of cells. The experiments proposed in this RO3 grant will provide the preliminary data for a future RO1 on IGF-1 as a survival factor in vitiligo. The detailed mechanistic studies of IGF-1 control of melanocyte survival will provide a proper basis for questions concerning the relative role of IGF-1 in melanocyte destruction in vitiligo, and of melanocyte survival during repigmentation of vitiligo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies

•

11

Project Title: MAPPING OF VITILIGO SUSCEPTIBILITY GENES Principal Investigator & Institution: Spritz, Richard A.; Professor and Director; Biochem & Molecular Genetics; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2003 Summary: Generalized vitiligo is a common, non-contagious disorder, characterized by progressive patchy loss of pigmentation of the skin, overlying hair, oral mucosa, and occasionally eyes, due to progressive loss of pigment forming melanocytes in the affected areas Vitiligo is thought to be autoimmune in origin, and frequently is associated with other autoimmune disorders. The prevalence of vitiligo is approximately 0.1 to 0.3 percent in different ethnic or racial groups. Vitiligo is most significant in dark-skinned populations, for its pigmentary disfigurement produces social stigmatization and is often confused with leprosy or other socially terrifying infectious diseases. But it can be a devastating disorder to those affected in any population. In preparation for this study, we conducted a survey of vitiligo patients in the United Kingdom, the largest ever done, thereby ascertaining a large cohort of families with vitiligo. These data were consistent with other studies in suggesting a total risk to first-degree relative of probands of about 7%. Further, one or more susceptibility loci appears to account for an apparent autosomal dominant inheritance of vitiligo. Further, one or more susceptibility loci appears to account for an apparent autosomal dominant inheritance of vitiligo in a fraction (approximately 8%) of families. However, the major gene(s) in these families does not account for the total increased risk for vitiligo in relatives, suggesting that susceptibility alleles with lower penetrance at the same or different loci are important in other families. These results suggest a mixed model for the inheritance of vitiligo, which has also been reported for many other complex disorders. The proposed studies will combine the UK vitiligo family cohort with a similarly sized vitiligo family cohort in the USA. Utilizing these resources, and 400 polymorphic markers spaced at approximately 10 cM intervals throughout the genome, we proposed a two-phased approach to mapping vitiligo susceptibility loci. The specific aims are: 1) Map autosomal dominant vitiligo susceptibility loci by parametric linkage analysis in families with 4 or more affected relatives; and (2) map other vitiligo susceptibility loci by parametric linkage analysis in families with 4 or more affected relatives; and (2) map other susceptibility genes using non-parametric linkage analysis in affected sib pairs. This rational and comprehensive approach will provide the greatest likelihood of mapping vitiligo susceptibility loci, thereby accelerating the identification, and the molecular, cellular, clinical, and epidemiological characterization, of the disease genes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: MOLECULAR MELANOCYTES

MECHANISMS

OF

SOD/GSH

GENES

IN

Principal Investigator & Institution: Bowers, Roger R.; Professor; California State University Los Angeles 5151 State University Dr Los Angeles, Ca 90032 Timing: Fiscal Year 2001 Summary: A hypothesis is proposed for premature death in Barred Plymouth Rock (PBR) and White Leghorn (WL) chicken melanocytes. BPR melanocytes are genetically sensitive due to a defect in their SOD and GSH levels caused by the barring gene and die prematurely from oxygen radical toxicity. WL chickens carry the dominant white gene in addition to the barring gene and have a further reduction of SOD and their

12

Vitiligo

melanocytes die much earlier than the BPR melanocytes. Some forms of human vitiligo may be caused by a similar mechanism. The specific aims are focused to further test this hypothesis and to elucidate at the molecular gene level why SOD and GSH levels are low in the mutant birds and to determine the role that the keratinocytes may play in these vitiliginous avian models. The in vivo experiments are as follows: (1) Isolation of Cytosolic (CT) Cu/Zn bird using a competitive reference standard and RT-PCR. Sequence and compare the CT Cu/Zn SOD of the WLH with the BPR and JF. Comparisons will also include other species. Compare and assess differences in CT SOD between the 3 bird types by expression of the enzyme under a single promoter. (2) Analysis of three CT SOD between the 3 bird types by expression of the enzyme under a single promoter. (2) Analysis of three important enzymes in glutathione metabolism will be performed in JF, BPR and WL feature tissue with the JF serving as a control. If the down regulation of GSH is determined to be caused by one or more of the enzymes involved, then a molecular characterization of the mutant gene will be performed in the same manner as that for the SOD gene. (3) A thorough light and electron microscope study of the JF, BPR and WL feature melanocytes and keratinocytes will be performed to determine if any structural aberrations like those described in human vitiligo melanocytes occur in these mutant line cells. Enzymes associated with melanogenesis and cell death will be analyzed cytochemically in the melanocytes. In all cases, the JF will serve as a control. The in vitro studies consist of: (1) establishing the primary melanocyte cultures of the JF, BPR MSH to the media or by not changing the media. (2) Thorough electron microscope studies will be done on these three genotypes of melanocytes in normal and premature death conditions to see if the morphology is similar to that of the in vivo normal and dying melanocytes. (3) Since keratinocytes may play a large role in the survival and differentiation of the melanocytes, SOD, GSH, catalase,. GSH-peroxidase under normal and oxygen radical stress conditions. The measurements of the above parameters of the feather tissue, which predominately includes the keratinocytes and few melanocytes, has already been performed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NOVEL OLIGOPEPTIDES AS TOPICAL SKIN LIGHTENING AGENTS Principal Investigator & Institution: Leyda, James P.; Emerging Concepts, Inc. 3130 Highland Ave, Ste 3115 Cincinnati, Oh 45219 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2003 Summary: (Verbatim) - Hyperpigmentary skin disorders affect several millions of people worldwide and are often the cause of social, life style and emotional problems. These disorders include solar lentigines (liver spots), vitiligo, freckles, and darkening of grafted skin. Additionally, the desire for skin whitening cosmetics is common in various cultures around the world. Current treatments lightening skin are usually topically applied harsh chemicals, such as hydroquinone or its derivatives, but overall lack reliability in efficacy and have issues of safety. We have isolated and characterized a unique and potent skin lightening protein from hyperpigmented xenographs. This natural agent provides a new approach to blocking the formation of melanin, the cause of hyperpigmentation. In both in vitro and in vivo models, the protein effectively inhibits the activity of tyrosinase, a marker for hyperpigmentation. A small fragment of the protein has been identified that effectively mimics the in vitro activity. The goals of these Phase I studies are to demonstrate in vivo effectiveness of the fragment and to identify a small series of peptides for optimization and clinical evaluation in Phase II. The effective topical products from Phase II will provide the prototype product for

Studies

13

commercialization in Phase III. PROPOSED COMMERCIAL APPLICATION: A topical skin lightening product has significant commercial medical opportunities in the prevention and treatment of skin discoloration disorders and in cosmeceutical use. Burn victims, the aging and other individuals with skin hyperpigmentation exist by the millions throughout the world. This would be a significant market. The cosmeceutical uses expand the potential many fold. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHENOLS/CATECHOLS IN OCCUPATIONAL/CONTACT VITILIGO SKIN Principal Investigator & Institution: Boissy, Raymond E.; Professor; Dermatology; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: Complexion coloration is essential to ones health, self-image, and thus overall wellness, both physically and psychologically. Cutaneous pigmentation protects a person from various environmental assaults, like ultraviolet light, as well as potential cellular injury, that can cause cancer and aging of the skin. Loss of skin pigmentation can result in cancer, aging, and compromised immunity of the skin as well as psychological and social problems of self- esteem and personal interactions. Occupational/contact vitiligo is a disease that results in the loss of cutaneous pigmentation. This form of vitiligo occurs relatively frequently in individuals exposed to phenolic/catecholic derivatives primarily in the work place. This disease can be financially and socially devastating for the individual, in addition to it compromising the productivity in the workplace. The general goal of this proposal is to assess the pathological effects of phenolic and catecholic derivatives on melanocytes. These prevalent chemical toxins are responsible for the development of occupational/contact vitiligo in the skin of some individuals exposed to these environmental agents in the workplace. Specifically, we propose to assess the relative cytotoxicity, the interaction with tyrosinase, and the generation of toxic free radical products within melanocytes exposed to various phenolic and catecholic derivatives. In this assessment, we will determine whether melanocytes from all patients with vitiligo, patients with the occupational/contact form of vitiligo, family members of patients with vitiligo, and/or a subset of the population in general, are more sensitive to cytotoxicity by these phenolic/catecholic derivatives. In addition, we will assess [1] genes that are differentially expressed and [2] regulators of apoptosis in cells treated with phenolic/catecholic derivatives. In addition, we will determine whether the response of these molecules is altered in vitiligo melanocytes demonstrated to be more susceptible to cytotoxicity. Finally, we will assess the effectiveness of various antioxidants, especially catalase, in dampening the cytotoxic effect of phenolic/catecholic derivatives using cultured melanocytes, organotypic cultures of human skin, and a guinea pig model. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: PRECLINICAL STUDY OF PEPTIDE BASED HUMAN TUMOR VACCINES Principal Investigator & Institution: Engelhard, Victor H.; Professor of Microbiology; Beirne Carter Center for Immunology Research; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2001; Project Start 01-SEP-1998; Project End 30-JUN-2003

14

Vitiligo

Summary: (Adapted from the Investigator's Abstract): Peptide antigens presented by class I MHC molecules and recognized by cytotoxic T lymphocytes (CTL) have been defined for several infectious agents and tumors of both murine and human origin. These peptides represent attractive candidates for the development of therapeutic and/or prophylactic vaccines for diseases in which CTL play an important role, including cancer. The technology for appropriate delivery of peptide antigens is still new and undergoing rapid development, and no consensus methodology exists. In addition, while CTL responses against pathogens and tumors have been stimulated by many of these methods, there have also been numerous failures. One important factor in the use of peptide antigens is that their affinity for the presenting MHC molecule will influence the level at which they are presented by APC in order to stimulate a CTL response, as well as their display on an infected cell or a tumor. In this regard, a large set of peptide antigens that are the subject of a number of clinical trials are those that have been defined as CTL targets on human melanoma cells. However, most of these peptides have a relatively low affinity for the presenting molecule HLA-A*0201, and it is not clear how to deliver these antigens in order to stimulate the most effective CTL. In addition, reproducible and generally accepted criteria for the development of effective CTL in response to vaccination are not well established. Therefore, it is important to develop means of quantifying CTL activity that bear a direct relationship to therapeutic efficacy. Comprehensive evaluation of these issues in vaccine delivery methodology in early stage clinical trials is prohibitive because of the difficulty in enrolling significant numbers of patients in many different protocols and comparing results obtained by the use of different methods. Therefore, development of appropriate preclinical models is a desirable goal. The specific aims of this proposal will lead to the definition of methodology to measure both CTL number and avidity, and the use of this methodology to evaluate the importance of these parameters in effective tumor-specific immune responses. In addition, the impact of peptide affinity for MHC molecules on both the stimulation of CTL and their effectiveness in tumor destruction will be examined systematically. These issues will be addressed through the development of a preclinical model that will allow the evaluation of effective immune responses to peptide antigens that are presented by human class I MHC molecules. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: R METHUSCF IN PATIENTS W/ VITILIGO Principal Investigator & Institution: Pandya, Amit G.; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2001 Summary: There is no text on file for this abstract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: ROLE OF MELANOCYTE DEFECT IN SMYTH LINE VITILIGO Principal Investigator & Institution: Erf, Gisela F.; Assistant Professor; Poultry Science; University of Arkansas at Fayetteville Fayetteville, Ar 72701 Timing: Fiscal Year 2001; Project Start 11-JUL-2001; Project End 30-JUN-2004 Summary: (provided by applicant): Vitiligo is a common acquired hypopigmentary disorder characterized by a loss of epidermal melanocytes. Although the pathogenesis of vitiligo is still poorly understood, evidence suggests that in many cases vitiligo is an autoimmune disorder and melanocyte loss is the result of an immunological response. The mutant Smyth line chicken is an accepted animal model for autoimmune vitiligo.

Studies

15

Chickens from this line develop a spontaneous, vitiligo-like, postnatal loss of melanin producing pigment cells (melanocytes) in feather and choroidal tissue between 6 and 14 weeks of age. Like many autoimmune diseases, SL vitiligo is a multifactorial disorder, involving an inherent melanocyte defect, an immune system component, and an environmental component. Studies examining the basic defect manifested within the SL melanocyte describe the presence of a competent pigment system at hatch. Prior to visible signs of vitiligo, the earliest abnormality detected within SL melanocytes are irregularly shaped melanosomes containing pigmented membrane extensions, hyperactive melanization, and selective autophagocytosis of melanosomes. These aberrant processes precede the degeneration of SL melanocytes in vivo and in vitro but are not sufficient to cause the expression of vitiligo without a functioning immune system. Mechanisms underlying the dysfunction, progressive degeneration, and eventually, immune recognition and destruction of SL melanocytes are poorly understood. It is the goal of this proposal to study the mechanism by which the local and internal environment of the vitiliginous SL melanocyte contributes to and/or results in the degeneration of melanocytes and the development of autoimmune vitiligo. Specifically, we propose to investigate the role of oxidative stress, antioxidant capacity, inflammatory mediators and immunofunctional activities of melanocytes in the degeneration/survival of melanocytes in vivo and in vitro. These studies will be carried out using feather tissue and melanocyte cultures from SL chickens that are highly susceptible to the development of vitiligo, parental BL chickens that are susceptible to the development of vitiligo but rarely express vitiligo, and LBL chickens that are vitiligo resistant. The knowledge that will be gained from these studies regarding the underlying mechanism of the SL melanocyte's inherent susceptibility for degeneration and autoimmune destruction. may open up new venues for treatment and prevention of this disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SEROLOGICAL EXPRESSION ANALYSIS OF VITILIGO AND ALOPECIA Principal Investigator & Institution: Setaluri, Vijayasaradhi; Associate Professor; Dermatology; Wake Forest University Health Sciences Winston-Salem, Nc 27157 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2003 Summary: (Taken from the application): Autoimmune reactions to components of skin and its appendages produce a spectrum of skin diseases. Vitiligo, characterized by partial or complete loss of skin pigmentation and alopecia areata, a chronic inflammatory hair disorder are two such diseases. Interestingly, while certain autoimmune skin disorders such as bullous diseases result from reactions limited to specific components of skin, vitiligo and alopecia often manifest in association with other autoimmune diseases. This suggests that immune tolerance to self-antigens on pigment producing melanocytes and cells in the hair follicles is broken relatively easily. The molecular identity of these antigens and the role of humoral vs. cellular immune responses in the pathogenesis of these diseases remain unknown. Biochemical and immunocytochemical techniques employed to identify antigens recognized by autoantibodies in the sera of patients have failed to yield definitive knowledge of target antigens in these disorders. Similarly, methodological limitations in analyzing and characterizing T lymphocytes in vitro have precluded extensive studies on the role of T cells in the pathogenesis of vitiligo and alopecia. Recent developments in the field of human tumor immunology provide an opportunity to overcome these limitations on molecular identification of targets for immune responses in autoimmune skin disorders.

16

Vitiligo

First, it has been demonstrated that screening cDNA expression libraries with serum antibodies from cancer patients can be used to identify antigen targets for humoral responses. Second, this screening method, termed SEREX, also allows identification of antigens recognized by cytotoxic CD8 T cells in patients with cancer. Together with recent studies that showed the presence of HLA class II-restricted CD4 T cells to tumor antigen recognized by CD8 cells, these observations from SEREX analysis reinforce the concept of simultaneous presentation of self-antigens to humoral and cellular immune systems. This raises the possibility that SEREX analysis with sera from patients with autoimmune skin disorders could allow identification of tissue-specific antigens recognized by antibodies and T cells. Molecular identification of the array of antigens targeted for immune response in these diseases will help delineate mechanisms of their pathogenesis. We propose to generate cDNA expression libraries from pooled cultures of neonatal melanocytes obtained from different racial backgrounds and pooled hair follicles microdissected from normal scalp biopsies. These expression libraries will provide a source of unlimited supply of tissue-specific gene products to begin dissecting immune responses by SEREX analysis. It is expected that such analysis will allow identification of targets for both antibody and T cell responses in vitiligo and alopecia areata. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STRESS PROTEINS IN AUTOIMMUNE DEPIGMENTATION Principal Investigator & Institution: Le Poole, Isabelle C.; Oncology Institute; Loyola University Medical Center Lewis Towers, 13Th Fl Chicago, Il 60611 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): Vitiligo is a pigmentary disorder that leaves patients with disfiguring white skin patches increasing in size over time. Especially for teenagers, the associated change in appearance can be devastating. In recent years, it has become clear that the expansion of lesions is associated with an autoimmune response specifically targeting melanocytes, the pigment-synthesizing cells of the skin. Genes associated with the development of vitiligo support the concept, that vitiligo should be considered a hereditary autoimmune disorder. What remains to be explored is the factors that contribute to the onset of disease, as prevention or intervention should preferably take place at this stage. Patients frequently experience skin trauma prior to the onset of new lesions. Precipitating factors include mechanical injury, contact with bleaching phenols, and overexposure to UV light. Such factors impose stress on the skin, and induce the expression of stress proteins to protect affected cells from undergoing apoptosis. These same stress proteins also serve immunogenic functions, evoking an immune response to the cells from which they are derived. The hypothesis underlying the current project is that stress proteins mediate the initiation of an immune response to melanocytes. Stress proteins aberrantly expressed in actively depigmenting vitiligo skin (including HSP27 and HSP70) will be assessed for their contribution to activation of dendritic cells (DCs), particularly in relation to recently discovered cytotoxic effector functions. Molecules mediating such effectormechanisms will be explored, as will accompanying receptor molecules on targeted melanocytes. Since expression of molecules involved in T cell recognition of melanocytes is altered following stress, the consequences for T cell responses will also be explored. In vitro results will be correlated to gene expression observed in depigmenting vitiligo skin and in skin maintained under stress. Finally, a mouse model will be generated that incorporates knowledge acquired in melanoma research, where vitiligo frequently develops in response to successful tumor immunotherapy. Pelage depigmentation serves as areadout for immune

Studies

17

responses directed to melanocytes after immunizing mice with and without stress proteins, to define the role of stress proteins in an in vivo model. The same model will be of use to test the efficacy of therapeutic modalities to be developed for vitiligo in the future. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “vitiligo” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for vitiligo in the PubMed Central database: •

Quality of life in patients with vitiligo. by Parsad D, Dogra S, Kanwar AJ.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=269995

•

The melanin-concentrating hormone receptor 1, a novel target of autoantibody responses in vitiligo. by Kemp EH, Waterman EA, Hawes BE, O'Neill K, Gottumukkala RV, Gawkrodger DJ, Weetman AP, Watson PF.; 2002 Apr 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=150932

•

Vaccination with a recombinant vaccinia virus encoding a "self" antigen induces autoimmune vitiligo and tumor cell destruction in mice: Requirement for CD4 + T lymphocytes. by Overwijk WW, Lee DS, Surman DR, Irvine KR, Touloukian CE, Chan CC, Carroll MW, Moss B, Rosenberg SA, Restifo NP.; 1999 Mar 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=15881

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. 3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

18

Vitiligo

To generate your own bibliography of studies dealing with vitiligo, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “vitiligo” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for vitiligo (hyperlinks lead to article summaries): •

A case of giant congenital nevocytic nevus with neurotization and onset of vitiligo. Author(s): Shin JH, Kim MJ, Cho S, Whang KK, Hahm JH. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 July; 16(4): 384-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12224698&dopt=Abstract

•

A comment on dressings for the recipient area of split-thickness skin grafts in vitiligo. Author(s): Mysore V. Source: Journal of the American Academy of Dermatology. 2002 June; 46(6): 961-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12063502&dopt=Abstract

•

A double-blind randomized trial of 0.1% tacrolimus vs 0.05% clobetasol for the treatment of childhood vitiligo. Author(s): Lepe V, Moncada B, Castanedo-Cazares JP, Torres-Alvarez MB, Ortiz CA, Torres-Rubalcava AB. Source: Archives of Dermatology. 2003 May; 139(5): 581-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756094&dopt=Abstract

•

A genomewide screen for generalized vitiligo: confirmation of AIS1 on chromosome 1p31 and evidence for additional susceptibility loci. Author(s): Fain PR, Gowan K, LaBerge GS, Alkhateeb A, Stetler GL, Talbert J, Bennett DC, Spritz RA. Source: American Journal of Human Genetics. 2003 June; 72(6): 1560-4. Epub 2003 April 18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707860&dopt=Abstract

•

A symbiotic concept of autoimmunity and tumour immunity: lessons from vitiligo. Author(s): Das PK, van den Wijngaard RM, Wankowicz-Kalinska A, Le Poole IC. Source: Trends in Immunology. 2001 March; 22(3): 130-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11286727&dopt=Abstract

•

Aberrant expression of complement regulatory proteins, membrane cofactor protein and decay accelerating factor, in the involved epidermis of patients with vitiligo. Author(s): van den Wijngaard RM, Asghar SS, Pijnenborg AC, Tigges AJ, Westerhof W, Das PK. Source: The British Journal of Dermatology. 2002 January; 146(1): 80-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11841370&dopt=Abstract

Studies

19

•

Acquired leukoderma in congenital pigmented nevus associated with vitiligo-like depigmentation. Author(s): Itin PH, Lautenschlager S. Source: Pediatric Dermatology. 2002 January-February; 19(1): 73-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11860577&dopt=Abstract

•

An association of twenty-nail dystrophy with vitiligo. Author(s): Khandpur S, Reddy BS. Source: The Journal of Dermatology. 2001 January; 28(1): 38-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280463&dopt=Abstract

•

An interesting case of colocalization of segmental lichen planus and vitiligo in a 14year-old boy. Author(s): Sardana K, Sharma RC, Koranne RV, Mahajan S. Source: International Journal of Dermatology. 2002 August; 41(8): 508-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12207769&dopt=Abstract

•

Antimelanoma immunity in vitiligo and melanoma patients. Author(s): Juranic ZD, Stanojevic-Bakic N, Zizak Z, Babovic N, Radovic-Kovacevic V, Stanojkovic T, Dzodic R. Source: Neoplasma. 2003; 50(4): 305-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937846&dopt=Abstract

•

Approaches to repigmentation of vitiligo skin: new treatment with ultrasonic abrasion, seed-grafting and psoralen plus ultraviolet A therapy. Author(s): Tsukamoto K, Osada A, Kitamura R, Ohkouchi M, Shimada S, Takayama O. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2002 October; 15(5): 331-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213088&dopt=Abstract

•

Associated localization of morphea and lichen planus of the lip in a patient with vitiligo. Author(s): Melato M, Gorji N, Rizzardi C, Maglione M. Source: Minerva Stomatol. 2000 November-December; 49(11-12): 549-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11345685&dopt=Abstract

•

Association between catechol-O-methyltransferase polymorphism and vitiligo. Author(s): Tursen U, Kaya TI, Erdal ME, Derici E, Gunduz O, Ikizoglu G. Source: Archives of Dermatological Research. 2002 May; 294(3): 143-6. Epub 2002 March 02. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12029502&dopt=Abstract

20

Vitiligo

•

Association of vitiligo with Sjogren's syndrome. Author(s): Montes LF, Pfister R, Elizalde F, Wilborn W. Source: Acta Dermato-Venereologica. 2003; 83(4): 293. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926804&dopt=Abstract

•

Autoantibodies in vitiligo patients are not directed to the melanocyte differentiation antigen MelanA/MART1. Author(s): Waterman EA, Kemp EH, Gawkrodger DJ, Watson PF, Weetman AP. Source: Clinical and Experimental Immunology. 2002 September; 129(3): 527-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197895&dopt=Abstract

•

Autoantibodies in vitiligo patients recognize multiple domains of the melaninconcentrating hormone receptor. Author(s): Gottumukkala RV, Waterman EA, Herd LM, Gawkrodger DJ, Watson PF, Weetman AP, Kemp EH. Source: The Journal of Investigative Dermatology. 2003 October; 121(4): 765-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14632194&dopt=Abstract

•

Autoimmune aspects of vitiligo. Author(s): Kemp EH, Waterman EA, Weetman AP. Source: Autoimmunity. 2001; 34(1): 65-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11681494&dopt=Abstract

•

Autoimmune diseases in vitiligo: do anti-nuclear antibodies decrease thyroid volume? Author(s): Zettinig G, Tanew A, Fischer G, Mayr W, Dudczak R, Weissel M. Source: Clinical and Experimental Immunology. 2003 February; 131(2): 347-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562399&dopt=Abstract

•

Autoimmune melanocyte destruction in vitiligo. Author(s): van den Wijngaard R, Wankowicz-Kalinska A, Pals S, Weening J, Das P. Source: Laboratory Investigation; a Journal of Technical Methods and Pathology. 2001 August; 81(8): 1061-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502857&dopt=Abstract

•

Autoimmune thyroiditis and vitiligo in a child with minimal change nephrotic syndrome. Author(s): Kuzmanovska DB, Shahpazova EM, Kocova MJ, Gruevska SJ, Petrushevska G. Source: Pediatric Nephrology (Berlin, Germany). 2001 December; 16(12): 1137-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11793116&dopt=Abstract

Studies

21

•

Behavior of pigment cells on lesions of the pigmented venus with vitiligo. Author(s): Hamada T, Sakurane HF, Saito T. Source: The Journal of Dermatology. 1979 June; 6(3): 143-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=393743&dopt=Abstract

•

Beta-adrenergic blocking drugs may exacerbate vitiligo. Author(s): Schallreuter KU. Source: The British Journal of Dermatology. 1995 January; 132(1): 168-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7756145&dopt=Abstract

•

Bilateral retinal pigment epithelium changes associated with periorbital vitiligo and seizure disorders. Author(s): Rosenbaum J, Bunke A, Cooperman E, Gombos GM. Source: Ann Ophthalmol. 1979 August; 11(8): 1191-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=556146&dopt=Abstract

•

Biologic characteristics of cultured human vitiligo melanocytes. Author(s): Im S, Hann SK, Kim HI, Kim NS, Park YK. Source: International Journal of Dermatology. 1994 August; 33(8): 556-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7960351&dopt=Abstract

•

Biological role of tyrosinase-related protein and its relevance to pigmentary disorders (vitiligo vulgaris). Author(s): Jimbow K. Source: The Journal of Dermatology. 1999 November; 26(11): 734-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10635615&dopt=Abstract

•

Blue vitiligo. Author(s): Mutalik S. Source: Journal of the American Academy of Dermatology. 1995 July; 33(1): 144. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7601938&dopt=Abstract

•

Blue vitiligo. Author(s): Ivker R, Goldaber M, Buchness MR. Source: Journal of the American Academy of Dermatology. 1994 May; 30(5 Pt 2): 829-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8169254&dopt=Abstract

•

Broad band ultraviolet light, midrange sunbeam spectrum in the treatment of vitiligo. Author(s): Sharma VK, Ramam M. Source: Trop Doct. 2002 April; 32(2): 93-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11931211&dopt=Abstract

22

Vitiligo

•

Calcipotriol ointment versus clobetasol ointment in localized vitiligo: an open, comparative clinical trial. Author(s): Kose O, Riza Gur A, Kurumlu Z, Erol E. Source: International Journal of Dermatology. 2002 September; 41(9): 616-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358838&dopt=Abstract

•

Can cognitive-behavioral therapy help patients with vitiligo? Author(s): Picardi A, Abeni D. Source: Archives of Dermatology. 2001 June; 137(6): 786-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11405772&dopt=Abstract

•

Carbon dioxide laser resurfacing and thin skin grafting in the treatment of “stable and recalcitrant” vitiligo. Author(s): Acikel C, Ulkur E, Celikoz B. Source: Plastic and Reconstructive Surgery. 2003 March; 111(3): 1291-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621204&dopt=Abstract

•

Carbon dioxide laser resurfacing and thin skin grafting in the treatment of stable and recalcitrant vitiligo. Author(s): Achauer BM. Source: Plastic and Reconstructive Surgery. 2003 September 15; 112(4): 1176. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12973243&dopt=Abstract

•

Case report: chronic dermatophyte infection in a patient with vitiligo and discoid lupus erythematosus. Author(s): Khosravi AR, Mansouri P, Moazzeni M. Source: Mycoses. 2000 September; 43(7-8): 317-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11036404&dopt=Abstract

•

Childhood vitiligo and tacrolimus: immunomodulating treatment for an autoimmune disease. Author(s): Plettenberg H, Assmann T, Ruzicka T. Source: Archives of Dermatology. 2003 May; 139(5): 651-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756103&dopt=Abstract

•

Chloroquine-induced, vitiligo-like depigmentation. Author(s): Martin-Garcia RF, del R Camacho N, Sanchez JL. Source: Journal of the American Academy of Dermatology. 2003 June; 48(6): 981-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789201&dopt=Abstract

Studies

23

•

Clinical course of 44 cases of localized type vitiligo. Author(s): Zaima H, Koga M. Source: The Journal of Dermatology. 2002 January; 29(1): 15-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837568&dopt=Abstract

•

Clinical evaluation of vitiligo and its relationship with viral hepatitis. Author(s): Adiloglu AK, Basak PY, Baysal V. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2003 May; 17(3): 365-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702096&dopt=Abstract

•

Clinical picture: leopard-like vitiligo with capecitabine. Author(s): Schmid-Wendtner MH, Wendtner CM, Volkenandt M, Heinemann V. Source: Lancet. 2001 November 10; 358(9293): 1575. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11716883&dopt=Abstract

•

Clinical presentation of vitiligo. Author(s): Jaigirdar MQ, Alam SM, Maidul AZ. Source: Mymensingh Med J. 2002 July; 11(2): 79-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12395673&dopt=Abstract

•

Coexistence of psoriasis vulgaris, bullous pemphigoid and vitiligo: a case report. Author(s): Pasic A, Ljubojevic S, Lipozencic J, Marinovic B, Loncaric D. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 July; 16(4): 426-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12224717&dopt=Abstract

•

Coexistence of vitiligo and sarcoidosis in a patient with circulating autoantibodies. Author(s): Terunuma A, Watabe A, Kato T, Tagami H. Source: International Journal of Dermatology. 2000 July; 39(7): 551-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10940124&dopt=Abstract

•

Combination of clobetasol and tretinoin in vitiligo -letter-. Author(s): Parsad D, Saini R, Juneja A. Source: International Journal of Dermatology. 2000 August; 39(8): 639-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041694&dopt=Abstract

•

Combination of narrowband UV-B and topical calcipotriene in vitiligo. Author(s): Dogra S, Parsad D. Source: Archives of Dermatology. 2003 March; 139(3): 393. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622650&dopt=Abstract

24

Vitiligo

•

Comparison of serum lipid in girls affected with vitiligo and control group. Author(s): Pietrzak A, Lecewicz-Torun B, Urban J. Source: Ann Univ Mariae Curie Sklodowska [med]. 2000; 55: 269-74. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11482085&dopt=Abstract

•

Comparison of two surgical approaches for treating vitiligo: a preliminary study. Author(s): Ozdemir M, Cetinkale O, Wolf R, Kotogyan A, Mat C, Tuzun B, Tuzun Y. Source: International Journal of Dermatology. 2002 March; 41(3): 135-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12010337&dopt=Abstract

•

Contact leukoderma of the scalp or an unusual variant of vitiligo? Author(s): Verma S, Kumar B. Source: The Journal of Dermatology. 2001 October; 28(10): 554-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732723&dopt=Abstract

•

Correspondence re: Y. Kiniwa et al., Tumor antigens isolated from a patient with vitiligo and T-cell-infiltrated melanoma. Cancer Res., 61: 7900-7907, 2001. Author(s): Fodor J. Source: Cancer Research. 2002 August 15; 62(16): 4836; Author Reply 4836-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12183444&dopt=Abstract

•

Cytotoxic T lymphocyte reactivity to gp100, MelanA/MART-1, and tyrosinase, in HLA-A2-positive vitiligo patients. Author(s): Mandelcorn-Monson RL, Shear NH, Yau E, Sambhara S, Barber BH, Spaner D, DeBenedette MA. Source: The Journal of Investigative Dermatology. 2003 September; 121(3): 550-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12925214&dopt=Abstract

•

Decreased photodamage and low incidence of non-melanoma skin cancer in 136 sunexposed caucasian patients with vitiligo. Author(s): Schallreuter KU, Tobin DJ, Panske A. Source: Dermatology (Basel, Switzerland). 2002; 204(3): 194-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037447&dopt=Abstract

•

Decreased total numbers of peripheral blood lymphocytes with elevated percentages of CD4+CD45RO+ and CD4+CD25+ of T-helper cells in non-segmental vitiligo. Author(s): Mahmoud F, Abul H, Haines D, Al-Saleh C, Khajeji M, Whaley K. Source: The Journal of Dermatology. 2002 February; 29(2): 68-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11890298&dopt=Abstract

Studies

25

•

Defective tetrahydrobiopterin and catecholamine biosynthesis in the depigmentation disorder vitiligo. Author(s): Schallreuter KU, Wood JM, Ziegler I, Lemke KR, Pittelkow MR, Lindsey NJ, Gutlich M. Source: Biochimica Et Biophysica Acta. 1994 May 25; 1226(2): 181-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8204666&dopt=Abstract

•

Depigmentation of the normally pigmented patches in universal vitiligo patients by cryotherapy. Author(s): Radmanesh M. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2000 May; 14(3): 149-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11032055&dopt=Abstract

•

Depigmentation therapy in vitiligo universalis with topical 4-methoxyphenol and the Q-switched ruby laser. Author(s): Njoo MD, Vodegel RM, Westerhof W. Source: Journal of the American Academy of Dermatology. 2000 May; 42(5 Pt 1): 760-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10775851&dopt=Abstract

•

Depigmentation therapy with Q-switched ruby laser after tanning in vitiligo universalis. Author(s): Kim YJ, Chung BS, Choi KC. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 November; 27(11): 969-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11737134&dopt=Abstract

•

Dermatitis herpetiformis and vitiligo: report of a case and review of the literature. Author(s): Amato L, Gallerani I, Fuligni A, Mei S, Fabbri P. Source: The Journal of Dermatology. 2000 July; 27(7): 462-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10935345&dopt=Abstract

•

Dermatologic surgery: pulsed erbium:YAG laser-assisted autologous epidermal punch grafting in vitiligo. Author(s): Sachdev M, Shankar DS. Source: International Journal of Dermatology. 2000 November; 39(11): 868-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11123454&dopt=Abstract

•

Dermatology Life Quality Index score in vitiligo and its impact on the treatment outcome. Author(s): Parsad D, Pandhi R, Dogra S, Kanwar AJ, Kumar B. Source: The British Journal of Dermatology. 2003 February; 148(2): 373-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12588405&dopt=Abstract

26

Vitiligo

•

Detection of antibodies to human melanoma cells in vitiligo and alopecia areata by Western blot analysis. Author(s): Hann SK, Koo SW, Kim JB, Park YK. Source: The Journal of Dermatology. 1996 February; 23(2): 100-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8839236&dopt=Abstract

•

Detection of antibodies to melanocytes in vitiligo by western immunoblotting. Author(s): Hann SK, Shin HK, Park SH, Reynolds SR, Bystryn JC. Source: Yonsei Medical Journal. 1996 December; 37(6): 365-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9048487&dopt=Abstract

•

Diascopy, the lips, and vitiligo. Author(s): Tolat SN, Gharpuray MB. Source: Archives of Dermatology. 1995 February; 131(2): 228-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7857128&dopt=Abstract

•

Difference in clinical features and HLA antigens between familial and non-familial vitiligo of non-segmental type. Author(s): Ando I, Chi HI, Nakagawa H, Otsuka F. Source: The British Journal of Dermatology. 1993 October; 129(4): 408-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8217754&dopt=Abstract

•

Differential diagnosis of idiopathic vitiligo from contact leukoderma. Part II: Leukoderma due to cosmetics and bleaching creams. Author(s): Fisher AA. Source: Cutis; Cutaneous Medicine for the Practitioner. 1994 May; 53(5): 232-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8039412&dopt=Abstract

•

Differential diagnosis of idiopathic vitiligo. Part III: Occupational leukoderma. Author(s): Fisher AA. Source: Cutis; Cutaneous Medicine for the Practitioner. 1994 June; 53(6): 278-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8070279&dopt=Abstract

•

Differential expression of inhibitory or activating CD94/NKG2 subtypes on MART-1reactive T cells in vitiligo versus melanoma: a case report. Author(s): Pedersen LO, Vetter CS, Mingari MC, Andersen MH, thor Straten P, Brocker EB, Becker JC. Source: The Journal of Investigative Dermatology. 2002 April; 118(4): 595-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11918704&dopt=Abstract

Studies

27

•

Dihydroxyacetone in a new formulation--a powerful therapeutic option in vitiligo. Author(s): Fesq H, Brockow K, Strom K, Mempel M, Ring J, Abeck D. Source: Dermatology (Basel, Switzerland). 2001; 203(3): 241-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11701979&dopt=Abstract

•

Direct evidence to support the role of antigen-specific CD8(+) T cells in melanomaassociated vitiligo. Author(s): Le Gal FA, Avril MF, Bosq J, Lefebvre P, Deschemin JC, Andrieu M, Dore MX, Guillet JG. Source: The Journal of Investigative Dermatology. 2001 December; 117(6): 1464-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11886510&dopt=Abstract

•

Discussion of a case of vitiligo. Author(s): Lerner MR, Fitzpatrick TB, Halder RM, Hawk JL. Source: Photodermatology, Photoimmunology & Photomedicine. 1999 February; 15(1): 41-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9990671&dopt=Abstract

•

Dopa responsive dystonia in a girl with vitiligo. Author(s): Chaudhary N, Mani J, Rawat S, Mulye R, Shah P. Source: Indian Pediatrics. 1998 July; 35(7): 663-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10216678&dopt=Abstract

•

Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Author(s): Parsad D, Pandhi R, Juneja A. Source: Clinical and Experimental Dermatology. 2003 May; 28(3): 285-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12780716&dopt=Abstract

•

Effectiveness of pseudocatalase formulations in vitiligo. Author(s): Schallreuter KU. Source: Clinical and Experimental Dermatology. 2003 September; 28(5): 562-3; Author Reply 563. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12950359&dopt=Abstract

•

Effectiveness of psoralen photochemotherapy for vitiligo. Author(s): Chuan MT, Tsai YJ, Wu MC. Source: J Formos Med Assoc. 1999 May; 98(5): 335-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10420701&dopt=Abstract

28

Vitiligo

•

Efficacy of erbium YAG laser-assisted autologous epidermal grafting in vitiligo. Author(s): Pai GS, Vinod V, Joshi A. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 November; 16(6): 604-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12482044&dopt=Abstract

•

Eosinophilic fasciitis in an adolescent girl with lymphadenopathy and vitiligo-like and linear scleroderma-like changes. A case report. Author(s): Stork J, Nemcova D, Hoza J, Kodetova D. Source: Clin Exp Rheumatol. 1996 May-June; 14(3): 337-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8809452&dopt=Abstract

•

Epidemiology of childhood vitiligo: a study of 625 patients from north India. Author(s): Handa S, Dogra S. Source: Pediatric Dermatology. 2003 May-June; 20(3): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787267&dopt=Abstract

•

Epidermal grafting after chemical epilation in the treatment of vitiligo. Author(s): Kim CY, Yoon TJ, Kim TH. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 October; 27(10): 855-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11722520&dopt=Abstract

•

Epidermal grafting for vitiligo in adolescents. Author(s): Gupta S, Kumar B. Source: Pediatric Dermatology. 2002 March-April; 19(2): 159-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11994184&dopt=Abstract

•

Epidermal grafting in vitiligo: influence of age, site of lesion, and type of disease on outcome. Author(s): Gupta S, Kumar B. Source: Journal of the American Academy of Dermatology. 2003 July; 49(1): 99-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833017&dopt=Abstract

•

Epidermal grafts for treatment of stable and progressive vitiligo. Author(s): Kim HY, Kang KY. Source: Journal of the American Academy of Dermatology. 1999 March; 40(3): 412-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10071311&dopt=Abstract

Studies

29

•

Epidermal H(2)O(2) accumulation alters tetrahydrobiopterin (6BH4) recycling in vitiligo: identification of a general mechanism in regulation of all 6BH4-dependent processes? Author(s): Schallreuter KU, Moore J, Wood JM, Beazley WD, Peters EM, Marles LK, Behrens-Williams SC, Dummer R, Blau N, Thony B. Source: The Journal of Investigative Dermatology. 2001 January; 116(1): 167-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11168813&dopt=Abstract

•

Epidermal oxidative stress in vitiligo. Author(s): Passi S, Grandinetti M, Maggio F, Stancato A, De Luca C. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 1998 April; 11(2): 81-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9585244&dopt=Abstract

•

Epidermal reconstructs in vitiligo: an extrinsic factor is needed to trigger the disease. Author(s): Bessou S, Gauthier Y, Surleve-Bazeille JE, Pain C, Taieb A. Source: The British Journal of Dermatology. 1997 December; 137(6): 890-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9470904&dopt=Abstract

•

Epidermal sheet grafts for repigmentation of vitiligo and piebaldism, with a review of surgical techniques. Author(s): Olsson MJ, Juhlin L. Source: Acta Dermato-Venereologica. 1997 November; 77(6): 463-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394984&dopt=Abstract

•

Erbium:YAG laser and cultured epidermis in the surgical therapy of stable vitiligo. Author(s): Guerra L, Primavera G, Raskovic D, Pellegrini G, Golisano O, Bondanza S, Paterna P, Sonego G, Gobello T, Atzori F, Piazza P, Luci A, De Luca M. Source: Archives of Dermatology. 2003 October; 139(10): 1303-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14568835&dopt=Abstract

•

Evaluation of cosmetic tattooing in localised stable vitiligo. Author(s): Mahajan BB, Garg G, Gupta RR. Source: The Journal of Dermatology. 2002 November; 29(11): 726-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484435&dopt=Abstract

•

Evidence for a susceptibility gene, SLEV1, on chromosome 17p13 in families with vitiligo-related systemic lupus erythematosus. Author(s): Nath SK, Kelly JA, Namjou B, Lam T, Bruner GR, Scofield RH, Aston CE, Harley JB. Source: American Journal of Human Genetics. 2001 December; 69(6): 1401-6. Epub 2001 October 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11592035&dopt=Abstract

30

Vitiligo

•

Experience with calcipotriol as adjunctive treatment for vitiligo in patients who do not respond to PUVA alone: a preliminary study. Author(s): Yalcin B, Sahin S, Bukulmez G, Karaduman A, Atakan N, Akan T, Kolemen F. Source: Journal of the American Academy of Dermatology. 2001 April; 44(4): 634-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11260538&dopt=Abstract

•

Expression and modulation of apoptosis regulatory molecules in human melanocytes: significance in vitiligo. Author(s): van den Wijngaard RM, Aten J, Scheepmaker A, Le Poole IC, Tigges AJ, Westerhof W, Das PK. Source: The British Journal of Dermatology. 2000 September; 143(3): 573-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971331&dopt=Abstract

•

Expression of the c-kit receptor in hypomelanosis: a comparative study between piebaldism, naevus depigmentosus and vitiligo. Author(s): Dippel E, Haas N, Grabbe J, Schadendorf D, Hamann K, Czarnetzki BM. Source: The British Journal of Dermatology. 1995 February; 132(2): 182-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7534102&dopt=Abstract

•

Factors affecting responses on Dermatology Life Quality Index items among vitiligo sufferers. Author(s): Kent G, al-Abadie M. Source: Clinical and Experimental Dermatology. 1996 September; 21(5): 330-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9136149&dopt=Abstract

•

Failure of Q-switched Nd/YAG laser to repigment vitiligo. Author(s): Lanigan SW. Source: Clinical and Experimental Dermatology. 1996 May; 21(3): 245-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8914376&dopt=Abstract

•

Familial aggregation of vitiligo in the French West Indies (Isle of Martinique). Author(s): Boisseau-Garsaud AM, Saint-Cyr I, Quist D, Arveiler B, Garsaud P. Source: Eur J Dermatol. 2001 November-December; 11(6): 554-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11701407&dopt=Abstract

•

Fasting plasma-gastrin in vitiligo. Author(s): Okosdinossian ET, Munshid HA, Wasfi AI, Ahmed MA, Russell RC, Hobsley M. Source: Lancet. 1978 May 6; 1(8071): 997. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=76927&dopt=Abstract

Studies

31

•

Focal gaps in the basement membrane of involved and uninvolved skin of vitiligo: are they normal? Author(s): Bose SK, Ortonne JP. Source: The Journal of Dermatology. 1994 March; 21(3): 152-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8014268&dopt=Abstract

•

Folic acid and vitamin B12 in vitiligo: a nutritional approach. Author(s): Montes LF, Diaz ML, Lajous J, Garcia NJ. Source: Cutis; Cutaneous Medicine for the Practitioner. 1992 July; 50(1): 39-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1516378&dopt=Abstract

•

Frequency and clinical correlates of vitiligo in myasthenia gravis. Author(s): Kubota A, Komiyama A, Tanigawa A, Hasegawa O. Source: Journal of Neurology. 1997 June; 244(6): 388-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9249625&dopt=Abstract

•

Full-blown hypothyroidism associated with vitiligo and acropachy. Report of one case. Author(s): Curti LG, Siccardi M, Santianello EB, Fresco G. Source: Thyroidology. 1992 December; 4(3): 111-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1285036&dopt=Abstract

•

Further evidence for involvement of both cell mediated and humoral immunity in generalized vitiligo. Author(s): Abdel-Naser MB, Kruger-Krasagakes S, Krasagakis K, Gollnick H, AbdelFattah A, Orfanos CE. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 1994 February; 7(1): 1-8. Erratum In: Pigment Cell Res 1994 June; 7(3): 191. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8072943&dopt=Abstract

•

Generalised acanthosis nigricans with vitiligo. Author(s): Blume-Peytavi U, Spieker T, Reupke H, Orfanos CE. Source: Acta Dermato-Venereologica. 1996 September; 76(5): 377-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8891012&dopt=Abstract

•

Generalized vitiligo after erythroderma. Author(s): Schwartz RA, Trotter MG. Source: Dermatologica. 1983; 167(1): 42-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6226547&dopt=Abstract

32

Vitiligo

•

Generalized vitiligo after lymphocyte infusion for relapsed leukaemia. Author(s): Au WY, Yeung CK, Chan HH, Lie AK. Source: The British Journal of Dermatology. 2001 December; 145(6): 1015-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11899125&dopt=Abstract

•

Generalized vitiligo following Sezary syndrome. Author(s): Alcalay J, David M, Shohat B, Sandbank M. Source: The British Journal of Dermatology. 1987 June; 116(6): 851-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3620345&dopt=Abstract

•

Generalized vitiligo preceded by a generalized figurate erythematosquamous eruption. Author(s): Arata J, Abe-Matsuura Y. Source: The Journal of Dermatology. 1994 June; 21(6): 438-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8064009&dopt=Abstract

•

Genetic association of the catalase gene (CAT) with vitiligo susceptibility. Author(s): Casp CB, She JX, McCormack WT. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2002 February; 15(1): 62-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837458&dopt=Abstract

•

Genetic epidemiology of vitiligo: multilocus recessivity cross-validated. Author(s): Nath SK, Majumder PP, Nordlund JJ. Source: American Journal of Human Genetics. 1994 November; 55(5): 981-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7977362&dopt=Abstract

•

Genetic nature of vitiligo. Author(s): Bhatia PS, Mohan L, Pandey ON, Singh KK, Arora SK, Mukhija RD. Source: Journal of Dermatological Science. 1992 November; 4(3): 180-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1286069&dopt=Abstract

•

Glucose tolerance, C-peptide response to glucagon, and thyroid and adrenal functions in relation to auto-antibodies in vitiligo. Author(s): Soliman AT, Al Suweid AR, Gamil H, Khader MM, Afour MG. Source: Journal of Tropical Pediatrics. 1996 February; 42(1): 60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8820627&dopt=Abstract

Studies

33

•

Graft exchange in vitiligo. Studies on the outcome of exchanging biopsies from vitiliginous skin to normal, pigmented skin and vice versa. Author(s): Beck HI, Schmidt H. Source: Acta Dermato-Venereologica. 1986; 66(4): 311-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2430401&dopt=Abstract

•

Grafting and transplantation of melanocytes for repigmenting vitiligo and other types of leukoderma. Author(s): Falabella R. Source: International Journal of Dermatology. 1989 July-August; 28(6): 363-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2670786&dopt=Abstract

•

Grafting of in vitro cultured melanocytes onto laser-ablated lesions in vitiligo. Author(s): Kaufmann R, Greiner D, Kippenberger S, Bernd A. Source: Acta Dermato-Venereologica. 1998 March; 78(2): 136-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9534893&dopt=Abstract

•

Growth defects of melanocytes in culture from vitiligo subjects are spontaneously corrected in vivo in repigmenting subjects and can be partially corrected by the addition of fibroblast-derived growth factors in vitro. Author(s): Puri N, Mojamdar M, Ramaiah A. Source: Archives of Dermatological Research. 1989; 281(3): 178-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2774645&dopt=Abstract

•

Growth of human melanocytes from suction blister of localized vitiligo patient and from foreskins of newborns and adults by modified culture medium. Author(s): Jee SH, Kuo YF, Wu YC, Chang CH, Kuo WL, Lu YC. Source: J Formos Med Assoc. 1993 January; 92(1): 7-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8099831&dopt=Abstract

•

GTP-cyclohydrolase and vitiligo. Author(s): Schallreuter KU, Blau N. Source: Lancet. 1997 October 25; 350(9086): 1254. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9652595&dopt=Abstract

•

GTP-cyclohydrolase I and vitiligo. Author(s): Schallreuter KU. Source: Clinical and Experimental Dermatology. 2000 November; 25(8): 655. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11167984&dopt=Abstract

34

Vitiligo

•

Guidelines for the treatment of vitiligo. Author(s): Antoniou C, Katsambas A. Source: Drugs. 1992 April; 43(4): 490-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1377115&dopt=Abstract

•

Guidelines for treatment of vitiligo: is an update pending if recommendations for children are not followed? Author(s): Mohrenschlager M, Schnopp C, Abeck D. Source: Archives of Dermatology. 2000 September; 136(9): 1173-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987882&dopt=Abstract

•

Guidelines of care for vitiligo. American Academy of Dermatology. Author(s): Drake LA, Dinehart SM, Farmer ER, Goltz RW, Graham GF, Hordinsky MK, Lewis CW, Pariser DM, Skouge JW, Turner ML, Webster SB, Whitaker DC, Lowery BJ, Nordlund JJ, Grimes PE, Halder RM, Minus HR. Source: Journal of the American Academy of Dermatology. 1996 October; 35(4): 620-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8859294&dopt=Abstract

•

Guttate psoriasis and vitiligo: anatomic cohabitation. Author(s): Menter A, Boyd AS, Silverman AK. Source: Journal of the American Academy of Dermatology. 1989 April; 20(4): 698-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2715422&dopt=Abstract

•

Helium-neon laser irradiation stimulates migration and proliferation in melanocytes and induces repigmentation in segmental-type vitiligo. Author(s): Yu HS, Wu CS, Yu CL, Kao YH, Chiou MH. Source: The Journal of Investigative Dermatology. 2003 January; 120(1): 56-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12535198&dopt=Abstract

•

High frequency of skin-homing melanocyte-specific cytotoxic T lymphocytes in autoimmune vitiligo. Author(s): Ogg GS, Rod Dunbar P, Romero P, Chen JL, Cerundolo V. Source: The Journal of Experimental Medicine. 1998 September 21; 188(6): 1203-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9743539&dopt=Abstract

•

High frequency of thyroid dysfunction in patients with vitiligo. Author(s): Hegedus L, Heidenheim M, Gervil M, Hjalgrim H, Hoier-Madsen M. Source: Acta Dermato-Venereologica. 1994 March; 74(2): 120-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7911617&dopt=Abstract

Studies

35

•

High prevalence of vitiligo in lepromatous leprosy. Author(s): Boisseau-Garsaud AM, Vezon G, Helenon R, Garsaud P, Saint-Cyr I, Quist D. Source: International Journal of Dermatology. 2000 November; 39(11): 837-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11123444&dopt=Abstract

•

Higher plasma catecholamine and metabolite levels in the early phase of nonsegmental vitiligo. Author(s): Cucchi ML, Frattini P, Santagostino G, Orecchia G. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2000 February; 13(1): 28-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10761993&dopt=Abstract

•

Histocompatibility antigens in vitiligo: Hamburg study on 102 patients from northern Germany. Author(s): Schallreuter KU, Levenig C, Kuhnl P, Loliger C, Hohl-Tehari M, Berger J. Source: Dermatology (Basel, Switzerland). 1993; 187(3): 186-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8219421&dopt=Abstract

•

Historic view of vitiligo in Korea. Author(s): Hann SK, Chung HS. Source: International Journal of Dermatology. 1997 April; 36(4): 313-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9169339&dopt=Abstract

•

Historical aspects and definition of vitiligo. Author(s): Kopera D. Source: Clinics in Dermatology. 1997 November-December; 15(6): 841-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9404686&dopt=Abstract

•

HLA antigens in Omani patients with vitiligo. Author(s): Venkataram MN, White AG, Leeny WA, al Suwaid AR, Daar AS. Source: Clinical and Experimental Dermatology. 1995 January; 20(1): 35-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7671393&dopt=Abstract

•

HLA associations in vitiligo patients in the Dutch population. Author(s): Venneker GT, de Waal LP, Westerhof W, D'Amaro J, Schreuder GM, Asghar SS. Source: Disease Markers. 1993 November; 11(4): 187-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8112023&dopt=Abstract

36

Vitiligo

•

HLA-A2 restricted, melanocyte-specific CD8(+) T lymphocytes detected in vitiligo patients are related to disease activity and are predominantly directed against MelanA/MART1. Author(s): Lang KS, Caroli CC, Muhm A, Wernet D, Moris A, Schittek B, KnaussScherwitz E, Stevanovic S, Rammensee HG, Garbe C. Source: The Journal of Investigative Dermatology. 2001 June; 116(6): 891-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11407977&dopt=Abstract

•

HLA-DR1 is associated with vitiligo. Author(s): Poloy A, Tibor L, Kramer J, Anh-Tuan N, Kraszits E, Medgyessy I, Fust G, Stenszky V, Farid NR. Source: Immunology Letters. 1991 January; 27(1): 59-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2019421&dopt=Abstract

•

How unstable is the concept of stability in surgical repigmentation of vitiligo. Author(s): Juhlin L. Source: Dermatology (Basel, Switzerland). 2000; 201(2): 183. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11184319&dopt=Abstract

•

How unstable is the concept of stability in surgical repigmentation of vitiligo? Author(s): Malakar S, Lahiri K, Malakar RS. Source: Dermatology (Basel, Switzerland). 2000; 201(2): 182-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11053932&dopt=Abstract

•

Human immunodeficiency virus-associated vitiligo: expression of autoimmunity with immunodeficiency? Author(s): Duvic M, Rapini R, Hoots WK, Mansell PW. Source: Journal of the American Academy of Dermatology. 1987 October; 17(4): 656-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3668011&dopt=Abstract

•

Hyperpigmentation, vitiligo, and Addison's disease. Author(s): Mulligan TM, Sowers JR. Source: Cutis; Cutaneous Medicine for the Practitioner. 1985 October; 36(4): 317-8, 322. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2998703&dopt=Abstract

•

Hypopigmentation, vitiligo, and melanoma. New data, more enigmas. Author(s): Nordlund JJ. Source: Archives of Dermatology. 1987 August; 123(8): 1005-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3631979&dopt=Abstract

Studies

37

•

Hypopigmented malignant melanoma simulating vitiligo. Author(s): Kossard S, Commens C. Source: Journal of the American Academy of Dermatology. 1990 May; 22(5 Pt 1): 840-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2347968&dopt=Abstract

•

Hypothesis: possible role for the melatonin receptor in vitiligo: discussion paper. Author(s): Slominski A, Paus R, Bomirski A. Source: Journal of the Royal Society of Medicine. 1989 September; 82(9): 539-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2552111&dopt=Abstract

•

Hypothesis: vitiligo virus. Author(s): Iverson MV. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2000 August; 13(4): 281-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10952397&dopt=Abstract

•

Identification of epitopes on tyrosinase which are recognized by autoantibodies from patients with vitiligo. Author(s): Kemp EH, Waterman EA, Gawkrodger DJ, Watson PF, Weetman AP. Source: The Journal of Investigative Dermatology. 1999 August; 113(2): 267-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10469315&dopt=Abstract

•

Idiopathic CD4+T-cell lymphocytopenia associated with vitiligo. Author(s): Yamauchi PS, Nguyen NQ, Grimes PE. Source: Journal of the American Academy of Dermatology. 2002 May; 46(5): 779-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12004324&dopt=Abstract

•

IgG anti-melanocyte antibodies purified from patients with active vitiligo induce HLA-DR and intercellular adhesion molecule-1 expression and an increase in interleukin-8 release by melanocytes. Author(s): Li YL, Yu CL, Yu HS. Source: The Journal of Investigative Dermatology. 2000 December; 115(6): 969-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11121127&dopt=Abstract

•

Immunohistochemical study of ACTH and alpha-MSH in vitiligo patients successfully treated with a sex steroid-thyroid hormone mixture. Author(s): Ichimiya M. Source: The Journal of Dermatology. 1999 August; 26(8): 502-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10487004&dopt=Abstract

38

Vitiligo

•

Immunopolarization of CD4+ and CD8+ T cells to Type-1-like is associated with melanocyte loss in human vitiligo. Author(s): Wankowicz-Kalinska A, van den Wijngaard RM, Tigges BJ, Westerhof W, Ogg GS, Cerundolo V, Storkus WJ, Das PK. Source: Laboratory Investigation; a Journal of Technical Methods and Pathology. 2003 May; 83(5): 683-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746478&dopt=Abstract

•

Impact of life events on the onset of vitiligo in adults: preliminary evidence for a psychological dimension in aetiology. Author(s): Papadopoulos L, Bor R, Legg C, Hawk JL. Source: Clinical and Experimental Dermatology. 1998 November; 23(6): 243-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10233617&dopt=Abstract

•

In vivo and in vitro evidence for hydrogen peroxide (H2O2) accumulation in the epidermis of patients with vitiligo and its successful removal by a UVB-activated pseudocatalase. Author(s): Schallreuter KU, Moore J, Wood JM, Beazley WD, Gaze DC, Tobin DJ, Marshall HS, Panske A, Panzig E, Hibberts NA. Source: The Journal of Investigative Dermatology. Symposium Proceedings / the Society for Investigative Dermatology, Inc. [and] European Society for Dermatological Research. 1999 September; 4(1): 91-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10537016&dopt=Abstract

•

In vivo delayed-type hypersensitivity in 109 patients with vitiligo. Author(s): Behrens-Williams SC, Peters EM, Schallreuter KU. Source: International Journal of Dermatology. 2000 August; 39(8): 593-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971727&dopt=Abstract

•

In vivo evidence for compromised phenylalanine metabolism in vitiligo. Author(s): Schallreuter KU, Zschiesche M, Moore J, Panske A, Hibberts NA, Herrmann FH, Metelmann HR, Sawatzki J. Source: Biochemical and Biophysical Research Communications. 1998 February 13; 243(2): 395-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9480820&dopt=Abstract

•

Increase in total blood antioxidant status and selenium levels in black patients with active vitiligo. Author(s): Boisseau-Garsaud AM, Garsaud P, Lejoly-Boisseau H, Robert M, Quist D, Arveiler B. Source: International Journal of Dermatology. 2002 October; 41(10): 640-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12390184&dopt=Abstract

Studies

39

•

Increased basic fibroblast growth factor levels in serum and blister fluid from patients with vitiligo. Author(s): Ozdemir M, Yillar G, Wolf R, Yillar O, Unal G, Tuzun B, Tuzun Y. Source: Acta Dermato-Venereologica. 2000 November-December; 80(6): 438-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11243639&dopt=Abstract

•

Increased interleukin-6 and granulocyte-macrophage colony stimulating factor levels in the sera of patients with non-segmental vitiligo. Author(s): Tu CX, Gu JS, Lin XR. Source: Journal of Dermatological Science. 2003 February; 31(1): 73-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12615367&dopt=Abstract

•

Increased prevalence of vitiligo, but no evidence of premature ageing, in the skin of patients with bp 3243 mutation in mitochondrial DNA in the mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes syndrome (MELAS). Author(s): Karvonen SL, Haapasaari KM, Kallioinen M, Oikarinen A, Hassinen IE, Majamaa K. Source: The British Journal of Dermatology. 1999 April; 140(4): 634-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10233312&dopt=Abstract

•

Increased sensitivity of melanocytes to oxidative stress and abnormal expression of tyrosinase-related protein in vitiligo. Author(s): Jimbow K, Chen H, Park JS, Thomas PD. Source: The British Journal of Dermatology. 2001 January; 144(1): 55-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11167683&dopt=Abstract

•

Inflammatory vitiligo in Vogt-Koyanagi-Harada disease. Author(s): Tsuruta D, Hamada T, Teramae H, Mito H, Ishii M. Source: Journal of the American Academy of Dermatology. 2001 January; 44(1): 129-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11148490&dopt=Abstract

•

Inflammatory vitiligo-like macules that simulate hypopigmented mycosis fungoides. Author(s): Petit T, Cribier B, Bagot M, Wechsler J. Source: Eur J Dermatol. 2003 July-August; 13(4): 410-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12948929&dopt=Abstract

•

Intrinsic and extrinsic pathomechanisms in vitiligo. Author(s): Taieb A. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2000; 13 Suppl 8: 41-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041356&dopt=Abstract

40

Vitiligo

•

Is ABO blood grouping a gene marker for vitiligo? Author(s): Olasode OA. Source: Niger J Med. 2002 October-December; 11(4): 193. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956000&dopt=Abstract

•

Is the combination of calcipotriol and PUVA effective in vitiligo? Author(s): Baysal V, Yildirim M, Erel A, Kesici D. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2003 May; 17(3): 299-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702070&dopt=Abstract

•

Is the efficacy of psoralen plus ultraviolet A therapy for vitiligo enhanced by concurrent topical calcipotriol? A placebo-controlled double-blind study. Author(s): Ermis O, Alpsoy E, Cetin L, Yilmaz E. Source: The British Journal of Dermatology. 2001 September; 145(3): 472-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11531839&dopt=Abstract

•

Kabuki make-up (Niikawa-Kuroki) syndrome in a girl presenting with vitiligo vulgaris, cleft palate, somatic and psychomotor retardation and facial dysmorphism. Author(s): Schrander-Stumpel C, Theunissen P, Hulsmans R, Fryns JP. Source: Genet Couns. 1993; 4(1): 71-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8471227&dopt=Abstract

•

Keratinocyte damage in vitiligo. Author(s): Bhawan J, Bhutani LK. Source: Journal of Cutaneous Pathology. 1983 June; 10(3): 207-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6190850&dopt=Abstract

•

Keratinocytes in vitiligo. Author(s): Moellmann G. Source: The Journal of Investigative Dermatology. 1992 November; 99(5): 665. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1431235&dopt=Abstract

•

Keratinocytes suppress TRP-1 expression and reduce cell number of co-cultured melanocytes - implications for grafting of patients with vitiligo. Author(s): Phillips J, Gawkrodger DJ, Caddy CM, Hedley S, Dawson RA, Smith-Thomas L, Freedlander E, Mac Neil S. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2001 April; 14(2): 116-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11310791&dopt=Abstract

Studies

41

•

Khellin photochemotherapy of vitiligo. Author(s): Honigsmann H, Ortel B. Source: Photodermatol. 1985 August; 2(4): 193-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4059075&dopt=Abstract

•

Lack of efficacy of the Q-switched ruby laser in the treatment of vitiligo. Author(s): Renfro L, Geronemus RG. Source: Archives of Dermatology. 1992 February; 128(2): 277-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1739317&dopt=Abstract

•

Langerhans' cell and vitiligo: quantitative study of T6 and HLA-DR antigenexpressing cells. Author(s): Claudy AL, Rouchouse B. Source: Acta Dermato-Venereologica. 1984; 64(4): 334-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6209893&dopt=Abstract

•

Langerhans' cell population studies with OKT6 and HLA-DR monoclonal antibodies in vitiligo patients treated with oral phenylalanine loading and UVA irradiation. Author(s): Westerhof W, Groot I, Krieg SR, Bos JD, Cormane RH. Source: Acta Dermato-Venereologica. 1986; 66(3): 259-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2426905&dopt=Abstract

•

Langerhans' cells in hair follicles of the depigmenting C57Bl/Ler-vit.vit mouse. A model for human vitiligo. Author(s): Palkowski MR, Nordlund ML, Rheins LA, Nordlund JJ. Source: Archives of Dermatology. 1987 August; 123(8): 1022-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2443080&dopt=Abstract

•

Laser treatment for further depigmentation in vitiligo. Author(s): Thissen M, Westerhof W. Source: International Journal of Dermatology. 1997 May; 36(5): 386-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9199992&dopt=Abstract

•

Left-right comparison study of the combination of fluticasone propionate and UV-A vs. either fluticasone propionate or UV-A alone for the long-term treatment of vitiligo. Author(s): Westerhof W, Nieuweboer-Krobotova L, Mulder PG, Glazenburg EJ. Source: Archives of Dermatology. 1999 September; 135(9): 1061-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10490110&dopt=Abstract

42

Vitiligo

•

Leopard vitiligo. Author(s): Bhargava RK. Source: Archives of Dermatology. 1986 April; 122(4): 378-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3954404&dopt=Abstract

•

Letter: Occupational vitiligo caused by paratertiary butylphenol. Author(s): Rodermund OE. Source: Archives of Dermatology. 1976 April; 112(4): 554-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=131517&dopt=Abstract

•

Levels of beta-endorphin in the plasma and skin tissue fluids of patients with vitiligo. Author(s): Caixia T, Daming Z, Xiran L. Source: Journal of Dermatological Science. 2001 May; 26(1): 62-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11323222&dopt=Abstract

•

Levels of neuropeptide-Y in the plasma and skin tissue fluids of patients with vitiligo. Author(s): Tu C, Zhao D, Lin X. Source: Journal of Dermatological Science. 2001 November; 27(3): 178-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11641057&dopt=Abstract

•

Levels of soluble interleukin-2 receptor in the sera and skin tissue fluids of patients with vitiligo. Author(s): Caixia T, Hongwen F, Xiran L. Source: Journal of Dermatological Science. 1999 September; 21(1): 59-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10468193&dopt=Abstract

•

Linkage and association of HLA class II genes with vitiligo in a Dutch population. Author(s): Zamani M, Spaepen M, Sghar SS, Huang C, Westerhof W, NieuweboerKrobotova L, Cassiman JJ. Source: The British Journal of Dermatology. 2001 July; 145(1): 90-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11453913&dopt=Abstract

•

Local immune response in skin of generalized vitiligo patients. Destruction of melanocytes is associated with the prominent presence of CLA+ T cells at the perilesional site. Author(s): van den Wijngaard R, Wankowicz-Kalinska A, Le Poole C, Tigges B, Westerhof W, Das P. Source: Laboratory Investigation; a Journal of Technical Methods and Pathology. 2000 August; 80(8): 1299-309. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10950121&dopt=Abstract

Studies

43

•

Localized vitiligo and frontoethmoidal meningoencephalocele. Author(s): Moore MH. Source: The Journal of Craniofacial Surgery. 1997 January; 8(1): 78-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10332304&dopt=Abstract

•

Localized vitiligo successfully treated with cream-psoralen + ultraviolet A. Author(s): Kreuter A, Gambichler T, Avermaete A, Jansen T, Altmeyer P, von Kobyletzki G. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2001 July; 15(4): 357-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11730053&dopt=Abstract

•

Long-term actinic damage in sun-exposed vitiligo and normally pigmented skin. Author(s): Calanchini-Postizzi E, Frenk E. Source: Dermatologica. 1987; 174(6): 266-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3622877&dopt=Abstract

•

Long-term results in the treatment of vitiligo with oral khellin plus UVA. Author(s): Hofer A, Kerl H, Wolf P. Source: Eur J Dermatol. 2001 May-June; 11(3): 225-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11358729&dopt=Abstract

•

Low catalase levels in the epidermis of patients with vitiligo. Author(s): Schallreuter KU, Wood JM, Berger J. Source: The Journal of Investigative Dermatology. 1991 December; 97(6): 1081-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1748819&dopt=Abstract

•

L-phenylalanine and UVA irradiation in the treatment of vitiligo. Author(s): Siddiqui AH, Stolk LM, Bhaggoe R, Hu R, Schutgens RB, Westerhof W. Source: Dermatology (Basel, Switzerland). 1994; 188(3): 215-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8186511&dopt=Abstract

•

L-Phenylalanine and UVA/sunlight for vitiligo. Author(s): Cormane RH, Siddiqui AH. Source: Archives of Dermatological Research. 1985; 277(6): 509. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4051563&dopt=Abstract

•

Management of gingival vitiligo with the use of a tattoo technique. Author(s): Center JM, Mancini S, Baker GI, Mock D, Tenenbaum HC. Source: J Periodontol. 1998 June; 69(6): 724-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9660342&dopt=Abstract

44

Vitiligo

•

Management of vitiligo. Author(s): Shaffrali F, Gawkrodger D. Source: Clinical and Experimental Dermatology. 2000 November; 25(8): 575-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11167964&dopt=Abstract

•

Management of vitiligo. Results of a questionnaire among dermatologists in The Netherlands. Author(s): Njoo MD, Bossuyt PM, Westerhof W. Source: International Journal of Dermatology. 1999 November; 38(11): 866-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10583624&dopt=Abstract

•

Markers for vitiligo related neuropeptides in human skin nerve fibers. Author(s): Hristakieva E, Lazarova R, Lazarov N, Stanimirovic A, Shani J. Source: Acta Med Croatica. 2000; 54(2): 53-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11028109&dopt=Abstract

•

Medical pearl: DHA application for camouflaging segmental vitiligo and piebald lesions. Author(s): Suga Y, Ikejima A, Matsuba S, Ogawa H. Source: Journal of the American Academy of Dermatology. 2002 September; 47(3): 436-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12196756&dopt=Abstract

•

Melanin and melanosome complexes in long standing stable vitiligo--an ultrastructural study. Author(s): Bartosik J, Wulf HC, Kobayasi T. Source: Eur J Dermatol. 1998 March; 8(2): 95-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9649719&dopt=Abstract

•

Melanocyte destruction after antigen-specific immunotherapy of melanoma: direct evidence of t cell-mediated vitiligo. Author(s): Yee C, Thompson JA, Roche P, Byrd DR, Lee PP, Piepkorn M, Kenyon K, Davis MM, Riddell SR, Greenberg PD. Source: The Journal of Experimental Medicine. 2000 December 4; 192(11): 1637-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11104805&dopt=Abstract

•

Melanocyte destruction and repigmentation in vitiligo: a model for nerve cell damage and regrowth. Author(s): Yu HS. Source: Journal of Biomedical Science. 2002 November-December; 9(6 Pt 2): 564-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432222&dopt=Abstract

Studies

45

•

Melanocyte detachment after skin friction in non lesional skin of patients with generalized vitiligo. Author(s): Gauthier Y, Cario-Andre M, Lepreux S, Pain C, Taieb A. Source: The British Journal of Dermatology. 2003 January; 148(1): 95-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534601&dopt=Abstract

•

Melanocyte transplantation for the treatment of vitiligo: effects of different surgical techniques. Author(s): Issa CM, Rehder J, Taube MB. Source: Eur J Dermatol. 2003 January-February; 13(1): 34-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12609779&dopt=Abstract

•

Melanocyte-keratinocyte cell transplantation for stable vitiligo. Author(s): Mulekar SV. Source: International Journal of Dermatology. 2003 February; 42(2): 132-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709002&dopt=Abstract

•

Melanocytes are not absent in lesional skin of long duration vitiligo. Author(s): Tobin DJ, Swanson NN, Pittelkow MR, Peters EM, Schallreuter KU. Source: The Journal of Pathology. 2000 August; 191(4): 407-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10918216&dopt=Abstract

•

Microphthalmia-associated transcription factor (MITF) locus lacks linkage to human vitiligo or osteopetrosis: an evaluation. Author(s): Tripathi RK, Flanders DJ, Young TL, Oetting WS, Ramaiah A, King RA, Boissy RE, Nordlund JJ. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 1999 June; 12(3): 187-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10385915&dopt=Abstract

•

Mitochondrial impairment in peripheral blood mononuclear cells during the active phase of vitiligo. Author(s): Dell'Anna ML, Maresca V, Briganti S, Camera E, Falchi M, Picardo M. Source: The Journal of Investigative Dermatology. 2001 October; 117(4): 908-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11676831&dopt=Abstract

•

Modern aspects of vitiligo pathogenesis. Author(s): Korsunskaya IM, Suvorova KN, Dvoryankova EV. Source: Doklady Biological Sciences : Proceedings of the Academy of Sciences of the Ussr, Biological Sciences Sections / Translated from Russian. 2003 January-February; 388: 38-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705126&dopt=Abstract

46

Vitiligo

•

Modified technique of autologous noncultured epidermal cell transplantation for repigmenting vitiligo: a pilot study. Author(s): van Geel N, Ongenae K, De Mil M, Naeyaert JM. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 October; 27(10): 873-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11722524&dopt=Abstract

•

Modified technique of suction blistering for epidermal grafting in vitiligo. Author(s): Gupta S, Shroff S, Gupta S. Source: International Journal of Dermatology. 1999 April; 38(4): 306-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10321951&dopt=Abstract

•

Molecular and functional bases of self-antigen recognition in long-term persistent melanocyte-specific CD8+ T cells in one vitiligo patient. Author(s): Mantovani S, Garbelli S, Palermo B, Campanelli R, Brazzelli V, Borroni G, Martinetti M, Benvenuto F, Merlini G, della Cuna GR, Rivoltini L, Giachino C. Source: The Journal of Investigative Dermatology. 2003 August; 121(2): 308-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880423&dopt=Abstract

•

Molecular mapping of epitopes on melanocyte-specific protein Pmel17 which are recognized by autoantibodies in patients with vitiligo. Author(s): Kemp EH, Waterman EA, Gawkrodger DJ, Watson PF, Weetman AP. Source: Clinical and Experimental Immunology. 2001 June; 124(3): 509-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11472416&dopt=Abstract

•

Multiple actinic keratoses and squamous cell carcinomas on the sun-exposed areas of widespread vitiligo. Author(s): Akimoto S, Suzuki Y, Ishikawa O. Source: The British Journal of Dermatology. 2000 April; 142(4): 824-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10792246&dopt=Abstract

•

Naproxen pseudoporphyria in a patient with vitiligo. Author(s): Diffey BL, Farr PM. Source: Clinical and Experimental Dermatology. 1988 May; 13(3): 207. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3246085&dopt=Abstract

•

Naproxen pseudoporphyria in a patient with vitiligo. Author(s): Burns DA. Source: Clinical and Experimental Dermatology. 1987 July; 12(4): 296-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3427818&dopt=Abstract

Studies

47

•

Narrow-band ultraviolet B is a useful and well-tolerated treatment for vitiligo. Author(s): Scherschun L, Kim JJ, Lim HW. Source: Journal of the American Academy of Dermatology. 2001 June; 44(6): 999-1003. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11369913&dopt=Abstract

•

Narrowband ultraviolet B radiation therapy for recalcitrant vitiligo in Asians. Author(s): Natta R, Somsak T, Wisuttida T, Laor L. Source: Journal of the American Academy of Dermatology. 2003 September; 49(3): 473-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12963911&dopt=Abstract

•

Narrow-band UV-B micro-phototherapy: a new treatment for vitiligo. Author(s): Menchini G, Tsoureli-Nikita E, Hercogova J. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2003 March; 17(2): 171-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705746&dopt=Abstract

•

Natural cell-mediated cytotoxicity in vitiligo. Author(s): Ghoneum M, Grimes PE, Gill G, Kelly AP. Source: Journal of the American Academy of Dermatology. 1987 October; 17(4): 600-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3668006&dopt=Abstract

•

Natural killer cell and lymphokine-activated killer cell activity against melanocytes in vitiligo. Author(s): Durham-Pierre DG, Walters CS, Halder RM, Pham HN, Vanderpool EA. Source: Journal of the American Academy of Dermatology. 1995 July; 33(1): 26-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7601942&dopt=Abstract

•

Neurohistological studies in lichen planus and vitiligo. Author(s): Saha KC, Arya M, Saha AK. Source: Indian J Dermatol. 1979 July; 24(4): 51-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=552376&dopt=Abstract

•

Neuropeptide and neuronal marker studies in vitiligo. Author(s): Al'Abadie MS, Senior HJ, Bleehen SS, Gawkrodger DJ. Source: The British Journal of Dermatology. 1994 August; 131(2): 160-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7522512&dopt=Abstract

•

New and emerging therapies for vitiligo. Author(s): Halder RM, Young CM. Source: Dermatologic Clinics. 2000 January; 18(1): 79-89, Ix. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10626114&dopt=Abstract

48

Vitiligo

•

New insights into the pathogenesis of vitiligo: imbalance of epidermal cytokines at sites of lesions. Author(s): Moretti S, Spallanzani A, Amato L, Hautmann G, Gallerani I, Fabiani M, Fabbri P. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2002 April; 15(2): 87-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11936274&dopt=Abstract

•

New observations on vitiligo and ocular disease. Author(s): Wagoner MD, Albert DM, Lerner AB, Kirkwood J, Forget BM, Nordlund JJ. Source: American Journal of Ophthalmology. 1983 July; 96(1): 16-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6869476&dopt=Abstract

•

No evidence of hearing loss in patients with vitiligo. Author(s): Escalante-Ugalde C, Poblano A, Montes de Oca E, Lagunes R, Saul A. Source: Archives of Dermatology. 1991 August; 127(8): 1240. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1863089&dopt=Abstract

•

Non PUVA nonsurgical therapies for vitiligo. Author(s): Mandel AS, Haberman HF, Pawlowski D, Goldstein E. Source: Clinics in Dermatology. 1997 November-December; 15(6): 907-19. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9404694&dopt=Abstract

•

Non-psoralen treatment of vitiligo. Part I. Cosmetics, systemic coloring agents, and corticosteroids. Author(s): Goldstein E, Haberman HF, Menon IA, Pawlowski D. Source: International Journal of Dermatology. 1992 April; 31(4): 229-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1634286&dopt=Abstract

•

Non-psoralen treatment of vitiligo. Part II. Less commonly used and experimental therapies. Author(s): Goldstein E, Haberman HF, Menon IA, Pawlowski D. Source: International Journal of Dermatology. 1992 May; 31(5): 314-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1587657&dopt=Abstract

•

Nonsegmental vitiligo: decrease of the CD45RA+ T-cell subset and evidence for peripheral T-cell activation. Author(s): Abdel-Naser MB, Ludwig WD, Gollnick H, Orfanos CE. Source: International Journal of Dermatology. 1992 May; 31(5): 321-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1587659&dopt=Abstract

Studies

49

•

Nonsurgical repigmentation therapies in vitiligo. Meta-analysis of the literature. Author(s): Njoo MD, Spuls PI, Bos JD, Westerhof W, Bossuyt PM. Source: Archives of Dermatology. 1998 December; 134(12): 1532-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9875190&dopt=Abstract

•

Normal-range plasma catecholamines in patients with generalized and acrofacial vitiligo: preliminary report. Author(s): Orecchia G, Frattini P, Cucchi ML, Santagostino G. Source: Dermatology (Basel, Switzerland). 1994; 189(4): 350-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7873818&dopt=Abstract

•

Occupational vitiligo and contact sensitivity to para-tertiary butyl catechol. Author(s): Gawkrodger DJ, Cork MJ, Bleehen SS. Source: Contact Dermatitis. 1991 September; 25(3): 200-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1838324&dopt=Abstract

•

Occupational vitiligo due to unsuspected presence of phenolic antioxidant byproducts in commercial bulk rubber. Author(s): O'Malley MA, Mathias CG, Priddy M, Molina D, Grote AA, Halperin WE. Source: J Occup Med. 1988 June; 30(6): 512-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2969045&dopt=Abstract

•

Occupational vitiligo following allergic contact dermatitis. Author(s): Riordan AT, Nahass GT. Source: Contact Dermatitis. 1996 May; 34(5): 371-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8807241&dopt=Abstract

•

Occupational vitiligo. Author(s): Das M, Tandon A. Source: Contact Dermatitis. 1988 March; 18(3): 184-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2966718&dopt=Abstract

•

Occurrence rates of HLA-DRB1, HLA-DQB1, and HLA-DPB1 alleles in patients suffering from vitiligo. Author(s): Buc M, Fazekasova H, Cechova E, Hegyi E, Kolibasova K, Ferencik S. Source: Eur J Dermatol. 1998 January-February; 8(1): 13-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9653015&dopt=Abstract

50

Vitiligo

•

Ocular abnormalities associated with cutaneous melanoma and vitiligolike leukoderma. Author(s): Chang MA, Fournier G, Koh HK, Sober AJ, Nakagawa H, Fitzpatrick TB, Albert DM. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 1986; 224(6): 529-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3792849&dopt=Abstract

•

Ocular disturbances in vitiligo. Author(s): Cowan CL Jr, Halder RM, Grimes PE, Chakrabarti SG, Kenney JA Jr. Source: Journal of the American Academy of Dermatology. 1986 July; 15(1): 17-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3722505&dopt=Abstract

•

On the association between vitiligo and malignant melanoma. Author(s): Lindelof B, Hedblad MA, Sigurgeirsson B. Source: Acta Dermato-Venereologica. 1998 November; 78(6): 483-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9833063&dopt=Abstract

•

Oral and topical L-phenylalanine, clobetasol propionate, and UVA/sunlight--a new study for the treatment of vitiligo. Author(s): Camacho F, Mazuecos J. Source: J Drugs Dermatol. 2002 September; 1(2): 127-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847735&dopt=Abstract

•

Oral dexamethasone pulse treatment for vitiligo. Author(s): Radakovic-Fijan S, Furnsinn-Friedl AM, Honigsmann H, Tanew A. Source: Journal of the American Academy of Dermatology. 2001 May; 44(5): 814-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11312430&dopt=Abstract

•

Oral minipulse therapy in vitiligo. Author(s): Kanwar AJ, Dhar S, Dawn G. Source: Dermatology (Basel, Switzerland). 1995; 190(3): 251-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7599392&dopt=Abstract

•

Oral mini-pulse therapy with betamethasone in vitiligo patients having extensive or fast-spreading disease. Author(s): Pasricha JS, Khaitan BK. Source: International Journal of Dermatology. 1993 October; 32(10): 753-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8225724&dopt=Abstract

Studies

51

•

Oral phenylalanine loading and sunlight as source of UVA irradiation in vitiligo on the Caribbean island of Curacao NA. Author(s): Kuiters GR, Hup JM, Siddiqui AH, Cormane RH. Source: J Trop Med Hyg. 1986 June; 89(3): 149-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3773027&dopt=Abstract

•

Oral photochemotherapy in vitiligo: follow-up, patient compliance. Author(s): al-Aboosi MM, Ajam ZA. Source: International Journal of Dermatology. 1995 March; 34(3): 206-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7751100&dopt=Abstract

•

Orbital myositis, vitiligo, and giant cell myocarditis. Author(s): Stevens AW, Grossman ME, Barr ML. Source: Journal of the American Academy of Dermatology. 1996 August; 35(2 Pt 2): 3102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8698913&dopt=Abstract

•

Organ-specific autoantibodies in vitiligo patients and their relatives. Author(s): Mandry RC, Ortiz LJ, Lugo-Somolinos A, Sanchez JL. Source: International Journal of Dermatology. 1996 January; 35(1): 18-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8838923&dopt=Abstract

•

Oxidative stress in vitiligo: photo-oxidation of pterins produces H(2)O(2) and pterin6-carboxylic acid. Author(s): Rokos H, Beazley WD, Schallreuter KU. Source: Biochemical and Biophysical Research Communications. 2002 April 12; 292(4): 805-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11944885&dopt=Abstract

•

Periumbilical contact vitiligo appearing after allergic contact dermatitis to nickel. Author(s): Silvestre JF, Botella R, Ramon R, Guijarro J, Betlloch I, Morell AM. Source: American Journal of Contact Dermatitis : Official Journal of the American Contact Dermatitis Society. 2001 March; 12(1): 43-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11300099&dopt=Abstract

•

Phakomatosis pigmentovascularis type IIa with generalized vitiligo. Author(s): Kim YC, Park HJ, Cinn YW. Source: The British Journal of Dermatology. 2002 November; 147(5): 1028-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12410727&dopt=Abstract

52

Vitiligo

•

Photo(chemo) therapy for vitiligo. Author(s): Roelandts R. Source: Photodermatology, Photoimmunology & Photomedicine. 2003 February; 19(1): 1-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12713546&dopt=Abstract

•

PIG3V, an immortalized human vitiligo melanocyte cell line, expresses dilated endoplasmic reticulum. Author(s): Le Poole IC, Boissy RE, Sarangarajan R, Chen J, Forristal JJ, Sheth P, Westerhof W, Babcock G, Das PK, Saelinger CB. Source: In Vitro Cellular & Developmental Biology. Animal. 2000 May; 36(5): 309-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10937834&dopt=Abstract

•

Polymorphic light eruption limited to areas of vitiligo. Author(s): Downs AM, Lear JT, Dunnill MG. Source: Clinical and Experimental Dermatology. 1999 September; 24(5): 379-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10564326&dopt=Abstract

•

Psoralen photochemotherapy (PUVA) is only moderately effective in widespread vitiligo: a 10-year retrospective study. Author(s): Kwok YK, Anstey AV, Hawk JL. Source: Clinical and Experimental Dermatology. 2002 March; 27(2): 104-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952699&dopt=Abstract

•

Psychiatric morbidity in psoriasis and vitiligo: a comparative study. Author(s): Sharma N, Koranne RV, Singh RK. Source: The Journal of Dermatology. 2001 August; 28(8): 419-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11560158&dopt=Abstract

•

Psychiatric morbidity in vitiligo and psoriasis: a comparative study from India. Author(s): Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Source: The Journal of Dermatology. 2001 August; 28(8): 424-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11560159&dopt=Abstract

•

Psychiatric morbidity in vitiligo: prevalence and correlates in India. Author(s): Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 November; 16(6): 573-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12482039&dopt=Abstract

Studies

53

•

PUVA and PUVB in vitiligo--are they equally effective? Author(s): Mofty ME, Zaher H, Esmat S, Youssef R, Shahin Z, Bassioni D, Enani GE. Source: Photodermatology, Photoimmunology & Photomedicine. 2001 August; 17(4): 159-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11499536&dopt=Abstract

•

Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC-KUS). Author(s): Schallreuter KU, Moore J, Behrens-Williams S, Panske A, Harari M. Source: International Journal of Dermatology. 2002 August; 41(8): 482-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12207762&dopt=Abstract

•

Rasmussen encephalitis associated with segmental vitiligo of the scalp: clinicopathologic report. Author(s): Yacubian EM, Rosemberg S, Garrido Neto TL, Marie SK, Valerio RM, Jorge CL. Source: Journal of Child Neurology. 2001 May; 16(5): 374-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11392525&dopt=Abstract

•

Recognition of melanoma cell antigens with antibodies present in sera from patients with vitiligo. Author(s): Rocha IM, Oliveira LJ, De Castro LC, de Araujo Pereira LI, Chaul A, Guerra JG, Silvestre MC, Batista KM, Pereira FA, Gomide MA, Guillo LA. Source: International Journal of Dermatology. 2000 November; 39(11): 840-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11123445&dopt=Abstract

•

Repigmentation after autologous miniature punch grafting in segmental vitiligo in North Indian patients. Author(s): Sarkar R, Mehta SD, Kanwar AJ. Source: The Journal of Dermatology. 2001 October; 28(10): 540-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732721&dopt=Abstract

•

Repigmentation of chronic vitiligo lesions by following tacrolimus plus ultraviolet-Bnarrow-band. Author(s): Castanedo-Cazares JP, Lepe V, Moncada B. Source: Photodermatology, Photoimmunology & Photomedicine. 2003 February; 19(1): 35-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12713553&dopt=Abstract

54

Vitiligo

•

Repigmentation of localized vitiligo with the xenon chloride laser. Author(s): Baltas E, Nagy P, Bonis B, Novak Z, Ignacz F, Szabo G, Bor Z, Dobozy A, Kemeny L. Source: The British Journal of Dermatology. 2001 June; 144(6): 1266-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422057&dopt=Abstract

•

Repigmentation of vitiligo with topical tacrolimus. Author(s): Smith DA, Tofte SJ, Hanifin JM. Source: Dermatology (Basel, Switzerland). 2002; 205(3): 301-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399684&dopt=Abstract

•

Report of a child with vitiligo and Evans syndrome. Author(s): Muwakkit S, Locatelli F, Abboud M, Razzouk B, Wilimas J. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2003 April; 25(4): 344-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679656&dopt=Abstract

•

Resolution of bullous pemphigoid and improvement of vitiligo after successful treatment of squamous cell carcinoma of the skin. Author(s): Deguchi M, Tsunoda T, Tagami H. Source: Clinical and Experimental Dermatology. 1999 January; 24(1): 14-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10233641&dopt=Abstract

•

Return of hyperpigmentation within a cafe-au-lait macule following treatment of vitiligo. Author(s): Schaffer JV, Bolognia JL, Watsky K. Source: Dermatology (Basel, Switzerland). 2000; 201(3): 283-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11096214&dopt=Abstract

•

Sjogren's syndrome and vitiligo in a woman with posttransfusion microchimerism. Author(s): Martin L, Watier H, Vaillant L, Aractingi S. Source: The American Journal of Medicine. 2001 October 1; 111(5): 419-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11599528&dopt=Abstract

•

Specific cytotoxic T lymphocyte responses against Melan-A/MART1, tyrosinase and gp100 in vitiligo by the use of major histocompatibility complex/peptide tetramers: the role of cellular immunity in the etiopathogenesis of vitiligo. Author(s): Palermo B, Campanelli R, Garbelli S, Mantovani S, Lantelme E, Brazzelli V, Ardigo M, Borroni G, Martinetti M, Badulli C, Necker A, Giachino C. Source: The Journal of Investigative Dermatology. 2001 August; 117(2): 326-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11511311&dopt=Abstract

Studies

55

•

Squamous cell carcinoma in a patient with generalized vitiligo. Author(s): Seo SL, Kim IH. Source: Journal of the American Academy of Dermatology. 2001 December; 45(6 Suppl): S227-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11712068&dopt=Abstract

•

Stressful life events, social support, attachment security and alexithymia in vitiligo. A case-control study. Author(s): Picardi A, Pasquini P, Cattaruzza MS, Gaetano P, Melchi CF, Baliva G, Camaioni D, Tiago A, Abeni D, Biondi M. Source: Psychotherapy and Psychosomatics. 2003 May-June; 72(3): 150-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707482&dopt=Abstract

•

Substance P may play a part during depigmentation in vitiligo. A pilot study. Author(s): Falabella R, Barona MI, Echeverri IC, Alzate A. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2003 May; 17(3): 355-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702089&dopt=Abstract

•

Successful treatment of non-segmental vitiligo: systemic therapy with sex hormonethyroid powder mixture. Author(s): Nagai K, Ichimiya M, Yokoyama K, Hamamoto Y, Muto M. Source: Hormone Research. 2000; 54(5-6): 316-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11595825&dopt=Abstract

•

Successful treatment of vitiligo with 0.1% tacrolimus ointment. Author(s): Travis LB, Weinberg JM, Silverberg NB. Source: Archives of Dermatology. 2003 May; 139(5): 571-4; Discussion 573. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756092&dopt=Abstract

•

Surgical pearl: autologous biological dressing for epidermal grafting in vitiligo and other achromic disorders. Author(s): Gupta S, Kumar B. Source: Journal of the American Academy of Dermatology. 2003 March; 48(3): 430-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637925&dopt=Abstract

•

Surgical pearl: composite film and graft unit for the recipient area dressing after splitthickness skin grafting in vitiligo. Author(s): Malakar S, Malakar RS. Source: Journal of the American Academy of Dermatology. 2001 May; 44(5): 856-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11312436&dopt=Abstract

56

Vitiligo

•

Surgical treatment for vitiligo through hair follicle grafting: how to make it easy. Author(s): Sardi JR. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 July; 27(7): 685-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11442626&dopt=Abstract

•

Tacrolimus ointment 0.1% produces repigmentation in patients with vitiligo: results of a prospective patient series. Author(s): Tanghetti EA. Source: Cutis; Cutaneous Medicine for the Practitioner. 2003 February; 71(2): 158-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12635898&dopt=Abstract

•

The liver and its ultrasonographic picture in children suffering from vitiligo. Author(s): Pietrzak A, Dybiec E, Urban J. Source: Ann Univ Mariae Curie Sklodowska [med]. 2002; 57(2): 419-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12898873&dopt=Abstract

•

The role of oxidants and antioxidants in generalized vitiligo. Author(s): Yildirim M, Baysal V, Inaloz HS, Kesici D, Delibas N. Source: The Journal of Dermatology. 2003 February; 30(2): 104-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692376&dopt=Abstract

•

Topical prostaglandin analog (PGE2) in vitiligo--a preliminary study. Author(s): Parsad D, Pandhi R, Dogra S, Kumar B. Source: International Journal of Dermatology. 2002 December; 41(12): 942-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492997&dopt=Abstract

•

Topical pseudocatalase mousse and narrowband UVB phototherapy is not effective for vitiligo: an open, single-centre study. Author(s): Patel DC, Evans AV, Hawk JL. Source: Clinical and Experimental Dermatology. 2002 November; 27(8): 641-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472535&dopt=Abstract

•

Topical tacrolimus for repigmentation of vitiligo. Author(s): Grimes PE, Soriano T, Dytoc MT. Source: Journal of the American Academy of Dermatology. 2002 November; 47(5): 78991. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399778&dopt=Abstract

Studies

57

•

Treatment of vitiligo by topical calcipotriol. Author(s): Chiaverini C, Passeron T, Ortonne JP. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 March; 16(2): 137-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12046816&dopt=Abstract

•

Treatment of vitiligo vulgaris with narrow band UVB (311 nm) for one year and the effect of addition of folic acid and vitamin B12. Author(s): Tjioe M, Gerritsen MJ, Juhlin L, van de Kerkhof PC. Source: Acta Dermato-Venereologica. 2002; 82(5): 369-72. Erratum In: Acta Derm Venereol. 2002; 82(6): 485. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12430737&dopt=Abstract

•

Treatment of vitiligo with the 308-nm xenon chloride excimer laser. Author(s): Baltas E, Csoma Z, Ignacz F, Dobozy A, Kemeny L. Source: Archives of Dermatology. 2002 December; 138(12): 1619-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472364&dopt=Abstract

•

Treatment of vitiligo: current methods and new approaches. Author(s): Kostovic K, Nola I, Bucan Z, Situm M. Source: Acta Dermatovenerol Croat. 2003; 11(3): 163-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12967509&dopt=Abstract

•

Ultrasonographic estimation of spleen size in children affected with vitiligo. Author(s): Pietrzak A, Dybiec E, Lecewicz-Torun B. Source: Ann Univ Mariae Curie Sklodowska [med]. 2000; 55: 111-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11482060&dopt=Abstract

•

Ultrastructural studies in stable vitiligo. Author(s): Panuncio AL, Vignale R. Source: The American Journal of Dermatopathology. 2003 February; 25(1): 16-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544094&dopt=Abstract

•

Ultrastructural studies of vitiligo with inflammatory raised borders. Author(s): Ishii M, Hamada T. Source: The Journal of Dermatology. 1981 August; 8(4): 313-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7028831&dopt=Abstract

58

Vitiligo

•

Ultrastructural study of vitiligo. Author(s): Galadari E, Mehregan AH, Hashimoto K. Source: International Journal of Dermatology. 1993 April; 32(4): 269-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8486458&dopt=Abstract

•

Ultraviolet-B treatment of psoriasis in patients with concomitant vitiligo. Author(s): Tham SN, Gange RW, Parrish JA. Source: Archives of Dermatology. 1987 January; 123(1): 26-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3800418&dopt=Abstract

•

Undifferentiated cell transplant techniques appear effective in treating leg ulcers, vitiligo. Author(s): Skolnick AA. Source: Jama : the Journal of the American Medical Association. 1991 September 11; 266(10): 1331-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1880857&dopt=Abstract

•

Unknown. The combination of vitiligo vulgaris with somatic and psychomotor retardation, cleft palate and facial dysmorphism: a distinct entity? Author(s): Schrander-Stumpel CT, Theunissen PM, Hulsmans RF, Fryns JP. Source: Genet Couns. 1991; 2(4): 259-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1799428&dopt=Abstract

•

Unusual cause of leg oedema and plexopathy in a patient with vitiligo. Author(s): Stollberger C, Finsterer J, Angel K, Eggl-Tyl E. Source: Acta Medica Austriaca. 2000; 27(5): 160-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261267&dopt=Abstract

•

Use of high-dose methylprednisolone pulse therapy in patients with progressive and stable vitiligo. Author(s): Seiter S, Ugurel S, Tilgen W, Reinhold U. Source: International Journal of Dermatology. 2000 August; 39(8): 624-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971735&dopt=Abstract

•

UV-B radiation microphototherapy. An elective treatment for segmental vitiligo. Author(s): Lotti TM, Menchini G, Andreassi L. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 1999 September; 13(2): 102-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10568488&dopt=Abstract

Studies

59

•

Value of histopathology in vitiligo. Author(s): Montes LF, Abulafia J, Wilborn WH, Hyde BM, Montes CM. Source: International Journal of Dermatology. 2003 January; 42(1): 57-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581146&dopt=Abstract

•

Vitiligo at the sites of irradiation in a patient with Hodgkin's disease. Author(s): Pajonk F, Weissenberger C, Witucki G, Henke M. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2002 March; 178(3): 159-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11962193&dopt=Abstract

•

Vitiligo in association with human immunodeficiency virus infection. Author(s): Antony FC, Marsden RA. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2003 July; 17(4): 456-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834461&dopt=Abstract

•

Vitiligo therapy: where are we now? Author(s): Arroyo MP, Tift L. Source: J Drugs Dermatol. 2003 August; 2(4): 404-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12884463&dopt=Abstract

•

Vitiligo treated with topical corticosteroids: children with head and neck involvement respond well. Author(s): Cockayne SE, Messenger AG, Gawkrodger DJ. Source: Journal of the American Academy of Dermatology. 2002 June; 46(6): 964-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12063504&dopt=Abstract

•

Vitiligo. Author(s): Montes L, Pfister R, Wilborn W, Elizalde F. Source: Lancet. 2002 August 3; 360(9330): 405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12241795&dopt=Abstract

•

Vitiligo: a manifestation of apoptosis? Author(s): Huang CL, Nordlund JJ, Boissy R. Source: American Journal of Clinical Dermatology. 2002; 3(5): 301-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069635&dopt=Abstract

60

Vitiligo

•

Vitiligo: complex segregation and linkage disequilibrium analyses with respect to microsatellite loci spanning the HLA. Author(s): Arcos-Burgos M, Parodi E, Salgar M, Bedoya E, Builes J, Jaramillo D, Ceballos G, Uribe A, Rivera N, Rivera D, Fonseca I, Camargo M, Palacio G. Source: Human Genetics. 2002 April; 110(4): 334-42. Epub 2002 March 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11941482&dopt=Abstract

•

Vitiligo: cytomegalovirus associated? Author(s): Akar A, Yapar M, Aksakal AB. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2002 April; 15(2): 134. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11936271&dopt=Abstract

•

Vitiligo-like leucoderma during photochemotherapy for mycosis fungoides. Author(s): Mimouni D, David M, Feinmesser M, Coire CI, Hodak E. Source: The British Journal of Dermatology. 2001 December; 145(6): 1008-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11899124&dopt=Abstract

•

Watermelon stomach in a patient with vitiligo and systemic lupus erythematosus. Author(s): Archimandritis A, Tsirantonaki M, Tzivras M, Hatzis G, Davaris P. Source: Clin Exp Rheumatol. 1996 March-April; 14(2): 227-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8737739&dopt=Abstract

•

Western blot analysis of serum antibody reactivity with human melanoma cell antigens in alopecia areata and vitiligo. Author(s): Galbraith GM, Miller D, Emerson DL. Source: Clinical Immunology and Immunopathology. 1988 September; 48(3): 317-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3042212&dopt=Abstract

61

CHAPTER 2. NUTRITION AND VITILIGO Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and vitiligo.

Finding Nutrition Studies on Vitiligo The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “vitiligo” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

62

Vitiligo

The following information is typical of that found when using the “Full IBIDS Database” to search for “vitiligo” (or a synonym): •

Alterations in IL-6, IL-8, GM-CSF, TNF-alpha, and IFN-gamma release by peripheral mononuclear cells in patients with active vitiligo. Author(s): Department of Dermatology, Kaohsiung Medical College, Taiwan. Source: Yu, H S Chang, K L Yu, C L Li, H F Wu, M T Wu, C S Wu, C S J-InvestDermatol. 1997 April; 108(4): 527-9 0022-202X

•

Analysis of esterification of retinoids in the retinal pigmented epithelium of the Mitfvit (vitiligo) mutant mouse. Author(s): Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta, Georgia 30912-2000, USA. Source: Evans, B L Smith, S B Mol-Vis. 1997 October 24; 311 1090-0535

•

Antioxidant status in the blood of patients with active vitiligo. Author(s): San Gallicano Dermatological Institute, Rome, Italy. Source: Picardo, M Passi, S Morrone, A Grandinetti, M Di Carlo, A Ippolito, F PigmentCell-Res. 1994 April; 7(2): 110-5 0893-5785

•

Association between catechol-O-methyltransferase polymorphism and vitiligo. Author(s): Mersin University Faculty of Medicine, Department of Dermatology, 33070 Zeytinlibahce, Mersin, Turkey. [email protected] Source: Tursen, U Kaya, T I Erdal, M E Derici, E Gunduz, O Ikizoglu, G Arch-DermatolRes. 2002 May; 294(3): 143-6 0340-3696

•

Calcipotriol in vitiligo: a preliminary study. Author(s): Department of Dermatology, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, India. [email protected] Source: Parsad, D Saini, R Nagpal, R Pediatr-Dermatol. 1999 Jul-August; 16(4): 317-20 0736-8046

•

Chronic arsenicism with vitiligo, hyperthyroidism, and cancer. Source: Bickley, L K Papa, C M N-J-Med. 1989 May; 86(5): 377-80 0885-842X

•

Combination of clobetasol and tretinoin in vitiligo -letter-. Source: Parsad, D Saini, R Juneja, A Int-J-Dermatol. 2000 August; 39(8): 639-40 0011-9059

•

Combination of PUVAsol and topical calcipotriol in vitiligo. Author(s): Department of Dermatology, HIMS, Dehradun, India. Source: Parsad, D Saini, R Verma, N Dermatology. 1998; 197(2): 167-70 1018-8665

•

Current treatment of vitiligo in China. Author(s): Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing. Source: Shao, C Ye, G Chin-Med-J-(Engl). 1995 September; 108(9): 647-9 0366-6999

•

Delayed rhodopsin regeneration and altered distribution of interphotoreceptor retinoid binding protein (IRBP) in the mi(vit)/mi(vit) (vitiligo) mouse. Author(s): Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta, USA. Source: Smith, S B McClung, J Wiggert, B N Nir, I J-Neurocytol. 1997 September; 26(9): 605-13 0300-4864

•

Depigmentation therapy in vitiligo universalis with topical 4-methoxyphenol and the Q-switched ruby laser. Author(s): Netherlands Institute for Pigmentary Disorders, Amsterdam. Source: Njoo, M D Vodegel, R M Westerhof, W J-Am-Acad-Dermatol. 2000 May; 42(5 Pt 1): 760-9 0190-9622

Nutrition

63

•

Dihydroxyacetone in a new formulation--a powerful therapeutic option in vitiligo. Author(s): Department of Dermatology and Allergy, Biederstein, Technical University, Munich, Germany. [email protected] Source: Fesq, H Brockow, K Strom, K Mempel, M Ring, J Abeck, D Dermatology. 2001; 203(3): 241-3 1018-8665

•

Direct evidence to support the role of antigen-specific CD8(+) T cells in melanomaassociated vitiligo. Author(s): Laboratoire des Pathologies Infectieuses et Tumorales, Departement d'Immunologie, INSERM U445, Institut Cochin de Genetique Moleculaire, Paris, France. [email protected] Source: Le Gal, F A Avril, M F Bosq, J Lefebvre, P Deschemin, J C Andrieu, M Dore, M X Guillet, J G J-Invest-Dermatol. 2001 December; 117(6): 1464-70 0022-202X

•

Discussion of a case of vitiligo. Author(s): Department of Dermatology, University of Texas Southwestern Medical Center, Dallas 75235, USA. Source: Lerner, M R Fitzpatrick, T B Halder, R M Hawk, J L PhotodermatolPhotoimmunol-Photomed. 1999 February; 15(1): 41-4 0905-4383

•

Dopa responsive dystonia in a girl with vitiligo. Author(s): Department of Neurology, K.E.M. Hospital, Parel, Mumbai, India. Source: Chaudhary, N Mani, J Rawat, S Mulye, R Shah, P Indian-Pediatr. 1998 July; 35(7): 663-5 0019-6061

•

Epidermal oxidative stress in vitiligo. Author(s): Centro Invecchiamento Cellulare, Istituto Dermopatico dell'Immacolata (IRCCS), Roma, Italy. Source: Passi, S Grandinetti, M Maggio, F Stancato, A De Luca, C Pigment-Cell-Res. 1998 April; 11(2): 81-5 0893-5785

•

Experience with calcipotriol as adjunctive treatment for vitiligo in patients who do not respond to PUVA alone: a preliminary study. Author(s): Department of Dermatology, Hacettepe University School of Medicine, Ankara, Turkey. Source: Yalcin, B Sahin, S Bukulmez, G Karaduman, A Atakan, N Akan, T Kolemen, F JAm-Acad-Dermatol. 2001 April; 44(4): 634-7 0190-9622

•

Folic acid and vitamin B12 in vitiligo: a nutritional approach. Author(s): Department of Dermatology, University of Alabama, Birmingham Medical Center. Source: Montes, L F Diaz, M L Lajous, J Garcia, N J Cutis. 1992 July; 50(1): 39-42 00114162

•

Guidelines for the treatment of vitiligo. Author(s): University of Athens, School of Medicine, Department of Dermatology, Greece. Source: Antoniou, C Katsambas, A Drugs. 1992 April; 43(4): 490-8 0012-6667

•

Historic view of vitiligo in Korea. Author(s): Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea. Source: Hann, S K Chung, H S Int-J-Dermatol. 1997 April; 36(4): 313-5 0011-9059

•

Identification of pigment cell antigens defined by vitiligo antibodies. Author(s): Department of Dermatology, New York University School of Medicine, NY 10016.

64

Vitiligo

Source: Cui, J Harning, R Henn, M Bystryn, J C J-Invest-Dermatol. 1992 February; 98(2): 162-5 0022-202X •

Idiopathic CD4+T-cell lymphocytopenia associated with vitiligo. Author(s): Division of Dermatology, University of California Los Angeles School of Medicine, USA. Source: Yamauchi, Paul S Nguyen, Nathalie Q Grimes, Pearl E J-Am-Acad-Dermatol. 2002 May; 46(5): 779-82 0190-9622

•

Immunohistochemical study of ACTH and alpha-MSH in vitiligo patients successfully treated with a sex steroid-thyroid hormone mixture. Author(s): Department of Dermatology, Yamaguchi University School of Medicine, Ube, Japan. Source: Ichimiya, M J-Dermatol. 1999 August; 26(8): 502-6 0385-2407

•

Improvement of vitiligo after oral treatment with vitamin B12 and folic acid and the importance of sun exposure. Author(s): Department of Dermatology, University Hospital, Uppsala, Sweden. Source: Juhlin, L Olsson, M J Acta-Derm-Venereol. 1997 November; 77(6): 460-2 00015555

•

In vivo evidence for compromised phenylalanine metabolism in vitiligo. Author(s): Department of Biomedical Sciences, University of Bradford, West Yorkshire, United Kingdom. Source: Schallreuter, K U Zschiesche, M Moore, J Panske, A Hibberts, N A Herrmann, F H Metelmann, H R Sawatzki, J Biochem-Biophys-Res-Commun. 1998 February 13; 243(2): 395-9 0006-291X

•

Increase in retinyl palmitate concentration in eyes and livers and the concentration of interphotoreceptor retinoid-binding protein in eyes of vitiligo mutant mice. Author(s): Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta 30912-2000. Source: Smith, S B Duncan, T Kutty, G Kutty, R K Wiggert, B Biochem-J. 1994 May 15; 300 ( Pt 1)63-8 0264-6021

•

Increase in total blood antioxidant status and selenium levels in black patients with active vitiligo. Author(s): Service de Dermatologie and Departement de Sante Publique, Centre Hospitalier Universitaire de Fort de France, Martinique, French West Indies. [email protected] Source: Boisseau Garsaud, A M Garsaud, P Lejoly Boisseau, H Robert, M Quist, D Arveiler, B Int-J-Dermatol. 2002 October; 41(10): 640-2 0011-9059

•

Is the efficacy of psoralen plus ultraviolet A therapy for vitiligo enhanced by concurrent topical calcipotriol? A placebo-controlled double-blind study. Author(s): Department of Dermatology, Akdeniz University School of Medicine, 07070 Antalya, Turkey. Source: Ermis, O Alpsoy, E Cetin, L Yilmaz, E Br-J-Dermatol. 2001 September; 145(3): 472-5 0007-0963

•

Local immune response in skin of generalized vitiligo patients. Destruction of melanocytes is associated with the prominent presence of CLA+ T cells at the perilesional site. Author(s): Department of Pathology, Academic Medical Center, Amsterdam University, The Netherlands.

Nutrition

65

Source: van den Wijngaard, R Wankowicz Kalinska, A Le Poole, C Tigges, B Westerhof, W Das, P Lab-Invest. 2000 August; 80(8): 1299-309 0023-6837 •

Long-term results in the treatment of vitiligo with oral khellin plus UVA. Author(s): Department of Dermatology, University of Graz, Auenbruggerplatz 8, A8036, Graz, Austria. Source: Hofer, A Kerl, H Wolf, P Eur-J-Dermatol. 2001 May-June; 11(3): 225-9 1167-1122

•

Management of vitiligo. Author(s): Department of Dermatology, University of Cincinnati, Ohio. Source: Nordlund, J J Halder, R M Grimes, P Dermatol-Clin. 1993 January; 11(1): 27-33 0733-8635

•

Medical pearl: DHA application for camouflaging segmental vitiligo and piebald lesions. Author(s): Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan. [email protected] Source: Suga, Y Ikejima, A Matsuba, S Ogawa, H J-Am-Acad-Dermatol. 2002 September; 47(3): 436-8 0190-9622

•

Mitochondrial impairment in peripheral blood mononuclear cells during the active phase of vitiligo. Author(s): Department of Cutaneous Physiopathology of the San Gallicano Dermatological Institute, Rome, Italy. Source: Dell'Anna, M L Maresca, V Briganti, S Camera, E Falchi, M Picardo, M J-InvestDermatol. 2001 October; 117(4): 908-13 0022-202X

•

Occupational vitiligo due to unsuspected presence of phenolic antioxidant byproducts in commercial bulk rubber. Author(s): Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH 45226. Source: O'Malley, M A Mathias, C G Priddy, M Molina, D Grote, A A Halperin, W E JOccup-Med. 1988 June; 30(6): 512-6 0096-1736

•

Pernicious anemia, vitiligo, and infertility. Author(s): Wilkes Family Health Center, North Wilkesboro, NC. Source: Gulden, K D J-Am-Board-Fam-Pract. 1990 Jul-September; 3(3): 217-20 0893-8652

•

Phenylalanine plus ultraviolet light: preliminary report of a promising treatment for childhood vitiligo. Author(s): Institute of Child Health, Aghia Sophia Children's Hospital, Athens, Greece. Source: Schulpis, C H Antoniou, C Michas, T Strarigos, J Pediatr-Dermatol. 1989 December; 6(4): 332-5 0736-8046

•

Picrorhiza kurroa, an ayurvedic herb, may potentiate photochemotherapy in vitiligo. Author(s): Regional Research Laboratory, Jammu, India. Source: Bedi, K L Zutshi, U Chopra, C L Amla, V J-Ethnopharmacol. 1989 December; 27(3): 347-52 0378-8741

•

PUVA and PUVB in vitiligo--are they equally effective? Author(s): Dermatology Department, Phototherapy Unit, Faculty of Medicine, Cairo University, Egypt. Source: Mofty, M E Zaher, H Esmat, S Youssef, R Shahin, Z Bassioni, D Enani, G E Photodermatol-Photoimmunol-Photomed. 2001 August; 17(4): 159-63 0905-4383

66

Vitiligo

•

Rasmussen encephalitis associated with segmental vitiligo of the scalp: clinicopathologic report. Author(s): Department of Neurology, University of Sao Paulo School of Medicine, Brazil. Source: Yacubian, E M Rosemberg, S Garrido Neto, T L Marie, S K Valerio, R M Jorge, C L J-Child-Neurol. 2001 May; 16(5): 374-7 0883-0738

•

Serum levels of folic acid and vitamin B12 in Korean patients with vitiligo. Author(s): Department of Dermatology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Suwon, Korea. Source: Kim, S M Kim, Y K Hann, S K Yonsei-Med-J. 1999 June; 40(3): 195-8 0513-5796

•

Successful culture of adult human melanocytes obtained from normal and vitiligo donors. Author(s): Department of Dermatology, University of Cincinnati College of Medicine, Ohio. Source: Medrano, E E Nordlund, J J J-Invest-Dermatol. 1990 October; 95(4): 441-5 0022202X

•

Successful treatment of non-segmental vitiligo: systemic therapy with sex hormonethyroid powder mixture. Author(s): Department of Dermatology and Biomolecular Recognition, Yamaguchi University School of Medicine, Ube, Japan. Source: Nagai, K Ichimiya, M Yokoyama, K Hamamoto, Y Muto, M Horm-Res. 2000; 54(5-6): 316-7 0301-0163

•

Sulphorhodamine B assay for measuring proliferation of a pigmented melanocyte cell line and its application to the evaluation of crude drugs used in the treatment of vitiligo. Author(s): Institute of Chinese Medicine, London, UK. Source: Lin, Z X Hoult, J R Raman, A J-Ethnopharmacol. 1999 August; 66(2): 141-50 0378-8741

•

Sulphurhodamine B assay for measuring proliferation of a pigmented melanocyte cell line and its application to the evalution of crude drugs used in the treatment of vitiligo. Source: Lin, Z.X. Hoult, J.R.S. Raman, A. J-ethnopharmacol. Oxford : Elsevier Science Ltd. August 1999. volume 66 (2) page 141-150. 0378-8741

•

The development of guidelines for the treatment of vitiligo. Clinical Epidemiology Unit of the Istituto Dermopatico dell'Immacolata-Istituto di Recovero e Cura a Carattere Scientifico (IDI-IRCCS) and the Archives of Dermatology. Author(s): Netherlands Institute for Pigmentary Disorders, Academic Medical Center, University of Amsterdam. [email protected] Source: Njoo, M D Westerhof, W Bos, J D Bossuyt, P M Arch-Dermatol. 1999 December; 135(12): 1514-21 0003-987X

•

The effects of vitamin E on the skin lipid peroxidation and the clinical improvement in vitiligo patients treated with PUVA. Author(s): Department of Dermatology, Medical Faculty of Cumhuriyet University, 58140-Sivas, Turkey. [email protected] Source: Akyol, Melih Celik, V Kenan Ozcelik, Sedat Polat, Murat Marufihah, Mehmet Atalay, Atilla Eur-J-Dermatol. 2002 Jan-February; 12(1): 24-6 1167-1122

•

The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patients. Author(s): Department of Dermatology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Suwon, South Korea.

Nutrition

67

Source: Kim, S M Lee, H S Hann, S K Int-J-Dermatol. 1999 July; 38(7): 546-50 0011-9059 •

Topical application of a melanotropin analogue to vulgar vitiligo dermo-epidermal minigrafts. Author(s): Hospital Municipal Dr. Fernando Mauro Pires da Rocha, Universidade de Sao Paulo, Brasil. Source: Schwartzmann Solon, A M Visconti, M A Castrucci, A M Braz-J-Med-Biol-Res. 1998 December; 31(12): 1557-64 0100-879X

•

Topical calcipotriol as monotherapy and in combination with psoralen plus ultraviolet A in the treatment of vitiligo. Author(s): Unit of Dermatology, Imperial College of Science, Technology and Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK. Source: Ameen, M Exarchou, V Chu, A C Br-J-Dermatol. 2001 September; 145(3): 476-9 0007-0963

•

Treatment of vitiligo by topical calcipotriol. Author(s): Department of Dermatology, Archet-2 Hospital, Nice, France. [email protected] Source: Chiaverini, C Passeron, T Ortonne, J P J-Eur-Acad-Dermatol-Venereol. 2002 March; 16(2): 137-8 0926-9959

•

Two cases of nickel dermatitis showing vitiligo-like depigmentations. Author(s): Department of Microbiology, Ajou University College of Medicine, Suwon, Korea. Source: Kim, H I Kim, D H Yoon, M S Kim, H J Lee, S Yonsei-Med-J. 1991 March; 32(1): 79-81 0513-5796

•

Vitiligo and pernicious anemia presenting as congestive heart failure. Author(s): Department of Medicine, Nashoba Community Hospital, Massachusetts. Source: Held, J L Kohn, S R Cutis. 1990 September; 46(3): 268-70 0011-4162

Ayer,

•

Vitiligo management update. Author(s): Netherlands Institute for Pigmentary Disorders, Department of Dermatology, University of Amsterdam, The Netherlands. Source: Westerhof, W Skin-Therapy-Lett. 2000; 5(6): 1-2,5 1201-5989

•

Vitiligo therapy with oral and topical phenylalanine with UVA exposure. Author(s): Dermatologic Clinic of Athens University, Andreas-Sygros Hospital, Greece. Source: Antoniou, C Schulpis, H Michas, T Katsambas, A Frajis, N Tsagaraki, S Stratigos, J Int-J-Dermatol. 1989 October; 28(8): 545-7 0011-9059

•

Vitiligo. Author(s): Department of Dermatology, University of Cincinnati, OH 45267-0592, USA. Source: Le Poole, C Boissy, R E Semin-Cutan-Med-Surg. 1997 March; 16(1): 3-14 10855629

•

Vitiligo. Therapeutic advances. Author(s): Department of Dermatology, Sapporo Medical University School of Medicine, Japan. Source: Jimbow, K Dermatol-Clin. 1998 April; 16(2): 399-407 0733-8635

•

Vitiligo: a retrospective comparative analysis of treatment modalities in 500 patients. Author(s): Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India. Source: Handa, S Pandhi, R Kaur, I J-Dermatol. 2001 September; 28(9): 461-6 0385-2407

68

Vitiligo

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMDHealth: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

Nutrition

69

The following is a specific Web list relating to vitiligo; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B12 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin C Source: Healthnotes, Inc.; www.healthnotes.com Vitamin D Source: Healthnotes, Inc.; www.healthnotes.com

•

Minerals Betaine Hydrochloride Source: Healthnotes, Inc.; www.healthnotes.com Folate Source: Prima Communications, Inc.www.personalhealthzone.com

71

CHAPTER 3. ALTERNATIVE MEDICINE AND VITILIGO Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to vitiligo. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to vitiligo and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “vitiligo” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to vitiligo: •

A report on the composition of mercurials used in traditional medicines in Oman. Author(s): Hardy AD, Sutherland HH, Vaishnav R, Worthing MA. Source: Journal of Ethnopharmacology. 1995 November 17; 49(1): 17-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8786653&dopt=Abstract

•

Abnormalities of the auditory brainstem response in vitiligo. Author(s): Nikiforidis GC, Tsambaos DG, Karamitsos DS, Koutsojannis CC, Georgiou SV. Source: Scandinavian Audiology. 1993; 22(2): 97-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8322003&dopt=Abstract

•

Atypical Kaposi's sarcoma in a patient with vitiligo and pernicious anemia. Author(s): Ruzicka T.

72

Vitiligo

Source: Dermatologica. 1981; 163(2): 199-204. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7286359&dopt=Abstract •

Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: Is it all in your mind? Author(s): Shenefelt PD. Source: Dermatologic Therapy. 2003 June; 16(2): 114-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919113&dopt=Abstract

•

Carcinogenic risk of bath PUVA in comparison to oral PUVA therapy. Author(s): Shephard SE, Panizzon RG. Source: Dermatology (Basel, Switzerland). 1999; 199(2): 106-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10559574&dopt=Abstract

•

Childhood vitiligo successfully treated with bath PUVA. Author(s): Mai DW, Omohundro C, Dijkstra JW, Bailin PL. Source: Pediatric Dermatology. 1998 January-February; 15(1): 53-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9496807&dopt=Abstract

•

Current treatment of vitiligo in China. Author(s): Shao C, Ye G. Source: Chinese Medical Journal. 1995 September; 108(9): 647-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8575227&dopt=Abstract

•

Dermatology at the Dead Sea spas. Author(s): Even-Paz Z. Source: Isr J Med Sci. 1996 July; 32 Suppl: S11-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8756969&dopt=Abstract

•

Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Author(s): Parsad D, Pandhi R, Juneja A. Source: Clinical and Experimental Dermatology. 2003 May; 28(3): 285-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12780716&dopt=Abstract

•

Folates: supplemental forms and therapeutic applications. Author(s): Kelly GS. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 1998 June; 3(3): 208-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9630738&dopt=Abstract

•

From medical herbalism to phytotherapy in dermatology: back to the future. Author(s): Dattner AM.

Alternative Medicine 73

Source: Dermatologic Therapy. 2003 June; 16(2): 106-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919112&dopt=Abstract •

Gastric acidity curves and their importance in certain dermatological condition. Author(s): CHATTERJEE ML, LAHIRI KD, BANERJEE AK, DE MS. Source: Indian J Dermatol. 1964 April; 123: 63-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14168132&dopt=Abstract

•

Genotoxicity of Brosimum gaudichaudii measured by the Salmonella/microsome assay and chromosomal aberrations in CHO cells. Author(s): Varanda EA, Pozetti GL, Lourenco MV, Vilegas W, Raddi MS. Source: Journal of Ethnopharmacology. 2002 July; 81(2): 257-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12065160&dopt=Abstract

•

Historic view of vitiligo in Korea. Author(s): Hann SK, Chung HS. Source: International Journal of Dermatology. 1997 April; 36(4): 313-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9169339&dopt=Abstract

•

Improvement of vitiligo after oral treatment with vitamin B12 and folic acid and the importance of sun exposure. Author(s): Juhlin L, Olsson MJ. Source: Acta Dermato-Venereologica. 1997 November; 77(6): 460-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394983&dopt=Abstract

•

In vitro assessment of 'T' lymphocyte functioning in vitiligo. Support for autoimmune hypothesis concerning the disease. Author(s): Taher-Uz-Zaman, Begum S, Waheed MA. Source: Acta Dermato-Venereologica. 1992 August; 72(4): 266-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1357881&dopt=Abstract

•

In vivo and in vitro evidence for hydrogen peroxide (H2O2) accumulation in the epidermis of patients with vitiligo and its successful removal by a UVB-activated pseudocatalase. Author(s): Schallreuter KU, Moore J, Wood JM, Beazley WD, Gaze DC, Tobin DJ, Marshall HS, Panske A, Panzig E, Hibberts NA. Source: The Journal of Investigative Dermatology. Symposium Proceedings / the Society for Investigative Dermatology, Inc. [and] European Society for Dermatological Research. 1999 September; 4(1): 91-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10537016&dopt=Abstract

•

Letter: Vitiligo in ancient Indian medicine. Author(s): Singh G, Ansari Z, Dwivedi RN.

74

Vitiligo

Source: Archives of Dermatology. 1974 June; 109(6): 913. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4598079&dopt=Abstract •

Leukoderma following occupational allergic contact dermatitis. Author(s): Kumar A, Freeman S. Source: Contact Dermatitis. 1999 August; 41(2): 94-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10445689&dopt=Abstract

•

Management of vitiligo. Author(s): Nordlund JJ, Halder RM, Grimes P. Source: Dermatologic Clinics. 1993 January; 11(1): 27-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8435915&dopt=Abstract

•

Melanocyte-keratinocyte cell transplantation for stable vitiligo. Author(s): Mulekar SV. Source: International Journal of Dermatology. 2003 February; 42(2): 132-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709002&dopt=Abstract

•

Perioral leukoderma simulating vitiligo from use of a toothpaste containing cinnamic aldehyde. Author(s): Mathias CG, Maibach HI, Conant MA. Source: Archives of Dermatology. 1980 October; 116(10): 1172-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7425664&dopt=Abstract

•

Picrorhiza kurroa, an ayurvedic herb, may potentiate photochemotherapy in vitiligo. Author(s): Bedi KL, Zutshi U, Chopra CL, Amla V. Source: Journal of Ethnopharmacology. 1989 December; 27(3): 347-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2615440&dopt=Abstract

•

PP-28 Autologous cultured melanocytes in vitiligo treatment. Author(s): Czajkowski R, Placek W. Source: Pigment Cell Research / Sponsored by the European Society for Pigment Cell Research and the International Pigment Cell Society. 2003 October; 16(5): 602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12950829&dopt=Abstract

•

Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC-KUS). Author(s): Schallreuter KU, Moore J, Behrens-Williams S, Panske A, Harari M. Source: International Journal of Dermatology. 2002 August; 41(8): 482-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12207762&dopt=Abstract

Alternative Medicine 75

•

Retrospective ocular study of patients receiving oral 8-methoxypsoralen and solar irradiation for the treatment of vitiligo. Author(s): El-Mofty AM, El-Mofty A. Source: Ann Ophthalmol. 1979 June; 11(6): 946-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=496187&dopt=Abstract

•

Sulphorhodamine B assay for measuring proliferation of a pigmented melanocyte cell line and its application to the evaluation of crude drugs used in the treatment of vitiligo. Author(s): Lin ZX, Hoult JR, Raman A. Source: Journal of Ethnopharmacology. 1999 August; 66(2): 141-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10433470&dopt=Abstract

•

Treatment of vitiligo based on the principle of pacifying liver by resolving stasis and activating blood circulation, plus exorcising “wind”. An observation on therapeutic effects in 100 cases. Author(s): Zhu GD. Source: J Tradit Chin Med. 1982 March; 2(1): 71-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6765693&dopt=Abstract

•

Vitiligo: a manifestation of apoptosis? Author(s): Huang CL, Nordlund JJ, Boissy R. Source: American Journal of Clinical Dermatology. 2002; 3(5): 301-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069635&dopt=Abstract

•

Vitiligo--a retrospect. Author(s): Nair BK. Source: International Journal of Dermatology. 1978 November; 17(9): 755-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=365814&dopt=Abstract

•

Vitiligo-like leucoderma during photochemotherapy for mycosis fungoides. Author(s): Mimouni D, David M, Feinmesser M, Coire CI, Hodak E. Source: The British Journal of Dermatology. 2001 December; 145(6): 1008-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11899124&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

76

Vitiligo

•

drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMDHealth: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to vitiligo; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Vitiligo Source: Healthnotes, Inc.; www.healthnotes.com Vitiligo Source: Integrative Medicine Communications; www.drkoop.com

•

Alternative Therapy Raktamoksha Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html

•

Chinese Medicine Gusuibu Alternative names: Fortune's Drynaria Rhizome; Rhizoma Drynariae Source: Chinese Materia Medica Tusizi Alternative names: Dodder Seed; Semen Cuseutae Source: Chinese Materia Medica

Alternative Medicine 77

•

Herbs and Supplements Amino Acids Overview Source: Healthnotes, Inc.; www.healthnotes.com Paba Source: Healthnotes, Inc.; www.healthnotes.com PABA Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10049,00.html PABA (Para-Aminobenzoic Acid) Source: Prima Communications, Inc.www.personalhealthzone.com Phenylalanine Source: Healthnotes, Inc.; www.healthnotes.com Phenylalanine Source: Integrative Medicine Communications; www.drkoop.com Phenylalanine Source: Prima Communications, Inc.www.personalhealthzone.com Picrorhiza Alternative names: Picrorhiza kurroa Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

79

CHAPTER 4. PATENTS ON VITILIGO Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “vitiligo” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on vitiligo, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Vitiligo By performing a patent search focusing on vitiligo, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We

8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

80

Vitiligo

will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on vitiligo: •

Composition and method for stimulating the synthesis of the melanotic pigment of the skin Inventor(s): Cao; Carlos M. M. (Miramar, CU), Gonzalez; Manuel T. (Miramar, CU) Assignee(s): Empresa Cubana Importadora Y Exportadora de Productos Medicos (Havana, CU) Patent Number: 4,507,277 Date filed: April 8, 1983 Abstract: A composition useful in the treatment of vitiligo, a method for preparing said composition and a method of treating vitiligo with said composition wherein said composition comprises a placental alpha lipoprotein component extracted from placental cotyledons. Excerpt(s): This invention relates to the treatment of vitiligo. More particularly, it relates to a composition useful in the treatment of vitiligo, a method for preparing said composition and a method of treating vitiligo with said composition wherein said composition comprises a placental alpha lipoprotein component extracted from placental cotyledons using a solution of benzoic acid in ethanol. Vitiligo is a dermatological illness, due to the absence of melanotic pigments, wherein portions of the body are devoid of color while the surrounding areas are excessively colored. This disease, whose etiology is unknown, afflicts about 1% of the world's population (i.e., about 40.times.10.sup.6 persons), with concommitant effects to the afflicted person's psyche and social behavior. Consequently, it has long been desirable to obtain treatments whereby the skin is enabled to regain its normal coloration. It has long been known to treat vitiligo with psoralens which are either ingested by the patients, or applied to the melanophores wherein the pigment is produced, followed by exposure to ultraviolet (UV) radiation, whereby the melanotic pgiment is produced and the normal coloration of the patient restored. Web site: http://www.delphion.com/details?pn=US04507277__

•

Composition and method of treating depigmentation disorders Inventor(s): Schallreuter; Karin U. (Quickborn, DE), Wood; John M. (Quickborn, DE) Assignee(s): Stiefel Laboratories, Inc. (Coral Gables, FL) Patent Number: 5,433,942 Date filed: November 15, 1993 Abstract: Vitiligo and other tyrosinase-positive depigmentation disorders are treated by topical application of a pseudocatalase and subsequent exposure to a sub-minimal erythema dose of UVB light. After a course of treatment, pigmentation of the affected areas can be maintained by treatment with the pseudocatalases without UVB light treatment. The preferred pseudocatalases are transition metal co-ordination complexes, especially manganese (II) bicarbonate. Excerpt(s): This application was filed under 35 USC.sctn. 371 through PCT/GB92/00878, filed May 15, 1992. The present invention relates to the treatment of tyrosinase-positive

Patents 81

depigmentation disorders and has particular application to the treatment of vitiligo. It provides compositions for said treatment and methods of said treatment. Vitiligo is a chronic depigmentation disorder in which the patient has unsightly white patches or spots which are caused by localized loss of pigment and are very liable to sunburn. Although the condition is not debilitating, it is often emotionally stressful to the patient. The cause presently is unknown but it has been speculated that it results from an autoimmune response, involvement of the nervous system or a toxic effect on melanocytes. Usually, the only treatment is the use of skin-colouring cosmetics to disguise the patches or, in the case of Blacks and Indians, of depigmenting agents such as hydroquinone to depigment the remaining pigmented skin. Some limited success in treatment has been reported using the so-called PUVA method. Web site: http://www.delphion.com/details?pn=US05433942__ •

Composition for stimulating the synthesis of the melanic pigment and process for obtaining it Inventor(s): Cao; Carlos M. Miyares (Habana, CU) Assignee(s): Centro de Histoterapia Placentaria (CU) Patent Number: 6,660,305 Date filed: May 7, 2001 Abstract: This invention relates to the field of human medicine, more specifically to dermatology, and in particular to a composition developed for the stimulation of the synthesis of the melanic pigment of the skin, therefore useful for the treatment of vitiligo. The technical goal of this invention is to provide a composition of natural origin useful in the treatment of vitiligo that has no toxic effects and no relapse. The composition obtained stimulates the synthesis of the melanic pigment of the skin and the reproduction of melanocytes, as demonstrated through pharmacological tests to which the composition was subjected, causing no serious secondary reactions at all, as demonstrated in the toxicological, teratological and clinical tests performed. The resulting product can easily be obtained and applied, repigmentation begins rapidly after initiating the treatment, and the effect is irreversible. The color acquired is identical to the color of the normal skin areas of the patient, but these areas do not further increase the intensity of their coloration after the product has been applied. The product can also be used for the treatment of any depigmentation process of the skin, for example, that caused by burns. Excerpt(s): This invention relates to the field of human medicine, more specifically to dermatology, and in particular to a composition developed for stimulating the synthesis of the melanic pigment of the skin, therefore useful in the treatment of vitiligo, as well as the procedure for obtaining that composition. Vitiligo or leukoderma is one of the oldest known diseases of humanity, and is characterized by the loss of the cells that produce melanic pigment in the skin. This disease affects approximately 1% of the world's population, without distinction as to age, sex or race. It is of unknown etiology and no treatment has been found for it up to now. It appears as a gradual depigmentation of the skin of patients who are in situations of extreme nervous tension, and has an unfavorable affect on their psyche and social behavior as its external symptoms emerge, appearing as white areas of skin surrounded by a halo of hyperpigmentation, and manifesting themselves primarily on the face, trunk and around the joints. Current technology recognizes that certain chemical substances of vegetable origin or produced semi-synthetically, known as psoralens, can be used in the

82

Vitiligo

treatment of vitiligo. These substances, administered orally or topically, concentrate in the melanocytes or cells that produce the dermic pigment, absorbing energy from ultraviolet radiation and stimulating the production of the pigment melanin. (Arnold, M. J. Jr. "Psoralens and Suntan," Hawaii Med. J., 1957-16391); (Becker, S. W. Jr. "Methods of Increasing Skin Pigmentation," J. Sec. Cosmetic Ehem., 1958-9-80); (Fitzpatrick, T.B. "Pigmentary Diseases," Current Therapy, 1958-314); (Becker, S. W. Jr. "Effects of 8Methoxy Psoralen and Ultraviolet Light in Human Skin," Science, 1958-127-878); (Sidi, E. Planat, P. "Practical Considerations on Current Treatment of Vitiligo," Revue of Medicine, Dec. 23, 1968). Web site: http://www.delphion.com/details?pn=US06660305__ •

Method and composition for treating vitiligo Inventor(s): Montes; Leopoldo F. (Buenos Aires, AR) Assignee(s): none reported Patent Number: 4,985,443 Date filed: August 4, 1989 Abstract: To cure vitiligo without side effects, a disease characterized by cutaneous depigmentation, a treatment consisting in the oral administration of folic acid in daily doses from 1 to 50 mg. The treatment of vitiligo with folic acid can be enhanced by also using oral vitamin C and intramuscular vitamin B.sub.12. Excerpt(s): The present invention deals with a new treatment of patients having vitiligo be means of chemical compositions containing folic acid. Vitiligo is a disease which affects 1%-2% of the world population according to J. A Rook, D. S. Wilkinson and F. J. G. Ebling ( Textbook to Dermatology, Blackwell Scientific Publications, Oxford, 1979). It results from the lack of melanin in the epidrmis due to the disappearance of melanocytes from the epidermis, as it is defined by A. S. Breathnach, S. Bohr and L. M. Wyllie in "Electron Microscopy of Peripheral Nerve Terminals and Marginal Melanocytes in Vitiligo", J. Invest. Dermat. 47:125-140, 1966. Web site: http://www.delphion.com/details?pn=US04985443__

•

Photochemotherapic method of treating psoriasis by using methylangelicin compounds Inventor(s): Baccichetti; Francarosa (Padua, IT), Bordin; Franco (Padua, IT), Bragadin; Carlo M. (Trieste, IT), Carlassare; Francesco (Padua, IT), Cristofolini; Mario (Trento, IT), Dall'Acqua; Francesco (Padua, IT), Guiotto; Adriano (Padua, IT), Pastorini; Giovanni (Padua, IT), Recchia; Giovanni (Trento, IT), Rodighiero; Giovanni (Padua, IT), Rodighiero; Paola (Padua, IT), Vedaldi; Daniela (Padua, IT) Assignee(s): Consiglio Nazionale delle Ricerche (Rome, IT) Patent Number: 5,001,147 Date filed: May 16, 1988 Abstract: The alkylangelicins according to the invention are obtained starting from an umbelliferone, in which the 6-position is already substituted by an alkyl group; in such a way the 7-allyloxy or 7-acyloxy umbelliferone intermediates can form by transposition of the allyl or acyl group only the 8-allyl and 8-acyl derivatives, and therefore the

Patents 83

presence, even in traces, of psoralens is absolutely excluded in the subsequent synthetic steps.The 6-alkylangelicins thus obtained are particularly usable for the photochemotherapy of psoriasys and of other skin diseases characterized by cellular hyperproliferation, as well as for the photochemotherapy of vitiligo and of alopecia aerata. Excerpt(s): The present invention concerns a process of producing alkylangelicins (angular furocoumarins) free from psoralens (linear furocoumarin) and alkylangelicins obtained therefrom, particularly to be used for the photochemotherapy of psoriasis and of other skin diseases characterized by cellular hyperproliferation, as well as for the photochemotherapy of vitiligo and of alopecia aerata. It is well known that the photochemotherapy of psoriasis, of mycosis fungoides and of other skin diseases characterized by cellular hyperproliferation is carried out with the combined action of psoralens (bifunctional linear furocoumarins) and long wave ultraviolet light; this therapy is also known as PUVA from psoralens+UV-A light (320-400 nm) (Parrish et al. New Eng. J. Med.--291, 1207 (1974)). This treatment utilizes the property of the psoralens to photodamage the skin cellular DNA in a selective way. Web site: http://www.delphion.com/details?pn=US05001147__ •

Process for the preparation of an extract from human placenta containing glycosphingolipids and endothelin-like constituent peptides useful for the treatment of vitiligo Inventor(s): Bhadra; Ranjan (Calcutta, IN), Dutta; Ajit Kumar (Calcutta, IN), Pal; Prajnamoy (Calcutta, IN), Roy; Rabindra (Dickinson, TX) Assignee(s): Council of Scientific & Industrial Research (IN) Patent Number: 5,690,966 Date filed: October 17, 1996 Abstract: A process for the preparation of an extract from human placenta containing glycosphingolipids and endothelin-like peptides useful for the treatment of vitiligo is disclosed. Excerpt(s): Vitiligo or `Swetakustha`, as described in ancient medical text, is a skin disfiguring phenomenon affecting about 1% of the world population compared to 3% Indians. Though not painful or lethal in nature but patients burdened with mental agony and depression due to social stigma, are extremely eager to have a wholly satisfactory-therapy for this disease. Unfortunately, vitiligo failed to respond in many oases with the therapies currently in use. So to develop a therapy satisfying the desired parameters has remained as a challenge to modern medical science. Among the therapies mostly ill-defined, human placental extract has been claimed to be effective for vitiligo without proper justification by scientific investigation namely indication of the active components. Still the method of preparation of the extract is secretly guarded. Regarding the efficacy of the available placental extract used in the treatment of vitiligo a lot of criticisms have been cropped up from different scientific quarters (Nordlund J. J., Halder R. Melagenina--An analysis of published and other available data. Dermatologica 1990; 181: 1-4; Goldstein E., Haberman H. F., Menon I. A., Pawlowski D. Non-psoralen treatment of vitiligo. Part II. Less commonly used and Experimental Therapies. Int. J. Dermatol. 1992; 31: 314-319) primarily for the lack of scientific evidences in respect of active principles present in it. But all the critics instead of discarding it as therapy, stressed the need for a thorough and intensive scientific

84

Vitiligo

investigation to look for the active components of the extracts. Some recent reports (Kojima N., Hakomori Sen-itiroth--Cell adhesion, spreading and motility of GM3expressing cells based on glycolipid-glycolipid interaction. J. Biol. Chem. 1991; 266: 17552-17558; Imokawa G., Yada Y., Miyagishi M. Endothelin secreted from human kerationcytes are intrinsic mitogens for human melanocytes. J. Biol. Chem. 1992; 267: 24675-24680) in this respect described that glycosphingolipids and a 21-amino acid vasocons-trictor peptide, endothelin are the potent modulators of melanocyte migration as well as motility and growth promotion respectively. These are the key events in the recovery of skin pigmentation. Web site: http://www.delphion.com/details?pn=US05690966__ •

Sunless tanning cream Inventor(s): Grimes; Pearl (340 S. Lorraine Blvd., Los Angeles, CA 90020), Klein; Ken (Fairlawn, NJ), Palefsky; Irwin (Clifton, NJ) Assignee(s): Grimes; Pearl (Los Angeles, CA) Patent Number: 6,630,130 Date filed: July 16, 2001 Abstract: A sunless tanning formulation is provided to impart a cosmetic coloring effect to skin. The formulation is particularly useful to camouflage the effects of vitiligo. The formulation has both makeup coloring components for instant coloring effect, and dihydroxyacetone for a lasting coloring effect. The formulation is a water-in-oil emulsion with water being the inner phase and oil being the outer phase. A method of camouflaging depigmented splotches resulting from vitiligo using dihydroxyacetone is also provided. Excerpt(s): The invention relates to a sunless tanning cream effective as a self tanning formulation and in camouflaging the effects of vitiligo on human skin. Millions of people desire efficacious products to camouflage skin imperfections as well as the effects of leukodermic conditions such as vitiligo. In addition, many of the same people also want tanned skin. Despite the well documented negative effects of long-term exposure to ultraviolet light, global populations generally equate tanned skin with health and affluence. Present sunless tanning products have proven inadequate to serve the above needs of consumers, particularly African American consumers, due to inadequate match of skin tone and poor functional longevity. It would be advantageous to provide a sunless tanning cream that effectively provides the appearance of tanned skin without having to go into the sun. It would be even more advantageous if such a cream would produce an immediate tanned appearance and last for an extended period of time. Web site: http://www.delphion.com/details?pn=US06630130__

•

Use of locally applied DNA fragments Inventor(s): Eller; Mark (Boston, MA), Gilchrest; Barbara A. (Brookline, MA), Yaar; Mina (Sharon, MA) Assignee(s): Trustees of Boston University (Boston, MA) Patent Number: 5,955,059 Date filed: June 6, 1995

Patents 85

Abstract: Methods of treatment or prevention of hyperproliferative diseases or precancerous conditions affecting epithelial cells, such as psoriasis, vitiligo, atopic dermatitis, or hyperproliferative or UV-induced dermatoses, and methods for reducing photoaging or for prophylaxis against or reduction in the likelihood of the development of skin cancer, are disclosed. The methods comprise administering to the cells of interest an effective amount of DNA fragments, either single- or double-stranded, or a mixture of both single- and double-stranded fragments, or deoxynucleotides, dinucleotides, or dinucleotide dimers. The DNA fragments, deoxynucleotides, dinucleotides, or dinucleotide dimers can be administered in an appropriate vehicle, such as a liposomal preparation or propylene glycol. Preparations useful in the present methods are additionally disclosed. The preparations comprise DNA fragments, either single- or double-stranded, or a mixture of both single- and double-stranded fragments, or deoxynucleotides, dinucleotides, or dinucleotide dimers, and an appropriate delivery vehicle, such as liposomes or propylene glycol. Excerpt(s): Human skin consists of two layers, the dermis and the epidermis. The epidermis, which is the uppermost of the two skin layers, encompasses many different cell types, including melanocytes and keratinocytes. Melanocytes are specialized cells in the basal layer of the epidermis which synthesize melanin; the melanin is then packaged into melanosomes and then transported into keratinocytes. Exposure of skin to the sun results in vitamin D synthesis, sunburn (erythema), and tanning, the skin's major form of endogenous protection against subsequent skin damage from ultraviolet (UV) irradiation. Various morphologic and enzymatic changes occur at the cellular level in epidermal melanocytes in response to UV irradiation. Melanin, which is increased in "tanned" skin, serves as a filter with absorbance within the UV range and provides photoprotection for the individual. The peak action spectrum for erythema is in the UVB range, 290-305 nm. UV-B rays are absorbed by proteins and nucleic acids of the epidermis, causing the production of thymine dimers, which are known to be formed by UV irradiation of nuclear DNA and to be excised from the DNA strand by the action of highly specific enzymes, including endonucleases. If not removed, these dimers can stall DNA replication forks generating regions of single-stranded DNA. Failure to remove thymine diners and other DNA mutations in the genome may lead to somatic mutations resulting in carcinogenesis. Web site: http://www.delphion.com/details?pn=US05955059__

Patent Applications on Vitiligo As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to vitiligo:

9

This has been a common practice outside the United States prior to December 2000.

86

Vitiligo

•

Composition and method for the treatment of vitiligo Inventor(s): Zhao, Huiping; (Etobicoke, CA) Correspondence: Gifford, Krass, Groh, Sprinkle; Anderson & Citkowski, PC; 280 N Old Woodard Ave; Suite 400; Birmingham; MI; 48009; US Patent Application Number: 20010044422 Date filed: December 28, 2000 Abstract: Compositions and methods for the treatment of vitiligo. The composition comprises at least one member selected from the group consisting of: Eclipta prostrata L., Angelica dahurica (Fish. ex. Hoffm), Polygonum multiforum Thumb, Astragalus complanatus, Tribulus terrestris L., Lithospermum erythrorhizon sieb et zucc, Paris petiolata (Bak. ex Forb), Salvia multiorrhiza Bge, Sophora flavescens Ait, Atractylodes lancea (Thumb) Dc, and combinations thereof. The method comprises treating the vitiligo by orally administering this composition to the patient. The treatment may be further enhanced by topically administering to the affected areas a composition selected from the group consisting of: a preparation of sulfur and kerosene; a preparation of Nevlum oporum solund and alcohol; a preparation of Cinnamomum cassia presl, Psoralea corylifalia L., alcohol and water; and a preparation of Portulaca oleracea L., brown sugar, and vinegar. Excerpt(s): This application claims priority from Provisional Patent Application No. 60/173,527, filed Dec. 29, 1999. This invention relates generally to treatment of skin conditions and, more specifically, to the treatment of vitiligo. Most specifically, the invention relates to compositions for the treatment of vitiligo, and methods for their use. Vitiligo, also referred to as leucoderma, is a skin condition characterized by patchy loss of pigmentation from a person's skin. The specific causes of vitiligo are unknown; however, the depigmented areas are lacking in the skin pigment melanin, and it is believed that the disease is the result of the destruction or inhibition of the melanin secreting melanocytes in the affected areas. There may be some hereditary component to the disease, since approximately 30% of the cases have a familial correlation. It is speculated that the disease may be the result of an autoimmune condition. It is also possible that a specific metabolic defect may be involved, and in some instances, environmental factors appear to play a role. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Human melanocyte stimulating hormone receptor polypeptide and DNA Inventor(s): Chhajlani, Vijay; (Uppsala, SE), Wikberg, Jarl; (Umea, SE) Correspondence: Sterne, Kessler, Goldstein & Fox Pllc; 1100 New York Avenue, N.W., Suite 600; Washington; DC; 20005-3934; US Patent Application Number: 20020142392 Date filed: January 23, 2002 Abstract: Novel DNA fragments encoding novel polypeptide having properties of melantropic hormone receptors, especially DNA fragments encoding melanocyte stimulating hormone receptors (MSH receptors), as well as polypeptide which are MSH receptors, are disclosed. The use and engineering of melanotropic hormone receptor DNA and polypeptide for production of monoclonal antibodies for diagnostic and therapeutic purposes, as well as the engineering of drugs, cell lines, vectors and DNA

Patents 87

for therapeutic and diagnostic purposes are also disclosed. Also disclosed are methods for therapy and diagnosis of malignant melanoma, skin cancer, vitiligo, pyretic condition, inflammatory condition, nociceptive condition, catatonic condition, impaired memory condition, reduced or increased skin tanning, pigmentation condition, epilepsy and nerve damage, using the DNA fragments, polypeptide and antibodies. Methods for selecting substances which interact with the receptors are also disclosed. Excerpt(s): The present invention relates to a DNA fragment encoding the human melanocyte stimulating hormone receptor (MSH receptor) or an analogue or subsequence thereof. The DNA fragment contains an open reading frame of 951 bp which codes for a polypeptide of 317 amino acids, said DNA fragment as well as its analogues, subsequences or modifications constitute an important aspect of the invention. The DNA fragment has been expressed in an eukaryotic cell line and the expressed protein has been found to have properties identical to that of a native MSH receptor. The invention also relates to a DNA fragment encoding a subtype of the human MSH receptor (in this application designated MC-2) which contains an open reading frame of 975 bp which codes for a polypeptide of 325 amino acids, said DNA fragment as well as its analogues, subsequences or modifications also constitute an important aspect of the invention. This DNA fragment has also been expressed in an eukaryotic cell line and the expressed protein has been found to have properties to that of an MSH receptor subtype. The invention also relates to a polypeptide encoded by a DNA fragment of the invention and to analogues and subsequences of said polypeptide. Furthermore, the invention relates to the use of the DNA fragments or analogues or subsequences thereof, and to the use of polypeptides of the invention encoded by the DNA fragments of the invention. Especially interesting is the use of the polypeptides of the invention which have MSH receptor activity. The use of the polypeptides of the invention or analogues or subsequences thereof for generation of antibodies constitutes yet another aspect of the invention. Also, the invention relates to diagnostic and therapeutic methods and diagnostic and therapeutic agents for use in the diagnosis and treatment of MSH receptor expressing disease conditions such as vitiligo, melanoma, skin cancer, pyretic conditions, inflammatory conditions and nociceptive conditions, catatonic conditions and impaired memory conditions, and to methods for detecting and quantitating the MSH receptor. In addition, the invention provides methods for testing substances capable of interfering with the activity of the MSH receptor and methods for treatment of MSH receptor expressing disease conditions. The patent application also relates to the use of the MSH receptor coding fragments or the MSH receptor during non-disease conditions for the control or diagnosis and/or determination and/or production control of skin and/or hair and/or fur color in man and/or animals. Moreover, the patent application relates to the elucidation of the structure of the MSH receptor in three dimensions by the utilization of computer modelling methods and/or by application of structure analysis by crystallographic approaches and/or NMR (Nuclear Magnetic Resonance) and to the use of the knowledge of the receptor structure for the design of drugs with binding affinity for the MSH receptor and/or its subtype (MC-2). The present invention which comprises a DNA fragment encoding the MSH receptor or analogues thereof and the application of these and in this connection methods for identifying products which pertains to the MSH receptor and/or its biological functions constitutes significant contributions which will become useful for biotechnological, pharmaceutical, medical and veterinary practices. As a background to the uses of a DNA fragment and analogues and subsequences thereof and the application of these, some of the most important facts regarding the MSH receptor and its biological functions in man and animals are summarized below.

88

Vitiligo

Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method of prophylaxis or treatment of antigen presenting cell driven skin conditions using inhibitors of the CD2/LFA-3 interaction Inventor(s): Cooper, Kevin D.; (Ann Arbor, MI), Wallner, Barbara P.; (Weston, MA) Correspondence: Louis Myers; Fish & Richardson P.C.; 225 Franklin Street; Boston; MA; 02110-2804; US Patent Application Number: 20020009449 Date filed: December 5, 2000 Abstract: Methods of using inhibitors of the CD2/LFA-3 interaction in treating skin conditions characterized by increased T cell activation and abnormal antigen presentation in the dermis and epidermis in mammals, including humans. Such conditions include psoriasis, UV damage, e.g., photoaging, atopic dermatitis, cutaneous T cell lymphoma such as mycosis fungoides, allergic and irritant contact dermatitis, lichen planus, alopecia areata, pyoderma gangrenosum, vitiligo, ocular cicatricial pemphigoid, and urticaria. Excerpt(s): This application is a continuation-in-part of U.S. Ser. No. 07/862,022, filed Apr. 2, 1992 and of PCT/U.S. 92/08755, filed Oct. 6, 1992, which is a continuation-inpart of U.S. Ser. No. 07/770,969, filed Oct. 7, 1991, all of which are herein incorporated by reference. This invention relates to methods of using inhibitors of the CD2/LFA-3 interaction in treating skin conditions characterized by increased T cell activation and abnormal antigen presentation in the dermis and epidermis in mammals, including humans. Such conditions include psoriasis, UV damage, e.g., photoaging, atopic dermatitis, cutaneous T cell lymphoma such as mycosis fungoides, allergic and irritant contact dermatitis, lichen planus, alopecia areata, pyoderma gangrenosum, vitiligo, ocular cicatricial pemphigoid, and urticaria. There are numerous skin conditions characterized by increased T cell activation and abnormal antigen presentation in the dermis and epidermis. The pathophysiologic mechanisms involved in the evolution of such inflammatory processes are poorly understood. However, it has become apparent that skin cells are important in the generation of a cutaneous inflammatory response (Kupper, "Immune and Inflammatory Processes in Cutaneous Tissues", J. Clin. Invest., 86, pp. 1783-89 (1990)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Methods and compositions for increasing skin remodeling Inventor(s): Pickart, Loren R.; (Bellevue, WA) Correspondence: Townsend And Townsend And Crew, Llp; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20030166510 Date filed: October 11, 2001 Abstract: Skin remodeling is stimulated at the site of blemished skin using an ionic metal-peptide complex to diminish or remove the skin imperfection. The blemish can be a scar, especially surgical or wound scars, acne scars, keloid scars, and the like, or a skin tag, callus, benign skin mole, stretch marks, facial keratosis, thickened sunspots of the

Patents 89

skin, or a vitiligo spot. The peptide-ionic metal complex is comprised of an ionic metal selected from copper(II), tin(II), tin(IV), and zinc(II), and salts thereof, and the peptide component can be a hydrolysis of casein, collagen, elastin, meat products, silk protein, or soybean protein, or a chemically synthesized dipeptide, tripeptide, tetrapeptide or the like which complexes with the ionic metal. Excerpt(s): This application claims priority to U.S. Provisional Patent Application No. 60/239,831, filed Oct. 11, 2000, incorporated herein by reference in its entirety. The treatment of skin imperfections such as scars, solar keratosis (sun damages marks), age spots, vitiligo marks, skin tags, calluses, keloids, moles, pigmentations, and stretch marks remains a major problem despite the development of numerous treatments such as the use of silicone sheets, scar subcision, deep chemical peels, laser resurfacing, dermabrasion and so forth. The problem with current techniques for removal of skin imperfections is that they all are poorly effective, expensive and often painful. And, if the dermatologist or esthetician performing the procedure is not highly skilled, the results can produce further scarring. One way to accelerate remodeling is the use of exfoliating chemicals to speed skin shedding; in stronger versions they are used as "chemical peels". Likewise, biochemicals such as retinol and retinoic acid activate systems that increase skin breakdown and resynthesis. Another way to accelerate skin remodeling is with the use of skin regeneration accelerators that enhance the skin's production of collagen and elastin. The use of skin regeneration accelerators can be combined with the methods that cause controlled skin damage. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods and compositions for the preparation of cell transplants Inventor(s): Seubert, Rainer; (Waldkirch/Kollnau, DE), Tanczos, Eszter; (Freiburg, DE) Correspondence: Michael R. Ward; Morrison & Foerster Llp; 425 Market Street; San Francisco; CA; 94105-2482; US Patent Application Number: 20010006813 Date filed: December 6, 2000 Abstract: The present invention relates to a method for the cultivation of eucaryotic cells, the use of cells cultured according to said method for the preparation of in particular autologous, but also allogenous (cell) transplants, as well as JIM particular the use of accordingly prepared autologous melanocyte and/or keratinocyte transplants for the treatment of vitiligo patients; furthermore, also to melanocyte and/or keratinocyte transplants prepared accordingly. The present invention furthermore relates to new compositions comprising melanocytes as Well as their use for the treatment of vitiligo patients; furthermore to the use of compositions comprising keratiziocytes for the treatment of various dermatological symptoms and diseases. Excerpt(s): The present invention in general relates to the technical field of eucaryotic cell culture and tissue engineering. It specifically relates to a method for the cultivation of eucaryotic cells, the use of cells cultured according to this method for the preparation of in particular autologous, but also allogenous (cell) transplants, as well as, in particular, the use of autologous melanocyte and/or keratinocyte transplants prepared according to the present invention for the treatment of vitiligo patients; it furthermore also relates to melanocyte and/or keratinocyte transplants prepared according to the present invention. The present invention further relates to new compositions comprising melanocytes as well as their use for the treatment of vitiligo patients; furthermore, the

90

Vitiligo

use of compositions comprising keratinocytes for the treatment of various dermatological symptoms and diseases. The medical-biotechnological field of tissue engineering encompasses the development, preparation, and modification of implants, biomolecules prepared in vitro, cells or tissues for the substitution or functional assistance of missing or injured body parts and tissues. One focus lies in the preparation of so-called autologous transplants. The underlying principle is to derive cells of the type to be transplanted from the healthy tissue of a patient, the so-called donor area, to culture them in vitro, to use them for the preparation of a transplant, e.g., by introducing hem into a suitable carrier matrix, and to finally apply them to an accordingly prepared receptor area of the same patient. A decisive advantage of this kind of therapy lies therein that there is usually little danger of immunological responses or infection, which frequently occur in the case of heterologous transplants. In principle, the preparation of such autologous transplants is imaginable on the basis of numerous cell and tissue types, e.g., skin, cartilage, bone, fatty or other kinds of tissue. In practice, the skin is, for example, particularly suitable due to its exposed location and thus easy accessibility. Furthermore, there are various dermatological indicational fields which require--often extended--skin transplantation. In this regard, in particular severe burn injuries as well as badly healing skin ulcera need to be mentioned on the one hand, on the other pigmentation deficiencies such as vitiligo. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Treatment of skin conditions Inventor(s): Hider, Robert C.; (Essex, GB), Lin, Zhixu; (London, GB), Raman, Amala; (London, GB), Venkatasamy, Radhakrishnan; (London, GB) Correspondence: Nixon & Vanderhye P.C.; 1100 North Glebe Road, 8th Floor; Arlington; VA; 22201-4714; US Patent Application Number: 20020168369 Date filed: January 22, 2002 Abstract: The present invention provides piperine and analogues or derivatives thereof for the treatment of skin conditions treatable by stimulation of melanocyte proliferation, such as vitiligo, and also for treating skin cancer. The piperine and analogues or derivatives thereof may also be used to cosmetically promote or enhance the natural coloration of the skin. Excerpt(s): This application is a continuation-in-part application from PCT (U.S.) application GB 99/02256 (Publication N.sup.0 WO 00/02544) filed Jul. 13, 1999. This invention relates to the treatment of skin conditions, comprising those conditions requiring stimulation of melanocyte proliferation and to the inhibition of melanomas. The invention is of especial application to the treatment of vitiligo and skin cancer. Vitiligo is a common skin pigment disorder characterised by the development of patchy de-pigmented lesions. Current treatments which include the use of photosensitisers (eg psoralens) with UVA radiation (PUVA), corticosteroids or skin grafting have low success rates and are generally accompanied by unpleasant side effects. Vitiligo has a highly detrimental impact on the emotional well-being of the sufferer, the disfiguring effects of the disease being compounded by the absence of a suitable treatment. Although vitiligo patches are not believed to contain melanocytes (pigment producing cells), a reservoir exists in hair follicles in vitiliginous skin. Thus activation of hair follicular melanocytes is a crucial process in the repigmentation of vitiliginous skin.

Patents 91

Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Treatment of skin disorders with UV light and cooling Inventor(s): Irwin, Dean S.; (Del Mar, CA) Correspondence: Knobbe Martens Olson & Bear Llp; 2040 Main Street; Fourteenth Floor; Irvine; CA; 91614; US Patent Application Number: 20020183811 Date filed: February 27, 2002 Abstract: Skin disorders such as, for example, atopic dermatitis, dyshidrosis, eczema, lichen planus, psoriasis, and vitiligo, are treated by applying high doses of ultraviolet light to diseased regions of a patients skin. The dosage employed exceeds 1 MED, an MED being determined for the particular patient being treated, and may range from about 1 MED to about 20 MED or higher. The ultraviolet light has a wavelength within the range of between about 295 nanometers to about 320 nanometers and preferably is between about 300 nanometers and about 310 nanometers. High doses of ultraviolet light are restricted to diseased tissue areas so as to avoid risk of detrimental side affects in healthy skin, which is more susceptible to damage from UV light. Cooling the skin prior to and/or while exposing the skin to the UV light can be used to minimize tissue damage resulting from exposure to the UV light. Higher doses of UV light can therefore be employed without injurious affects. Excerpt(s): This application is a Continuation-in-part of U.S. patent application No. 09/694,086, filed Oct. 20, 2000. This application also claims priority under 35 U.S.C.sctn.119(e) from U.S. Provisional Patent Application No. 60/272,277, filed Feb. 28, 2001. The invention relates a method and apparatus for treating skin disorders such as psoriasis, and more specifically, to a method and apparatus for treating skin disorders involving exposing a patient's skin to high intensity ultraviolet (UV) light. Skin disorders, including atopic dermatitis, dyshidrosis, eczema, lichen planus, psoriasis, and vitiligo, are conditions that commonly affect large populations at some time in their lives. For example, about 2% to 3% of the population of northern Europe is estimated to be afflicted with psoriasis. Although the disease's prevalence in the United States is not as well understood, it appears that between 150,000 and 260,000 new cases are diagnosed each year. This suggests that at least several million people suffer from the disease in the United States. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Treatment of vitiligo Inventor(s): Spencer, James M.; (New York, NY) Correspondence: Darby & Darby P.C.; 805 Third Avenue; New York; NY; 10022-7513; US Patent Application Number: 20020013609 Date filed: February 22, 2001 Abstract: Disclosed herein is a novel method of treating vitiligo by using an excimer laser that emits light in the UVB range. The invention includes a method of

92

Vitiligo

incrementally increasing exposure of affected vitiligo areas with UVB laser light from an excimer laser to restore pigmentation to skin areas afflicted with vitiligo. Excerpt(s): This application claims priority under 35 U.S.C.sctn. 119 from the Provisional Application Ser. No. 60/184,971 filed Feb. 25, 2000, incorporated herein by reference in its entirety. Vitiligo is a cutaneous disease in which there is a complete loss of pigment in localized areas of the skin. This loss of pigment results in the effected areas being completely white. This condition has a predilection for the skin around the mouth and the eyes. The result is cosmetically disfiguring, especially for dark skinned people. Furthermore, the depigmented skin is sun sensitive, and thus is subject to sunburns and skin cancer. In sum, vitiligo is both cosmetically and practically distressing to patients afflicted with the disease. In normal skin, varying shades of brown are seen (depending on a person's race) representing the pigment melanin. This pigment is produced by a cell type known as a melanocyte. In vitiligo, there is an absence of melanocytes in the areas afflicted with the disorder. An absence of melanocytes results in an absence of melanin pigment, and thus the melanin-free area is white. Normal skin responds to ultraviolet light with an increase in the brown pigment melanin (tanning). Specifically, ultraviolet radiation stimulates melanocytes to proliferate and produce more melanin. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Vanilloid receptor ligands and their use in treatments Inventor(s): Bo, Yunxin Y.; (Thousand Oaks, CA), Chakrabarti, Partha P.; (Simi Valley, CA), Chen, Ning; (Thousand Oaks, CA), Doherty, Elizabeth M.; (Newbury Park, CA), Fotsch, Christopher H.; (Thousand Oaks, CA), Han, Nianhe; (Thousand Oaks, CA), Kelly, Michael G.; (Thousand Oaks, CA), Liu, Qingyian; (Camarillo, CA), Norman, Mark Henry; (Thousand Oaks, CA), Ognyanov, Vassil I.; (Thousand Oaks, CA), Wang, Xianghong; (Moorpark, CA), Zhu, Jiawang; (Simi Valley, CA) Correspondence: U.S Patent Operations/rvp; DEPT. 4300, M/s 27-4-a; Amgen INC.; One Amgen Center Drive; Thousand Oaks; CA; 91320-1799; US Patent Application Number: 20030195201 Date filed: December 10, 2002 Abstract: Compounds having the general structure 1and compositions containing them, for the treatment of acute, inflammatory and neuropathic pain, dental pain, general headache, migraine, cluster headache, mixed-vascular and non-vascular syndromes, tension headache, general inflammation, arthritis, rheumatic diseases, osteoarthritis, inflammatory bowel disorders, inflammatory eye disorders, inflammatory or unstable bladder disorders, psoriasis, skin complaints with inflammatory components, chronic inflammatory conditions, inflammatory pain and associated hyperalgesia and allodynia, neuropathic pain and associated hyperalgesia and allodynia, diabetic neuropathy pain, causalgia, sympathetically maintained pain, deafferentation syndromes, asthma, epithelial tissue damage or dysfunction, herpes simplex, disturbances of visceral motility at respiratory, genitourinary, gastrointestinal or vascular regions, wounds, burns, allergic skin reactions, pruritis, vitiligo, general gastrointestinal disorders, gastric ulceration, duodenal ulcers, diarrhea, gastric lesions induced by necrotising agents, hair growth, vasomotor or allergic rhinitis, bronchial disorders or bladder disorders. Excerpt(s): This application claims the benefit of U.S. Provisional Application Nos. 60/339,161 filed Dec. 10, 2001, 60/344,737, filed Dec. 21, 2001, 60/383,331, filed May 22, 2002 and 60/402,422, filed Aug. 8, 2002, which are hereby incorporated by reference.

Patents 93

The vanilloid receptor 1 (VR1) is the molecular target of capsaicin, the active ingredient in hot peppers. Julius et al. reported the molecular cloning of VR1 (Caterina et al., 1997). VR1 is a non-selective cation channel which is activated or sensitized by a series of different stimuli including capsaicin and resiniferatoxin (exogenous activators), heat & acid stimulation and products of lipid bilayer metabolism, anandamide (Premkumar et al., 2000, Szabo et al., 2000, Gauldie et al., 2001, Olah et al., 2001) and lipoxygenase metabolites (Hwang et al., 2000). VR1 is highly expressed in primary sensory neurons (Caterina et al., 1997) in rats, mice and humans (Onozawa et al., 2000, Mezey et al., 2000, Helliwell et al., 1998, Cortright et al., 2001). These sensory neurons innervate many visceral organs including the dermis, bones, bladder, gastrointestinal tract and lungs; VR1 is also expressed in other neuronal and non-neuronal tissues including but not limited to, CNS nuclei, kidney, stomach and T-cells (Nozawa et al., 2001, Yiangou et al., 2001, Birder et al., 2001). Presumably expression in these various cells and organs may contribute to their basic properties such as cellular signaling and cell division. Prior to the molecular cloning of VR1, experimentation with capsaicin indicated the presence of a capsaicin sensitive receptor, which could increase the activity of sensory neurons in humans, rats and mice (Holzer, 1991; Dray, 1992, Szallasi and Blumberg 1996, 1999). The results of acute activation by capsaicin in humans was pain at injection site and in other species increased behavioral sensitivity to sensory stimuli (Szallasi and Blumberg, 1999). Capsaicin application to the skin in humans causes a painful reaction characterized not only by the perception of heat and pain at the site of administration but also by a wider area of hyperalgesia and allodynia, two characteristic symptoms of the human condition of neuropathic pain (Holzer, 1991). Taken together, it seems likely that increased activity of VR1 plays a significant role in the establishment and maintenance of pain conditions. Topical or intradermal injection of capsaicin has also been shown to produce localized vasodilation and edema production (Szallasi and Blumberg 1999, Singh et al., 2001). This evidence indicates that capsaicin through it's activation of VR1 can regulate afferent and efferent function of sensory nerves. Sensory nerve involvement in diseases could therefore be modified by molecules which effect the function of the vanilloid receptor to increase or decrease the activity of sensory nerves. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with vitiligo, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “vitiligo” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on vitiligo. You can also use this procedure to view pending patent applications concerning vitiligo. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

95

CHAPTER 5. BOOKS ON VITILIGO Overview This chapter provides bibliographic book references relating to vitiligo. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on vitiligo include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “vitiligo” at online booksellers’ Web sites, you may discover nonmedical books that use the generic term “vitiligo” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “vitiligo” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Alopecia and Vitiligo in Autoimmune Polyendocrine Syndrome Type I (Comprehensive Summaries of Uppsala Dissertations, 935) by Hakan Hedstrand (2000); ISBN: 9155447333; http://www.amazon.com/exec/obidos/ASIN/9155447333/icongroupinterna

•

Molecular Mechanisms of Vitiligo by Pranab Das (2004); ISBN: 1587062062; http://www.amazon.com/exec/obidos/ASIN/1587062062/icongroupinterna

•

The Official Patient's Sourcebook on Vitiligo by James N. Parker (Editor), Philip M. Parker (Editor); ISBN: 0597832110; http://www.amazon.com/exec/obidos/ASIN/0597832110/icongroupinterna

•

Vitiligo & Piebaldism: Treatment of Leucoderma by Transplantation of Autologous Melanocytes (Comprehensive Summaries of Uppsala Dissertations from the Faculty of mediciNe, 1061) by Mats J. Olsson (2001); ISBN: 9155450806; http://www.amazon.com/exec/obidos/ASIN/9155450806/icongroupinterna

96

Vitiligo

•

Vitiligo : nutritional therapy by Leopoldo F. Montes; ISBN: 9879624009; http://www.amazon.com/exec/obidos/ASIN/9879624009/icongroupinterna

•

Vitiligo and Other Hypomelanoses of Hair and Skin by Jean-Paul Ortonne, et al; ISBN: 0306409747; http://www.amazon.com/exec/obidos/ASIN/0306409747/icongroupinterna

•

Vitiligo: A Monograph on the Basic and Clinical Science by Seung-Kung Hann (Editor), et al; ISBN: 0632050713; http://www.amazon.com/exec/obidos/ASIN/0632050713/icongroupinterna

•

Vitiligo: Problems and Solutions by Torello Lotti (Editor) (2003); ISBN: 0824743059; http://www.amazon.com/exec/obidos/ASIN/0824743059/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “vitiligo” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •

A comparative study of albinism, partial albinism, and vitiligo in man with reference to the presence and activity of melanocytes in areas of hypopigmentation; presentation of histological material with a discussion of techniques and review of the literature. Author: Kugelman, Thomas Peter.; Year: 1979; [New Haven, Dept. of Internal Medicine, Yale Univ. School of Medicine, 1960

•

Genetic, biochemical, and cytochemical studies on leucoderma-vitiligo: report, 19751980 Author: Shah, V. C. (Vinodkant Chunilal),; Year: 1982; Ahmedabad: Gujarat University, 1982

•

Vitiligo: klinika, etiologiia, patogenez, lechenie, reabilitatsiia, profilaktika. Author: IU.N. Koshevenko; Year: 2002

•

Vitiligo: neural and immunologic linkages Author: Dutta, A. K.; Year: 1988; Calcutta: Indira Publication, 1988

•

Vitiligo: nutritional therapy. Author: Leopoldo F. Montes; Year: 1997

•

Vitiligo and psoralens. Author: El-Mofty, Abdel Monem.; Year: 1979; Oxford, New York, Pergamon [c1968]

•

Vitiligo; etiologiia, patogenez, klinika i lechenie. Pod red. I. A. Telishevskogo. Author: Tadzhibaev, Tokhtapulat Tadzhibaevich; Year: 1972

10

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

Books

97

Chapters on Vitiligo In order to find chapters that specifically relate to vitiligo, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and vitiligo using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “vitiligo” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on vitiligo: •

Solving Skin Problems Source: in Touchette, N. Diabetes Problem Solver. Alexandria, VA: American Diabetes Association. 1999. p. 295-311. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $19.95 for members; plus shipping and handling. ISBN: 1570400091. Summary: This chapter deals with solving skin problems in people who have diabetes. People who have diabetes may experience many skin problems, including digital sclerosis, Dupuytren's contracture, yellow skin, diabetic dermopathy, necrobiosis lipoidica diabeticorum, granuloma annulare, scleredema, bullosis diabeticorum, xanthomas, acanthus nigricans, vitiligo, pruritus, and necrolytic migratory erythema. Other skin problems include yeast infections; fungal infections; and bacterial infections such as impetigo, erythrasma, erysipelas, carbuncles and furuncles, cellulitis, necrotizing fascitis and cellulitis, and abscesses. In addition, skin problems may occur as a result of reactions to diabetes medications such as insulin and sulfonylureas. The chapter presents the symptoms of these skin conditions and explains what action people should take if they experience any of the symptoms of these conditions.

•

Chapter 206: Pigment Disorders Source: in Berkow, R., ed. The Merck Manual of Medical Information: Home Edition (online version). Rahway, NJ: Merck and Company, Inc. 2000. 3 p. Contact: Available online from Merck and Company, Inc. (800) 819-9456. Website: www.merck.com/pubs/mmanual_home/contents.htm. Also available from your local book store. PRICE: $29.95 plus shipping. Summary: This chapter provides the general public and people who have skin pigment disorders with information on the symptoms and treatment of albinism, vitiligo, and melasma. The main skin pigment is melanin. Abnormally low pigment is usually restricted to small areas of skin. Increased amounts of melanin can be a response to hormonal changes or particular drugs or can occur as a result of certain diseases. Albinism is a rare, inherited disorder in which a person produces no melanin. People with this disorder are prone to sunburn and, thus, to skin cancers. They can minimize these problems by avoiding direct sunlight, wearing sunglasses, and applying sunscreen with a sun protection factor higher than 15. Vitiligo, a condition in which a loss of melanocytes results in smooth, whitish patches of skin, may occur after unusual physical trauma and tends to accompany certain other diseases. The condition is most striking in darkly pigmented people. There is no cure for vitiligo, but small areas can be

98

Vitiligo

camouflaged with various dyes. Psoralens plus ultraviolet A light treatment is sometimes effective. Melasma, which usually affects the face, is characterized by a roughly symmetric group of dark brown patches of pigmentation that are often clearly delineated. The condition is most likely to occur during pregnancy and may also appear in women taking oral contraceptives. Sunscreens and avoidance of sun exposure may prevent the condition from getting worse. •

Association Between Insulin-Dependent Diabetes Mellitus and Other Autoimmune Diseases Source: in LeRoith, D.; Taylor, S.I.; Olefsky, J.M., eds. Diabetes Mellitus: A Fundamental and Clinical Text. Philadelphia, PA: Lippincott-Raven Publishers. 1996. p. 333-339. Contact: Available from Lippincott-Raven Publishers. 12107 Insurance Way, Hagerstown, MD 21740-5184. (800) 777-2295. Fax (301) 824-7390. PRICE: $199.00. ISBN: 0397514565. Summary: This chapter, from a medical text on diabetes mellitus, investigates the association between insulin-dependent diabetes mellitus (IDDM, or Type 1) and other autoimmune diseases. The authors first review the historical background of this autoimmune pathogenesis. Other topics include the genetics of IDDM, the genetic associations between IDDM and other autoimmune endocrinopathies, clinical relevance (notably to thyroiditis, Addison's disease, atrophic gastritis, and steroidal antibodies), and recommendations for screening. The authors conclude that IDDM often occurs in the context of other autoimmune endocrinopathies. Its most common presentation with other autoimmunity is as part of APS III, which is the constellation of IDDM and autoimmune thyroiditis, sometimes with pernicious anemia, vitiligo, and or hypogonadism. The possible genetic explanations for the association between other endocrinopathies and IDDM remain unclear. Until the issue of genetics has been resolved, the clinician must rely entirely on the recognition of subtle symptoms and a knowledge of serum autoantibody profiles to diagnose and treat polyglandular autoimmunity. 1 figure. 4 tables. 81 references.

•

Genetic Hearing Loss Associated with Eye Disorders Source: in Gorlin, R.J.; Toriello, H.V.; Cohen, M.M., Jr., eds. Hereditary Hearing Loss and Its Syndromes. New York, NY: Oxford University Press. 1995. p. 105-140. Contact: Available from Oxford University Press. 200 Madison Avenue, New York, NY 10016. (800) 334-4249 or (212) 679-7300. PRICE: $195.00 plus shipping and handling. ISBN: 0195065522. Summary: This chapter, from a text on hereditary hearing loss and its syndromes, discusses genetic hearing loss associated with eye disorders. Conditions covered include Usher syndrome (retinitis pigmentosis and sensorineural hearing loss); Alstrom syndrome; Edwards syndrome; retinitis pigmentosa, nystagmus, hemiplegic migraine, and sensorineural hearing loss; retinitis pigmentosa, vitiligo, and sensorineural hearing loss; Hersh syndrome; choroideremia, obesity, and congenital sensorineural hearing loss; Refsum syndrome; infantile Refsum syndrome; inverse retinitis pigmentosa, hypogonadism, and sensorineural hearing loss; miscellaneous disorders of pigmentary retinopathy and sensorineural hearing loss; myopia and congenital sensorineural hearing loss; Marshall syndrome; Holmes-Schepens syndrome; Harboyan syndrome; familial band keratopathy, abnormal calcium metabolism, and hearing loss; EhlersDanlos syndrome, type IV; corneal anesthesia, retinal abnormalities, mental retardation, unusual facies, and sensorineural hearing loss; DeHauwere syndrome; Abruzzo-

Books

99

Erickson syndrome; aniridia and sensorineural hearing loss; congenital total color blindness, cataracts, hyperinsulinism, and sensorineural hearing loss; total color blindness, liver degeneration, endocrine dysfunction, and sensorineural hearing loss; rod-cone dystrophy, renal dysfunction, and sensorineural hearing loss; OHAHA syndrome; IVIC syndrome; cataracts and progressive sensorineural hearing loss; Ohdo syndrome; Michels syndrome; Fraser syndrome; ocular albinism with late-onset sensorineural hearing loss; Norrie syndrome; Gernet syndrome; Jensen syndrome; BerkTabatznik syndrome; and Mohr-Mageroy syndrome. For each condition discussed, the author covers the ocular system involvement, the auditory system, laboratory findings, pathology, heredity, diagnosis, and prognosis. References are included in each section. 23 figures. 4 tables. 346 references.

101

CHAPTER 6. PERIODICALS AND NEWS ON VITILIGO Overview In this chapter, we suggest a number of news sources and present various periodicals that cover vitiligo.

News Services and Press Releases One of the simplest ways of tracking press releases on vitiligo is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “vitiligo” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to vitiligo. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “vitiligo” (or synonyms). The following was recently listed in this archive for vitiligo: •

Tacrolimus safe, effective for the treatment of childhood vitiligo Source: Reuters Industry Breifing Date: June 05, 2003

•

Phototherapy with 308-nm excimer laser effective treatment for vitiligo Source: Reuters Medical News Date: June 24, 2002

102 Vitiligo

•

Dermal autografts for stable vitiligo may yield long-term benefits Source: Reuters Medical News Date: September 18, 2001

•

Narrow-band UVB phototherapy effective for vitiligo Source: Reuters Industry Breifing Date: June 28, 2001

•

Adding calcipotriol to PUVA for vitiligo may hasten response Source: Reuters Industry Breifing Date: April 10, 2001

•

FDA clears PhotoMedex's excimer laser for vitiligo Source: Reuters Industry Breifing Date: March 02, 2001

•

FDA clears PhotoMedex's excimer laser for treatment of vitiligo Source: Reuters Medical News Date: March 02, 2001

•

PhotoMedex files for expanded use of its laser system to treat vitiligo Source: Reuters Industry Breifing Date: February 12, 2001

•

Long-Term Severity Of Vitiligo Can Be Predicted Source: Reuters Medical News Date: March 05, 1998 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “vitiligo” (or synonyms) into the search box, and click on “Search News.” As this service is technology

Periodicals and News

103

oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “vitiligo” (or synonyms). If you know the name of a company that is relevant to vitiligo, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “vitiligo” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “vitiligo” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on vitiligo: •

Patient Selection Is Key: Sheet Grafting Has Role in Stable Vitiligo Source: Skin and Allergy News. 29(2): 45. February 1998. Summary: This newsletter article provides health professionals with information on using epidermal sheet grafting to treat vitiligo. This approach is highly effective if the disease is stable, the graft recipient area can be immobilized, and the graft itself is of appropriate and even thickness. In 20 patients treated with the procedure, 8 had 100 percent repigmentation 3 months after treatment, 2 had no response, and the remainder showed partial repigmentation, usually more than 70 percent. The poorest results occurred on the hands, eyelids, and perioral areas. The most common adverse effect was the presence of milialike cysts at the graft sites during the first 6 months after treatment.

Academic Periodicals covering Vitiligo Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to vitiligo. In addition to these sources, you can search for articles covering vitiligo that have been published by any of the

104 Vitiligo

periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

105

CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for vitiligo. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with vitiligo. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

106 Vitiligo

following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to vitiligo: Chloroquine •

Systemic - U.S. Brands: Aralen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202133.html

Methoxsalen •

Systemic - U.S. Brands: 8-MOP; Oxsoralen-Ultra http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202357.html

Nadroparin •

Systemic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202133.html

Nafarelin •

Systemic - U.S. Brands: Synarel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202646.html

Naltrexone •

Systemic - U.S. Brands: ReVia http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202388.html

Naphazoline •

Ophthalmic - U.S. Brands: Ak-Con; Albalon; Allerest; I-Naphline; Nafazair; Naphcon; VasoClear http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202389.html

Naratriptan •

Systemic - U.S. Brands: Amerge http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203513.html

Narcotic Analgesics and Acetaminophen •

Systemic - U.S. Brands: Allay; Anexsia 5/500; Anexsia 7.5/650; Anolor DH 5; Bancap-HC; Capital with Codeine; Co-Gesic; Darvocet-N 100; Darvocet-N 50; DHCplus; Dolacet; Dolagesic; Duocet; E-Lor; Endocet; EZ III; Hycomed; HycoPap; Hydrocet; Hydrogesic; HY-PHEN; Lorcet 10/650; L http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202392.html

Narcotic Analgesics and Aspirin •

Systemic - U.S. Brands: Damason-P; Darvon Compound-65; Empirin with Codeine No.3; Empirin with Codeine No.4; Endodan; Lortab ASA; Panasal 5/500; PC-Cap; Percodan; Percodan-Demi; Propoxyphene Compound-65; Roxiprin; Synalgos-DC; Talwin Compound http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202393.html

Researching Medications

107

Narcotic Analgesics for Pain Relief •

Systemic - U.S. Brands: Astramorph PF; Buprenex; Cotanal-65; Darvon; DarvonN; Demerol; Dilaudid; Dilaudid-5; Dilaudid-HP; Dolophine; Duramorph; Hydrostat IR; Kadian; Levo-Dromoran; M S Contin; Methadose; MS/L; MS/L Concentrate; MS/S; MSIR; Nubain; Numorphan; OMS Concentrate; http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202390.html

Narcotic Analgesics for Surgery and Obstetrics •

Systemic - U.S. Brands: Alfenta; Astramorph; Astramorph PF; Buprenex; Demerol; Duramorph; Nubain; Stadol; Sublimaze; Sufenta; Ultiva http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202391.html

Natamycin •

Ophthalmic - U.S. Brands: Natacyn http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202394.html

Nateglinide •

Systemic - U.S. Brands: Starlix http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500277.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter,

108 Vitiligo

Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

109

APPENDICES

111

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

112 Vitiligo

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

113

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

114 Vitiligo

•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “vitiligo” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 2611 32 28 0 0 2671

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “vitiligo” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

115

Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Vitiligo In the following section, we will discuss databases and references which relate to the Genome Project and vitiligo. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 19 Adapted 20

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

116 Vitiligo

To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “vitiligo” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for vitiligo: •

Deafness, Congenital, with Vitiligo and Achalasia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221350

•

Spastic Paraparesis, Vitiligo, Premature Graying, Characteristic Facies Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?270680

•

Systemic Lupus Erythematosus, Vitiligo-related Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?606579

•

Vitiligo Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?193200

•

Vitiligo, Progressive, with Mental Retardation and Urethral Duplication Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?277465 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan

Physician Resources

117

syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html •

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

118 Vitiligo

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “vitiligo” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis.

23

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 24 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

Physician Resources

119

To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “vitiligo” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

121

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on vitiligo can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to vitiligo. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to vitiligo. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “vitiligo”:

122 Vitiligo

•

Guides on vitiligo Vitiligo http://www.nlm.nih.gov/medlineplus/vitiligo.html

•

Other guides Children's Page http://www.nlm.nih.gov/medlineplus/childrenspage.html Head and Brain Malformations http://www.nlm.nih.gov/medlineplus/headandbrainmalformations.html Melanoma http://www.nlm.nih.gov/medlineplus/melanoma.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Multiple Myeloma http://www.nlm.nih.gov/medlineplus/multiplemyeloma.html Multiple Myeloma http://www.nlm.nih.gov/medlineplus/tutorials/multiplemyelomaloader.html Multiple Sclerosis http://www.nlm.nih.gov/medlineplus/multiplesclerosis.html Multiple Sclerosis http://www.nlm.nih.gov/medlineplus/tutorials/multiplesclerosisloader.html Psoriasis http://www.nlm.nih.gov/medlineplus/psoriasis.html Skin Diseases http://www.nlm.nih.gov/medlineplus/skindiseases.html Sun Exposure http://www.nlm.nih.gov/medlineplus/sunexposure.html Tuberous Sclerosis http://www.nlm.nih.gov/medlineplus/tuberoussclerosis.html

Within the health topic page dedicated to vitiligo, the following was listed: •

General/Overviews Handbook for Patients with Vitiligo Source: National Vitiligo Foundation http://www.vitiligofoundation.org/handbook.htm Vitiligo Source: American Academy of Dermatology http://www.aad.org/pamphlets/Vitiligo.html

Patient Resources

•

123

Treatment Approach to Treatment of Patients with Vitiligo Source: National Vitiligo Foundation http://www.vitiligofoundation.org/approach.htm Depigmentation Source: National Vitiligo Foundation http://www.vitiligofoundation.org/depig.htm Guidelines for the Treatment of Vitiligo Patients with the Usage of PUVA Source: National Vitiligo Foundation http://www.vitiligofoundation.org/pavia.htm Study Confirms Effectiveness of Revolutionary Vitiligo Treatment Source: American Academy of Dermatology http://www.aad.org/PressReleases/vitiligo.html Vitiligo Treatment Procedures Source: National Vitiligo Foundation http://www.vitiligofoundation.org/yale.htm

•

Children If Your Child Has Vitiligo Source: National Vitiligo Foundation http://www.vitiligofoundation.org/parents.htm Vitiligo: The Pigment Problem Source: American Academy of Dermatology http://www.aad.org/Kids/vitiligo.html

•

Organizations American Academy of Dermatology http://www.aad.org/ American Society for Dermatologic Surgery http://www.asds-net.org/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/ National Vitiligo Foundation http://www.vitiligofoundation.org/menu.htm

•

Research New Laser Treatment Holds Promise for Millions of Americans with Psoriasis and Vitiligo Source: American Academy of Dermatology http://www.aad.org/PressReleases/psoriasisvit.html

124 Vitiligo

•

Teenagers For Junior High School Students with Vitiligo Source: National Vitiligo Foundation http://www.vitiligofoundation.org/jrhigh.htm

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on vitiligo. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Vitiligo Source: Schaumberg, IL: American Academy of Dermatology. 1999. 8 p. Contact: Available from American Academy of Dermatology. 930 N. Meacham Road, P.O. Box 4014, Schaumberg, IL 60168. (888)462-DERM ext. 22. Website: www.aad.org. PRICE: Single copy free. Summary: This brochure discusses vitiligo, a skin condition causing white patches to appear on the skin as a result of loss of pigment. Although the exact cause of vitiligo is unknown, theories suggest that it may be the result of a genetic defect, abnormally functioning nerve cells that injure melanocytes (the pigment-producing cells of the skin), self-destructive melanocytes, or the body's immune system destroying melanocytes. Vitiligo is more noticeable in darker skinned people and usually begins with a rapid loss of pigment. Commonly affected areas are the face, lips, hands, arms, legs, and genital areas. Topical corticosteroids and photochemotherapy can help return pigment to the skin. Other options include avoiding tanning of normal skin for fair-skinned people and disguising vitiligo with make-up, self-tanning compound, or dyes. In extreme cases, chemicals can be used to remove the remaining pigment from the skin. Sunscreens and cover-up methods are the best treatments for children with vitiligo. At the present time, no cure exists for this condition; however, research is ongoing. 2 figures.

•

Questions and Answers About Vitiligo Source: Bethesda, MD: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 2001. 24 p. Contact: Available from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1 AMS Circle, Bethesda, MD 20892-3675. (877) 226-4267 or (301) 495-4484. Fax (301) 718-6366. TTY (301) 565-2966. E-mail:

Patient Resources

125

[email protected]. Website: www.niams.nih.gov. PRICE: 1 to 25 copies free. Order Number: AR-05QA (booklet), or AR-05L QA (large print). Summary: This fact sheet for people with vitiligo uses a question and answer format to provide information. It describes the symptoms of this pigmentation disorder, whom it can affect, how it progresses, how a doctor makes a diagnosis, and the available options for treatment. The fact sheet emphasizes the importance of good medical, family, and other support in helping people cope with the disorder. It also describes current research on the causes and treatments for the disorder. The fact sheet then refers the reader to a list of voluntary and professional health organizations for additional information about vitiligo. A large print version of this fact sheet is also available. •

Guidelines for the Treatment of Patients With Vitiligo Source: Tyler, TX: National Vitiligo Foundation. 199x. 6 p. Contact: National Vitiligo Foundation. 611 South Fleishel Avenue, Tyler, TX 75701. (903) 531-0074. Fax (903) 525-1234. E-mail: [email protected]. Website: www.vitiligofoundation.org. PRICE: Single copy free; donation or membership requested. Summary: This fact sheet provides health professionals with guidelines for treating patients who have vitiligo. It outlines considerations for using topical steroids or psoralen with ultraviolet light A (PUVA)to treat children age 12 years or older and adults. Suggestions for treating children under 12 years of age are also offered. Other guidelines focus on cosmetic and supportive care and depigmentation therapy. Following is an approach to treating patients who have vitiligo, which involves performing a general patient workup, considering treatment options, and using repigmentation therapy with indoor PUVA or outdoor PUVA. Additional information includes vitiligo treatment procedures, a procedure for administering topical PUVA therapy, and approaches to treating vitiligo that were formulated by a clinic in Italy.

•

Handbook for Patients: Vitiligo Source: Tyler, TX: National Vitiligo Foundation. 199x. 16 p. Contact: National Vitiligo Foundation. 611 South Fleishel Avenue, Tyler, TX 75701. (903) 531-0074. Fax (903) 525-1234. E-mail: [email protected]. Website: www.vitiligofoundation.org. PRICE: Single copy free; donation or membership requested. Summary: This pamphlet uses a question and answer format to provide people who have vitiligo with information on this noncontagious, noncancerous disease in which the skin loses pigment as a result of the destruction of pigment cells. Skin in body folds, around body openings, and on the hands and face are the most common sites of pigment loss. Although vitiligo is common in the general population, its incidence is higher in people with thyroid conditions and some other metabolic diseases. The cause of vitiligo is unknown, but it may have a hereditary component. Vitiligo may spread to other areas of the body; however, there is no way of predicting whether or where it will spread. The symptoms of vitiligo can be treated with a combination of a drug called psoralen and regulated doses of sunlight. Total depigmentation may be attempted in severe cases of vitiligo to give the patient an even color. Cosmetic coverups may also be effective in minimizing the visibility of vitiligo. The disease should not interfere with interpersonal relations, even intimate ones, if people who have vitiligo have a healthy self image and seek relationships with people who value more than superficial

126 Vitiligo

appearance. The pamphlet offers advice to junior high school students who have vitiligo and the parents of children who have the disease. In addition, sources of information about the disease are identified. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Questions and Answers About Vitiligo Summary: An online consumer health information document that provides basic information on this pigmentation disorder. Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2252 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to vitiligo. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. NORD (The National Organization of Rare Disorders, Inc.) NORD provides an invaluable service to the public by publishing short yet comprehensive guidelines on over 1,000 diseases. NORD primarily focuses on rare diseases that might not be covered by the previously listed sources. NORD’s Web address is http://www.rarediseases.org/. A complete guide on vitiligo can be purchased from NORD for a nominal fee. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

Patient Resources

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

127

Associations and Vitiligo The following is a list of associations that provide information on and resources relating to vitiligo: •

H.I.T.S. (UK) (Hypomelanosis of Ito Family Support Network) Telephone: (44) 7940 114943 Toll-free: 999-999-9999 Fax: (44) 208 352 1824 Email: [email protected] Web Site: http://www.e-fervour.com/hits Background: The aim of the Hypomelanosis of Ito Family Support Network is to enrich the lives of children and families affected by Hypomelanosis of Ito by encouraging communication, facilitating the flow of information between families and health professionals, and generally reducing the sense of isolation patients and families may experience. A voluntary, not-for-profit organization, the Network publishes a quarterly newsletter, organizes an annual family event, and promotes broader understanding of Hypomelanosis of Ito. This rare disorder can affect individuals in many different ways. It may produce dermatologic or neurologic symptoms, specific eye conditions, seizures, autism, and/or abnormalities of the bones, among other things. The Family Support Network operates predominantly in the U.K., where it is based, but will provide assistance in other parts of the world, if necessary.

•

National Vitiligo Foundation Telephone: (903) 531-0074 Fax: (903) 525-1234 Email: [email protected] Web Site: http://www.vitiligofoundation.org Background: The National Vitiligo Foundation is a voluntary not-for-profit self-help organization dedicated to providing information and support to individuals with vitiligo, a skin disorder in which pigment cells are destroyed, resulting in irregularly shaped white patches on the skin. Established in 1985, the Foundation is committed to locating, informing, and counseling affected individuals and family members; increasing public awareness and concern for affected individuals; and promoting and funding scientific and clinical research into the cause, treatment, and cure of vitiligo. The Foundation is interested in broadening the concern for people with vitiligo within the medical community and establishing a central vitiligo center and local treatment facilities across the country. In addition, the National Vitiligo Foundation promotes patient advocacy and legislation beneficial to affected individuals and engages in patient, professional, and community education. The Foundation provides a variety of informational materials including a bi-annual newsletter, guidelines for physicians

128 Vitiligo

concerning the treatment of patients with vitiligo, fact sheets, pamphlets, and handbooks for patients, physicians, and schools. Relevant area(s) of interest: Vitiligo

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to vitiligo. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with vitiligo. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about vitiligo. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “vitiligo” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “vitiligo”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “vitiligo” (or synonyms) into the “For these words:”

Patient Resources

129

box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “vitiligo” (or a synonym) into the search box, and click “Submit Query.”

131

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.25

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

25

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

132 Vitiligo

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)26: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

26

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

133

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

134 Vitiligo

•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

135

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

136 Vitiligo

•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

137

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on vitiligo: •

Basic Guidelines for Vitiligo Vitiligo Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000831.htm

•

Signs & Symptoms for Vitiligo Hyperpigmentation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003242.htm Sunburn Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003227.htm Telangiectasia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003284.htm

•

Diagnostics and Tests for Vitiligo Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm

138 Vitiligo

CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Skin biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003840.htm TSH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm •

Background Topics for Vitiligo Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Systemic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002294.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

139

VITILIGO DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Acantholysis: Separation of the prickle cells of the stratum spinosum of the epidermis, resulting in atrophy of the prickle cell layer. It is seen in diseases such as pemphigus vulgaris (see pemphigus) and keratosis follicularis. [NIH] Acanthosis Nigricans: A circumscribed melanosis consisting of a brown-pigmented, velvety verrucosity or fine papillomatosis appearing in the axillae and other body folds. It occurs in association with endocrine disorders, underlying malignancy, administration of certain drugs, or as in inherited disorder. [NIH] Acatalasia: A rare autosomal recessive disorder resulting from the absence of catalase activity. Though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH]

140 Vitiligo

Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Affinity Chromatography: In affinity chromatography, a ligand attached to a column binds specifically to the molecule to be purified. [NIH] Ageing: A physiological or morphological change in the life of an organism or its parts, generally irreversible and typically associated with a decline in growth and reproductive vigor. [NIH] Albinism: General term for a number of inherited defects of amino acid metabolism in which there is a deficiency or absence of pigment in the eyes, skin, or hair. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Allografts: A graft of tissue obtained from the body of another animal of the same species but with genotype differing from that of the recipient; tissue graft from a donor of one genotype to a host of another genotype with host and donor being members of the same species. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons,

Dictionary 141

i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amber: A yellowish fossil resin, the gum of several species of coniferous trees, found in the alluvial deposits of northeastern Germany. It is used in molecular biology in the analysis of organic matter fossilized in amber. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test

142 Vitiligo

new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Aniridia: A congenital abnormality in which there is only a rudimentary iris. This is due to the failure of the optic cup to grow. Aniridia also occurs in a hereditary form, usually autosomal dominant. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anthraquinones: An anthracene ring which contains two ketone moieties in any position. Can be substituted in any position except on the ketone groups. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiserum: The blood serum obtained from an animal after it has been immunized with a particular antigen. It will contain antibodies which are specific for that antigen as well as

Dictionary 143

antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Aplasia: Lack of development of an organ or tissue, or of the cellular products from an organ or tissue. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arachidonate 12-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 12-hydroperoxyarachidonate (12-HPETE) which is itself rapidly converted by a peroxidase to 12-hydroxy-5,8,10,14-eicosatetraenoate (12-HETE). The 12-hydroperoxides are preferentially formed in platelets. EC 1.13.11.31. [NIH] Arachidonate 15-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 15-hydroperoxyarachidonate (15-HPETE) which is rapidly converted to 15-hydroxy5,8,11,13-eicosatetraenoate (15-HETE). The 15-hydroperoxides are preferentially formed in neutrophils and lymphocytes. EC 1.13.11.33. [NIH] Arachidonate Lipoxygenases: Enzymes catalyzing the oxidation of arachidonic acid to hydroperoxyarachidonates (HPETES). These products are then rapidly converted by a peroxidase to hydroxyeicosatetraenoic acids (HETES). The positional specificity of the enzyme reaction varies from tissue to tissue. The final lipoxygenase pathway leads to the leukotrienes. EC 1.13.11.- . [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arsenicals: Inorganic or organic compounds that contain arsenic. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Articular: Of or pertaining to a joint. [EU] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astringent: Causing contraction, usually locally after topical application. [EU] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures.

144 Vitiligo

Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrophic Gastritis: Chronic irritation of the stomach lining. Causes the stomach lining and glands to wither away. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autophagocytosis: The segregation and degradation of damaged or unwanted cytoplasmic constituents by autophagic vacuoles (cytolysosomes) composed of lysosomes containing cellular components in the process of digestion; it plays an important role in metamorphosis of amphibians, in the removal of bone by osteoclasts, and in the degradation of normal cell components in nutritional deficiency states. [NIH] Avian: A plasmodial infection in birds. [NIH] Avidity: The strength of the interaction of an antiserum with a multivalent antigen. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of

Dictionary 145

donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH]

146 Vitiligo

Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Preservation: The process by which blood or its components are kept viable outside of the organism from which they are derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Blotting, Western: Identification of proteins or peptides that have been electrophoretically separated by blotting and transferred to strips of nitrocellulose paper. The blots are then detected by radiolabeled antibody probes. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bullous: Pertaining to or characterized by bullae. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed

Dictionary 147

round the edges and fragments of broken bone. [NIH] Capecitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Cassia: Leguminous plants Cassia senna L. (or C. acutifolia) and C. angustifolia that contain anthraquinones which are used as laxatives. [NIH] Catalase: An oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. It is present in many animal cells. A deficiency of this enzyme results in acatalasia. EC 1.11.1.6. [NIH] Cataracts: In medicine, an opacity of the crystalline lens of the eye obstructing partially or totally its transmission of light. [NIH] Catechol: A chemical originally isolated from a type of mimosa tree. Catechol is used as an astringent, an antiseptic, and in photography, electroplating, and making other chemicals. It can also be man-made. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH]

148 Vitiligo

Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chorioretinitis: Inflammation of the choroid in which the sensory retina becomes

Dictionary 149

edematous and opaque. The inflammatory cells and exudate may burst through the sensory retina to cloud the vitreous body. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cicatricial: Ectropion due to scar tissue on the margins or the surrounding surfaces of the eyelids. [NIH] Cicatrix: The formation of new tissue in the process of wound healing. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] C-kit receptor: A protein on the surface of some cells that binds to stem cell factor (a substance that causes certain types of cells to grow). Altered forms of this receptor may be associated with some types of cancer. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clobetasol: Topical corticosteroid that is absorbed faster than fluocinonide. It is used in psoriasis, but may cause marked adrenocortical suppression. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cod Liver Oil: Oil obtained from fresh livers of the cod family, Gadidae. It is a source of vitamins A and D. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH]

150 Vitiligo

Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Color blindness: A form of defective color vision requiring only two primary colors, mixed in various proportions, to match all other colors. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH]

Dictionary 151

Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [NIH]

Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein

152 Vitiligo

metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cowpox: A mild, eruptive skin disease of milk cows caused by cowpox virus, with lesions occurring principally on the udder and teats. Human infection may occur while milking an infected animal. [NIH] Cowpox Virus: A species of orthopoxvirus that is the etiologic agent of cowpox. It is closely related to but antigenically different from vaccina virus. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Criterion: A standard by which something may be judged. [EU] Cryotherapy: Any method that uses cold temperature to treat disease. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Daclizumab: A monoclonal antibody that is being studied for treatment of adult T-cell leukemia. Also called dacliximab. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks.

Dictionary 153

The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]

Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depigmentation: Removal or loss of pigment, especially melanin. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatologist: A doctor who specializes in the diagnosis and treatment of skin problems. [NIH]

Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Dermo-epidermal: A patch of skin taken from the patient is directly grafted on the wound. [NIH]

DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH]

154 Vitiligo

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydroxyacetone: A ketotriose compound. Its addition to blood preservation solutions results in better maintenance of 2,3-diphosphoglycerate levels during storage. It is readily phosphorylated to dihydroxyacetone phosphate by triokinase in erythrocytes. In combination with naphthoquinones it acts as a sunscreening agent. [NIH] Dihydroxyacetone Phosphate: An important intermediate in lipid biosynthesis and in glycolysis. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discoid: Shaped like a disk. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH]

Dictionary 155

Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Ectoderm: The outer of the three germ layers of the embryo. [NIH] Ectodermal Dysplasia: A group of hereditary disorders involving tissues and structures derived from the embryonic ectoderm. They are characterized by the presence of abnormalities at birth and involvement of both the epidermis and skin appendages. They are generally nonprogressive and diffuse. Various forms exist, including anhidrotic and hidrotic dysplasias, focal dermal hypoplasia, and aplasia cutis congenita. [NIH] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electron microscope: A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscopes shows tiny details better than any other type of microscope. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electroplating: Coating with a metal or alloy by electrolysis. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryogenesis: The process of embryo or embryoid formation, whether by sexual (zygotic) or asexual means. In asexual embryogenesis embryoids arise directly from the explant or on intermediary callus tissue. In some cases they arise from individual cells (somatic cell embryoge). [NIH]

156 Vitiligo

Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endonucleases: Enzymes that catalyze the hydrolysis of the internal bonds and thereby the formation of polynucleotides or oligonucleotides from ribo- or deoxyribonucleotide chains. EC 3.1.-. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]

Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU]

Dictionary 157

Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Erbium: Erbium. An element of the rare earth family of metals. It has the atomic symbol Er, atomic number 68, and atomic weight 167.26. [NIH] Erysipelas: An acute infection of the skin caused by species of streptococcus. This disease most frequently affects infants, young children, and the elderly. Characteristics include pink-to-red lesions that spread rapidly and are warm to the touch. The commonest site of involvement is the face. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms. [NIH] Erythrasma: A chronic bacterial infection of major folds of the skin, caused by Corynebacterium minutissimum. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Esterification: The process of converting an acid into an alkyl or aryl derivative. Most frequently the process consists of the reaction of an acid with an alcohol in the presence of a trace of mineral acid as catalyst or the reaction of an acyl chloride with an alcohol. Esterification can also be accomplished by enzymatic processes. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and

158 Vitiligo

distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Excimer laser: An ultraviolet laser used in refractive surgery to remove corneal tissue. [NIH] Exfoliation: A falling off in scales or layers. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye socket: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen

Dictionary 159

and other macromolecules. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flatus: Gas passed through the rectum. [NIH] Flexor: Muscles which flex a joint. [NIH] Fluocinonide: A topical glucocorticoid used in the treatment of eczemas. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicles: Shafts through which hair grows. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gamma-interferon: Interferon produced by T-lymphocytes in response to various mitogens and antigens. Gamma interferon appears to have potent antineoplastic, immunoregulatory and antiviral activity. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH]

160 Vitiligo

Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen

Dictionary 161

frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonads: The gamete-producing glands, ovary or testis. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gp120: 120-kD HIV envelope glycoprotein which is involved in the binding of the virus to its membrane receptor, the CD4 molecule, found on the surface of certain cells in the body. [NIH]

Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Granuloma Annulare: Benign granulomatous disease of unknown etiology characterized by a ring of localized or disseminated papules or nodules on the skin and palisading histiocytes surrounding necrobiotic tissue resulting from altered collagen structures. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when

162 Vitiligo

coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heliotherapy: Sunbathing as a therapeutic measure. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Herpetiformis: Duhring's disease a recurring, inflammatory disease of the skin of unknown etiology characterized by erythematous, papular, pustular, or vesicular lesions which tend

Dictionary 163

to group and are accompanied by itching and burning. [NIH] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Histocompatibility: The degree of antigenic similarity between the tissues of different individuals, which determines the acceptance or rejection of allografts. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH]

164 Vitiligo

Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hyperpigmentation: Excessive pigmentation of the skin, usually as a result of increased melanization of the epidermis rather than as a result of an increased number of melanocytes. Etiology is varied and the condition may arise from exposure to light, chemicals or other substances, or from a primary metabolic imbalance. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypopigmentation: A condition caused by a deficiency in melanin formation or a loss of pre-existing melanin or melanocytes. It can be complete or partial and may result from trauma, inflammation, and certain infections. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immune Tolerance: The specific failure of a normally responsive individual to make an immune response to a known antigen. It results from previous contact with the antigen by an immunologically immature individual (fetus or neonate) or by an adult exposed to extreme high-dose or low-dose antigen, or by exposure to radiation, antimetabolites, antilymphocytic serum, etc. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue

Dictionary 165

(thymus or bone marrow). [NIH] Immunoblotting: Immunologic methods for isolating and quantitatively measuring immunoreactive substances. When used with immune reagents such as monoclonal antibodies, the process is known generically as western blot analysis (blotting, western). [NIH]

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impetigo: A common superficial bacterial infection caused by staphylococcus aureus or group A beta-hemolytic streptococci. Characteristics include pustular lesions that rupture and discharge a thin, amber-colored fluid that dries and forms a crust. This condition is commonly located on the face, especially about the mouth and nose. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU]

166 Vitiligo

Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Integrins: A family of transmembrane glycoproteins consisting of noncovalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement, and other cells, while their intracellular domains interact with the cytoskeleton. The integrins consist of at least three identified families: the cytoadhesin receptors, the leukocyte adhesion receptors, and the very-late-antigen receptors. Each family contains a common beta-subunit combined with one or more distinct alpha-subunits. These receptors participate in cell-matrix and cell-cell adhesion in many physiologically important processes, including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. [NIH] Intercellular Adhesion Molecule-1: A cell-surface ligand with a role in leukocyte adhesion and inflammation. Its production is induced by gamma-interferon and it is required for

Dictionary 167

neutrophil migration into inflamed tissue. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Interleukin-8: A cytokine that activates neutrophils and attracts neutrophils and Tlymphocytes. It is released by several cell types including monocytes, macrophages, Tlymphocytes, fibroblasts, endothelial cells, and keratinocytes by an inflammatory stimulus. IL-8 is a member of the beta-thromboglobulin superfamily and structurally related to platelet factor 4. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Invertebrates: Animals that have no spinal column. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH]

168 Vitiligo

Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Islet: Cell producing insulin in pancreas. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keloid: A sharply elevated, irregularly shaped, progressively enlarging scar resulting from formation of excessive amounts of collagen in the dermis during connective tissue repair. It is differentiated from a hypertrophic scar (cicatrix, hypertrophic) in that the former does not spread to surrounding tissues. [NIH] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keratosis: Any horny growth such as a wart or callus. [NIH] Kerosene: A refined petroleum fraction used as a fuel as well as a solvent. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Leg Ulcer: Ulceration of the skin and underlying structures of the lower extremity. About 90% of the cases are due to venous insufficiency (varicose ulcer), 5% to arterial disease, and the remaining 5% to other causes. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Dictionary 169

Leukaemia: An acute or chronic disease of unknown cause in man and other warm-blooded animals that involves the blood-forming organs, is characterized by an abnormal increase in the number of leucocytes in the tissues of the body with or without a corresponding increase of those in the circulating blood, and is classified according of the type leucocyte most prominently involved. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]

Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH]

170 Vitiligo

Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lupus Nephritis: Glomerulonephritis associated with systemic lupus erythematosus. It is classified into four histologic types: mesangial, focal, diffuse, and membranous. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphokine: A soluble protein produced by some types of white blood cell that stimulates other white blood cells to kill foreign invaders. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH]

Dictionary 171

Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Man-made: Ionizing radiation emitted by artificial or concentrated natural, radioactive material or resulting from the operation of high voltage apparatus, such as X-ray apparatus or particle accelerators, of nuclear reactors, or from nuclear explosions. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Meat Products: Articles of food which are derived by a process of manufacture from any portion of carcasses of any animal used for food (e.g., head cheese, sausage, scrapple). [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melanin: The substance that gives the skin its color. [NIH] Melanoblasts: Cell originating from the neural crest that differentiates into a melanocyte. [NIH]

Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Melanophores: Chromatophores (large pigment cells of fish, amphibia, reptiles and many invertebrates) which contain melanin. Short term color changes are brought about by an active redistribution of the melanophores pigment containing organelles (melanosomes). Mammals do not have melanophores; however they have retained smaller pigment cells known as melanocytes. [NIH] Melanosis: Disorders of increased melanin pigmentation that develop without preceding inflammatory disease. [NIH] Melanosomes: Melanin-containing organelles found in melanocytes and melanophores. [NIH]

Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and

172 Vitiligo

intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metamorphosis: The ontogeny of insects, i. e. the series of changes undergone from egg, through larva and pupa, or through nymph, to adult. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microsome: One of the specific metabolic pathways of the liver. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU]

Dictionary 173

Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Multivalent: Pertaining to a group of 5 or more homologous or partly homologous chromosomes during the zygotene stage of prophase to first metaphasis in meiosis. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mycosis: Any disease caused by a fungus. [EU] Mycosis Fungoides: A chronic malignant T-cell lymphoma of the skin. In the late stages the lymph nodes and viscera are affected. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the

174 Vitiligo

heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Myositis: Inflammation of a voluntary muscle. [EU] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naevus: A circumscribed area of pigmentation or vascularization, usually in the form of a congenital benign neoplasm occurring in the skin or in various ocular tissues. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naphthoquinones: Naphthalene rings which contain two ketone moieties in any position. They can be substituted in any position except at the ketone groups. [NIH] Nearsightedness: The common term for myopia. [NIH] Necrobiosis Lipoidica: A degenerative disease of the dermal connective tissue characterized by the development of erythematous papules or nodules in the pretibial area. The papules form plaques covered with telangiectatic vessels. More than half of the affected patients have diabetes. [NIH] Necrolysis: Separation or exfoliation of tissue due to necrosis. [EU] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neon: Neon. A noble gas with the atomic symbol Ne, atomic number 10, and atomic weight 20.18. It is found in the earth's crust and atmosphere as an inert, odorless gas and is used in vacuum tubes and incandescent lamps. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH]

Dictionary 175

Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Crest: A strip of specialized ectoderm flanking each side of the embryonal neural plate, which after the closure of the neural tube, forms a column of isolated cells along the dorsal aspect of the neural tube. Most of the cranial and all of the spinal sensory ganglion cells arise by differentiation of neural crest cells. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neuroretinitis: Inflammation of the optic nerve head and adjacent retina. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Nevus: A benign growth on the skin, such as a mole. A mole is a cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin. The plural of nevus is nevi (NEE-vye). [NIH] Nickel: A trace element with the atomic symbol Ni, atomic number 28, and atomic weight 58.69. It is a cofactor of the enzyme urease. [NIH] Night Blindness: Anomaly of vision in which there is a pronounced inadequacy or complete absence of dark-adaptation. [NIH]

176 Vitiligo

Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nystagmus: An involuntary, rapid, rhythmic movement of the eyeball, which may be horizontal, vertical, rotatory, or mixed, i.e., of two varieties. [EU] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the

Dictionary 177

optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone. An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Osteopetrosis: Excessive formation of dense trabecular bone leading to pathological fractures, osteitis, splenomegaly with infarct, anemia, and extramedullary hemopoiesis. [NIH]

Oxidants: Oxidizing agents or electron-accepting molecules in chemical reactions in which electrons are transferred from one molecule to another (oxidation-reduction). In vivo, it appears that phagocyte-generated oxidants function as tumor promoters or cocarcinogens rather than as complete carcinogens perhaps because of the high levels of endogenous antioxidant defenses. It is also thought that oxidative damage in joints may trigger the autoimmune response that characterizes the persistence of the rheumatoid disease process. [NIH]

Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH]

178 Vitiligo

Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pedigree: A record of one's ancestors, offspring, siblings, and their offspring that may be used to determine the pattern of certain genes or disease inheritance within a family. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pemphigus: Group of chronic blistering diseases characterized histologically by acantholysis and blister formation within the epidermis. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide T: N-(N-(N(2)-(N-(N-(N-(N-D-Alanyl L-seryl)-L-threonyl)-L-threonyl) L-threonyl)L-asparaginyl)-L-tyrosyl) L-threonine. Octapeptide sharing sequence homology with HIV envelope protein gp120. It is potentially useful as antiviral agent in AIDS therapy. The core pentapeptide sequence, TTNYT, consisting of amino acids 4-8 in peptide T, is the HIV envelope sequence required for attachment to the CD4 receptor. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU]

Dictionary 179

Perioral: Situated or occurring around the mouth. [EU] Periorbital: Situated around the orbit, or eye socket. [EU] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Petrolatum: A colloidal system of semisolid hydrocarbons obtained from petroleum. It is used as an ointment base, topical protectant, and lubricant. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenolphthalein: An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH]

180 Vitiligo

Phosphorylated: Attached to a phosphate group. [NIH] Photochemotherapy: Therapy using oral or topical photosensitizing agents with subsequent exposure to light. [NIH] Photosensitizing Agents: Drugs that are pharmacologically inactive but when exposed to ultraviolet radiation or sunlight are converted to their active metabolite to produce a beneficial reaction affecting the diseased tissue. These compounds can be administered topically or systemically and have been used therapeutically to treat psoriasis and various types of neoplasms. [NIH] Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Piebaldism: Autosomal dominant, congenital disorder characterized by localized hypomelanosis of the skin and hair. The most familiar feature is a white forelock presenting in 80 to 90 percent of the patients. The underlying defect is possibly related to the differentiation and migration of melanoblasts, as well as to defective development of the neural crest (neurocristopathy). Piebaldism may be closely related to Waardenburg's syndrome. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Planets: Heavenly bodies with their own motion among the stars, revolving, in the case of the solar system, around the sun, along the plane of the ecliptic. They are grouped into inner planets and outer planets, based on distance from the sun and common characteristics. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH]

Dictionary 181

Platelet Factor 4: A high-molecular-weight proteoglycan-platelet factor complex which is released from blood platelets by thrombin. It acts as a mediator in the heparin-neutralizing capacity of the blood and plays a role in platelet aggregation. At high ionic strength (I=0.75), the complex dissociates into the active component (molecular weight 29,000) and the proteoglycan carrier (chondroitin 4-sulfate, molecular weight 350,000). The molecule exists in the form of a dimer consisting of 8 moles of platelet factor 4 and 2 moles of proteoglycan. [NIH]

Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postnatal: Occurring after birth, with reference to the newborn. [EU] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on

182 Vitiligo

the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Prickle: Several layers of the epidermis where the individual cells are connected by cell bridges. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Promyelocytic leukemia: A type of acute myeloid leukemia, a quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. [NIH]

Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propylene Glycol: A clear, colorless, viscous organic solvent and diluent used in pharmaceutical preparations. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the

Dictionary 183

prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psoralen: A substance that binds to the DNA in cells and stops them from multiplying. It is being studied in the treatment of graft-versus-host disease and is used in the treatment of psoriasis and vitiligo. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH]

184 Vitiligo

Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyoderma: Any purulent skin disease (Dorland, 27th ed). [NIH] Pyoderma Gangrenosum: An idiopathic, rapidly evolving, and severely debilitating disease occurring most commonly in association with chronic ulcerative colitis. It is characterized by the presence of boggy, purplish ulcers with undermined borders, appearing mostly on the legs. The majority of cases are in people between 40 and 60 years old. Its etiology is unknown. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU]

Dictionary 185

Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Power: The ability of an object, such as the eye, to bend light as light passes through it. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal pigment epithelium: The pigment cell layer that nourishes the retinal cells; located just outside the retina and attached to the choroid. [NIH] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retinitis Pigmentosa: Hereditary, progressive degeneration of the neuroepithelium of the retina characterized by night blindness and progressive contraction of the visual field. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH]

186 Vitiligo

Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retinyl palmitate: A drug being studied in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rituximab: A type of monoclonal antibody used in cancer detection or therapy. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH]

Dictionary 187

Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senna: Preparations of Cassia senna L. and C. angustifolia of the Leguminosae. They contain sennosides, which are anthraquinone type cathartics and are used in many different preparations as laxatives. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sequence Homology: The degree of similarity between sequences. Studies of amino acid and nucleotide sequences provide useful information about the genetic relatedness of certain species. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shedding: Release of infectious particles (e. g., bacteria, viruses) into the environment, for example by sneezing, by fecal excretion, or from an open lesion. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by

188 Vitiligo

a physician, or subjective when perceived by the patient. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin graft: Skin that is moved from one part of the body to another. [NIH] Skin Physiology: The functions of the skin in the human and animal body. It includes the pigmentation of the skin and its appendages. [NIH] Skin Pigmentation: Coloration of the skin. [NIH] Skin Transplantation: The grafting of skin in humans or animals from one site to another to replace a lost portion of the body surface skin. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smallpox: A generalized virus infection with a vesicular rash. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Behavior: Any behavior caused by or affecting another individual, usually of the same species. [NIH] Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic mutations: Alterations in DNA that occur after conception. Somatic mutations can occur in any of the cells of the body except the germ cells (sperm and egg) and therefore are not passed on to children. These alterations can (but do not always) cause cancer or other diseases. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH]

Dictionary 189

Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Staphylococcus aureus: Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Stem Cell Factor: Hematopoietic growth factor and the ligand of the c-kit receptor CD117 (proto-oncogene protein C-kit). It is expressed during embryogenesis and provides a key signal in multiple aspects of mast-cell differentiation and function. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones,

190 Vitiligo

bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sun protection factor: SPF. A scale for rating the level of sunburn protection in sunscreen products. The higher the SPF, the more sunburn protection it provides. Sunscreens with an SPF value of 2 through 11 provide minimal protection against sunburns. Sunscreens with an SPF of 12 through 29 provide moderate protection, which is adequate for most people. Those

Dictionary 191

with an SPF of 30 or higher provide high protection against sunburn and are sometimes recommended for people who are highly sensitive to the sun. [NIH] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systemic therapy: Treatment that uses substances that travel through the bloodstream, reaching and affecting cells all over the body. [NIH] T cell: One type of white blood cell that attacks virus-infected cells, foreign cells, and cancer cells. T cells also produce a number of substances that regulate the immune response. [NIH] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are

192 Vitiligo

concerned in regulating the metabolic rate of the body. [NIH] Thyroiditis: Inflammation of the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tonicity: The normal state of muscular tension. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH]

Dictionary 193

Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tretinoin: An important regulator of gene expression, particularly during growth and development and in neoplasms. Retinoic acid derived from maternal vitamin A is essential for normal gene expression during embryonic development and either a deficiency or an excess can be teratogenic. It is also a topical dermatologic agent which is used in the treatment of psoriasis, acne vulgaris, and several other skin diseases. It has also been approved for use in promyelocytic leukemia. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vaccinia: The cutaneous and occasional systemic reactions associated with vaccination using smallpox (variola) vaccine. [NIH] Vaccinia Virus: The type species of Orthopoxvirus, related to cowpox virus, but whose true origin is unknown. It has been used as a live vaccine against smallpox. It is also used as a

194 Vitiligo

vector for inserting foreign DNA into animals. Rabbitpox virus is a subspecies of vaccinia virus. [NIH] Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Varicella: Chicken pox. [EU] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Variola: A generalized virus infection with a vesicular rash. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venus: The second planet in order from the sun. It has no known natural satellites. It is one of the four inner or terrestrial planets of the solar system. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visual field: The entire area that can be seen when the eye is forward, including peripheral

Dictionary 195

vision. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Wart: A raised growth on the surface of the skin or other organ. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Xenon: A noble gas with the atomic symbol Xe, atomic number 54, and atomic weight 131.30. It is found in the earth's atmosphere and has been used as an anesthetic. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zoster: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH]

197

INDEX A Abdomen, 139, 146, 167, 170, 178, 179, 189, 190, 194 Aberrant, 15, 18, 139 Abrasion, 19, 139 Acantholysis, 139, 178 Acanthosis Nigricans, 31, 139 Acatalasia, 139, 147 Acceptor, 139, 169, 177 Accommodation, 139, 174 Acetylcholine, 139, 176 Acidosis, 39, 139 Acne, 88, 139, 193 Acne Vulgaris, 139, 193 Acrylonitrile, 139, 186 Acyl, 82, 139, 157 Adaptability, 139, 148 Adjunctive Therapy, 3, 139 Adrenal Cortex, 140, 151, 182 Adrenal Medulla, 140, 147, 157, 176 Adrenergic, 21, 140, 154, 157 Adverse Effect, 103, 140, 187 Aetiology, 38, 140 Afferent, 93, 140 Affinity, 5, 14, 87, 140 Affinity Chromatography, 5, 140 Ageing, 39, 140 Albinism, 5, 7, 96, 97, 99, 140 Algorithms, 140, 145 Alimentary, 140, 178 Alkaline, 139, 140, 146, 179 Alkaloid, 140, 147 Alleles, 11, 49, 140, 169 Allergic Rhinitis, 92, 140 Allografts, 140, 163 Alopecia, 15, 26, 60, 83, 88, 95, 140 Alpha Particles, 140, 184 Alternative medicine, 102, 141 Amber, 141, 165 Amino Acid Sequence, 141, 142, 145, 160 Amino Acids, 77, 87, 141, 145, 160, 175, 178, 181, 183, 190 Anaesthesia, 141, 165 Analgesic, 141, 156 Analog, 56, 141 Analogous, 7, 141, 192 Anaphylatoxins, 141, 150 Anaplasia, 141

Anatomical, 141, 154, 165, 186 Androgens, 140, 141, 152 Anemia, 117, 141, 159, 177, 179 Anesthesia, 98, 141 Aneurysm, 141, 194 Animal model, 14, 141 Aniridia, 99, 142 Annealing, 142, 181 Anthraquinones, 142, 147 Antiallergic, 142, 152 Antibacterial, 142, 189 Antibiotic, 142, 189 Antigen-Antibody Complex, 142, 150 Antigen-presenting cell, 142, 153 Anti-infective, 142, 163 Anti-inflammatory, 142, 152, 153, 160 Anti-Inflammatory Agents, 142, 152 Antineoplastic, 142, 152, 159 Antioxidant, 15, 38, 49, 62, 64, 65, 142, 177 Antiseptic, 142, 147 Antiserum, 142, 144 Antiviral, 143, 159, 178 Aplasia, 143, 155 Apolipoproteins, 143, 169 Apoptosis, 8, 10, 13, 16, 30, 59, 75, 143 Aqueous, 143, 144, 152, 156, 163, 168 Arachidonate 12-Lipoxygenase, 143, 169 Arachidonate 15-Lipoxygenase, 143, 169 Arachidonate Lipoxygenases, 143, 169 Arachidonic Acid, 143, 182 Arginine, 7, 141, 143, 176 Aromatic, 143, 179, 190 Arsenicals, 5, 143 Arterial, 143, 148, 164, 168, 183 Arteries, 143, 146, 151, 170, 172 Articular, 143, 177 Ascites, 143, 176 Assay, 4, 5, 9, 66, 73, 75, 143 Astringent, 143, 147 Ataxia, 117, 143, 148, 191 Atopic, 85, 88, 91, 144 Atrophic Gastritis, 98, 144 Atrophy, 116, 117, 139, 144 Attenuated, 144, 154 Auditory, 71, 99, 144 Autoantibodies, 15, 20, 23, 37, 46, 51, 144 Autoantigens, 144

198 Vitiligo

Autoimmune disease, 4, 6, 10, 15, 20, 22, 98, 144, 173 Autoimmunity, 6, 18, 20, 36, 98, 144 Autologous, 25, 28, 46, 53, 55, 74, 89, 95, 144 Autophagocytosis, 15, 144 Avian, 12, 144 Avidity, 14, 144 Axons, 144, 175, 176, 179 B Bacteria, 139, 142, 144, 172, 187, 189, 190, 193 Bacterial Infections, 97, 144, 148 Bactericidal, 144, 158 Basal Ganglia, 144, 159 Basal Ganglia Diseases, 144 Base, 144, 153, 160, 168, 179 Basement Membrane, 31, 145, 158, 168 Benign, 88, 145, 159, 161, 162, 174, 175, 184 Benzoic Acid, 80, 145 Beta-Endorphin, 42, 145 Beta-Thromboglobulin, 145, 167 Bilateral, 21, 145, 185 Bile, 145, 163, 170, 190 Biochemical, 15, 38, 51, 96, 140, 145, 177 Biological therapy, 145, 161 Biopsy, 4, 137, 138, 145 Biopsy specimen, 4, 145 Biosynthesis, 25, 143, 145, 154 Biotechnology, 17, 96, 102, 113, 115, 116, 117, 118, 145 Bladder, 92, 93, 145, 173, 183, 193 Blastocyst, 145, 151, 180 Blister, 33, 39, 145, 178 Blood Cell Count, 146, 179 Blood Coagulation, 146 Blood Glucose, 146, 162, 166 Blood Preservation, 146, 154 Blood vessel, 146, 156, 160, 162, 168, 170, 172, 188, 190, 191, 194 Blot, 26, 60, 146, 165 Blotting, Western, 146, 165 Bowel, 92, 146, 166, 167, 193 Brachytherapy, 146, 167, 184, 195 Bradykinin, 146, 176 Branch, 135, 146, 170, 178, 188, 191 Breakdown, 89, 146, 154, 159, 176 Bronchi, 146, 157, 192 Bronchial, 92, 146 Buccal, 146, 170 Bullous, 15, 23, 54, 146 Burns, 46, 81, 92, 146

Burns, Electric, 146 C Calcium, 98, 146, 150 Callus, 88, 146, 155, 168 Capecitabine, 23, 147 Capsaicin, 93, 147 Carbohydrate, 147, 151, 181 Carbon Dioxide, 147, 180 Carcinogenesis, 85, 147 Carcinogenic, 72, 147, 166, 176, 182, 190 Carcinogens, 147, 176, 177 Carcinoma, 9, 147 Cardiac, 147, 157, 174, 189 Carotene, 147, 185 Case report, 22, 23, 26, 28, 147 Cassia, 86, 147, 187 Catalase, 12, 13, 32, 43, 139, 147 Cataracts, 99, 147 Catechol, 19, 49, 62, 147 Catecholamine, 25, 35, 147, 154 Causal, 9, 147 Celiac Disease, 6, 147 Cell Adhesion, 147, 166 Cell Cycle, 148, 149 Cell Death, 10, 12, 143, 148, 160, 174 Cell Differentiation, 148, 189 Cell Division, 93, 116, 144, 148, 161, 172, 180, 187 Cell membrane, 7, 148, 179 Cell Survival, 148, 161 Cell Transplantation, 45, 46, 74, 148 Cellulitis, 97, 148 Central Nervous System, 139, 148, 159, 161, 162, 173, 177 Central Nervous System Infections, 148, 162 Cerebellar, 144, 148, 185, 193 Cerebellar Diseases, 144, 148, 193 Cerebral, 144, 148, 157, 159, 183 Cerebrum, 148, 193 Chemotactic Factors, 148, 150 Cholesterol, 145, 148, 149, 169, 170, 190 Cholesterol Esters, 148, 169 Chorioretinitis, 148, 185 Choroid, 148, 149, 185 Chromatin, 143, 149 Chromosomal, 9, 73, 149 Chromosome, 18, 29, 149, 169, 187 Chronic Disease, 149, 169 Chronic renal, 149, 181 Chylomicrons, 149, 169 Cicatricial, 88, 149

Index 199

Cicatrix, 149, 168 CIS, 149, 185 Cisplatin, 5, 149 C-kit receptor, 30, 149, 189 Clear cell carcinoma, 149, 153 Cleft Palate, 40, 58, 149 Clinical trial, 4, 6, 14, 22, 113, 149, 151, 184 Clobetasol, 18, 22, 23, 50, 62, 149 Cloning, 93, 145, 149 Cod Liver Oil, 149, 156 Cofactor, 18, 149, 175, 183 Colitis, 150 Collagen, 89, 145, 150, 158, 161, 168, 180, 182 Collapse, 146, 150 Color blindness, 99, 150 Complement, 6, 18, 141, 150, 160, 166, 170 Complementary and alternative medicine, 71, 77, 150 Complementary medicine, 71, 150 Computational Biology, 113, 115, 150 Conception, 151, 158, 188, 189 Concomitant, 58, 151 Cone, 99, 151 Congenita, 151, 155 Congestion, 151, 157 Congestive heart failure, 67, 151 Conjugated, 145, 151 Connective Tissue, 148, 150, 151, 159, 168, 170, 172, 174, 179, 186, 191 Constitutional, 151, 173, 185 Contact dermatitis, 49, 51, 74, 88, 151 Contracture, 97, 151 Contraindications, ii, 151 Control group, 24, 151 Coordination, 151, 173 Cornea, 151, 195 Corneum, 151, 157 Coronary, 151, 172 Coronary Thrombosis, 151, 172 Cortex, 144, 151, 159, 185 Cortical, 151, 187, 191 Corticosteroid, 3, 149, 151 Cortisone, 152, 153 Cowpox, 152, 193 Cowpox Virus, 152, 193 Cranial, 152, 162, 175, 176, 179 Craniocerebral Trauma, 144, 152, 162, 191 Criterion, 10, 152 Cryotherapy, 25, 152 Curative, 152, 191

Cutaneous, 7, 8, 13, 26, 31, 36, 40, 50, 56, 65, 82, 88, 92, 151, 152, 170, 193 Cyclic, 152, 161, 176, 183 Cysteine, 152, 190 Cytokine, 152, 167 Cytomegalovirus, 4, 60, 152 Cytoplasm, 143, 148, 152, 156, 173 Cytoskeleton, 152, 166 Cytotoxic, 5, 8, 13, 14, 16, 24, 34, 54, 147, 152, 184 Cytotoxicity, 5, 8, 13, 47, 149, 152 D Daclizumab, 6, 152 Databases, Bibliographic, 113, 152 Decidua, 153, 180 Defense Mechanisms, 153, 166 Degenerative, 153, 162, 174, 177, 186 Deletion, 5, 143, 153 Denaturation, 153, 181 Dendrites, 153, 175 Dendritic, 16, 153, 171 Dendritic cell, 16, 153 Density, 153, 169, 176 Depigmentation, 3, 6, 16, 19, 22, 25, 41, 55, 62, 80, 81, 82, 123, 125, 153, 195 Dermal, 102, 153, 155, 169, 174 Dermatitis, 25, 49, 51, 67, 74, 85, 88, 91, 153, 155 Dermatologist, 89, 153 Dermo-epidermal, 67, 153 DES, 63, 141, 153 Deuterium, 153, 163 Dexamethasone, 50, 153 Diabetes Mellitus, 98, 153, 161, 162 Diagnostic procedure, 79, 103, 153 Diarrhea, 92, 153 Diffusion, 153, 154, 166 Digestion, 140, 144, 145, 146, 154, 167, 170, 190, 194 Digestive tract, 154, 188, 189 Dihydroxyacetone, 27, 63, 84, 154 Dihydroxyacetone Phosphate, 154 Dilatation, 141, 154, 194 Dilatation, Pathologic, 154, 194 Dilation, 146, 154, 194 Dilution, 5, 154 Direct, iii, 14, 27, 44, 63, 97, 105, 154, 185 Discoid, 22, 154 Disinfectant, 154, 158 Dissociation, 140, 154 Dopamine, 154, 179 Dorsal, 154, 157, 175, 181

200 Vitiligo

Drug Interactions, 107, 154 Drug Tolerance, 154, 192 Duodenal Ulcer, 92, 155 Duodenum, 145, 155, 190 Dyes, 98, 124, 155 Dysplasia, 117, 155 Dystonia, 27, 63, 155 Dystrophy, 19, 99, 116, 155 E Ectoderm, 155, 175 Ectodermal Dysplasia, 9, 155 Eczema, 91, 155 Edema, 93, 151, 155, 174, 176 Effector, 7, 16, 139, 150, 155, 175 Efficacy, 12, 14, 17, 28, 40, 41, 64, 66, 83, 155, 192 Elastin, 89, 150, 155 Elective, 58, 155 Electrolyte, 152, 155, 172 Electron microscope, 12, 155 Electrons, 142, 145, 155, 167, 177, 184 Electroplating, 147, 155 Embryo, 145, 148, 155, 165 Embryogenesis, 155, 189 Emulsion, 84, 156 Encapsulated, 156, 169 Encephalitis, 53, 66, 156 Encephalitis, Viral, 156 Endonucleases, 85, 156 Endorphin, 145, 156 Endothelial cell, 156, 158, 167 Endothelium, 156, 176 Endothelium-derived, 156, 176 Endotoxins, 150, 156 End-stage renal, 149, 156, 181 Enkephalin, 145, 156 Environmental Exposure, 156, 176 Environmental Health, 112, 114, 156 Enzymatic, 85, 146, 147, 150, 156, 157, 181, 185 Enzyme, 12, 143, 147, 155, 156, 161, 169, 172, 175, 179, 181, 183, 195 Eosinophilia, 156, 158 Epidemiological, 11, 156 Epidermal, 7, 8, 9, 14, 25, 28, 29, 46, 48, 55, 63, 85, 103, 157, 168, 169, 171 Epidermal Growth Factor, 9, 157 Epidermoid carcinoma, 157, 189 Epinephrine, 140, 154, 157, 176 Epithelial, 85, 92, 153, 157, 162, 168 Epithelial Cells, 85, 157, 162, 168 Epithelium, 62, 145, 156, 157, 167, 195

Epitopes, 37, 46, 157 Erbium, 25, 28, 29, 157 Erysipelas, 97, 157 Erythema, 8, 80, 85, 97, 151, 157, 191, 193 Erythema Multiforme, 8, 157 Erythrasma, 97, 157 Erythrocytes, 141, 146, 154, 157 Esophagus, 154, 157, 190 Essential Tremor, 117, 157 Esterification, 62, 157 Ethanol, 80, 157 Eukaryotic Cells, 158, 165, 177 Excimer laser, 57, 91, 101, 102, 158 Exfoliation, 158, 174 Exogenous, 93, 155, 158 Extensor, 158, 183, 195 External-beam radiation, 158, 167, 184, 195 Extracellular, 8, 151, 158, 166 Extracellular Matrix, 8, 151, 158, 166 Extracellular Space, 158 Extremity, 158, 168 Eye socket, 158, 179 F Facial, 40, 58, 88, 158, 178 Family Planning, 113, 158 Fasciitis, 28, 158 Fat, 143, 147, 151, 158, 169, 173, 186, 188 Fatigue, 158, 162 Fatty acids, 158, 169, 182 Fetus, 158, 164, 180 Fibroblast Growth Factor, 39, 158 Fibroblasts, 158, 167 Fibrosarcoma, 158, 159 Fibrosis, 117, 151, 159, 186 Fissure, 149, 159 Flatus, 159 Flexor, 158, 159, 169 Fluocinonide, 149, 159 Folate, 69, 159 Fold, 13, 159 Folic Acid, 57, 64, 66, 69, 73, 82, 159 Follicles, 16, 159 Forearm, 158, 159 Friction, 45, 159 Fungistatic, 145, 159 Fungus, 159, 173 G Gamma Rays, 159, 184 Gamma-interferon, 159, 166 Ganglia, 139, 144, 159, 175 Ganglion, 159, 175, 176, 195

Index 201

Gas, 7, 147, 153, 159, 163, 174, 176, 190, 195 Gastric, 73, 92, 157, 160 Gastrin, 30, 160, 163 Gastritis, 160 Gastrointestinal, 92, 93, 146, 157, 160, 190 Gastrointestinal tract, 93, 157, 160 Gene, 5, 9, 11, 16, 29, 32, 40, 96, 117, 118, 140, 145, 160, 169, 176, 187, 193 Gene Expression, 5, 16, 117, 160, 193 Genetic Code, 160, 176 Genetic Engineering, 145, 149, 160 Genetic testing, 160, 181 Genetics, 5, 11, 18, 29, 32, 60, 98, 160 Genital, 124, 149, 160, 193 Genitourinary, 92, 160, 193 Genotype, 140, 160, 179 Gestation, 160, 178, 180 Giant Cells, 160, 186 Gland, 140, 152, 160, 170, 177, 178, 180, 183, 187, 190, 191, 192 Glomerulus, 160, 174 Glucocorticoid, 153, 159, 160 Glucose, 32, 116, 146, 153, 160, 162, 166, 186 Glucose Intolerance, 153, 160 Glutamic Acid, 159, 161, 182 Glutathione Peroxidase, 161, 187 Gluten, 147, 161 Glycine, 145, 161 Gonadal, 161, 189 Gonads, 161, 164 Governing Board, 161, 182 Gp120, 161, 178 Graft, 7, 33, 55, 103, 140, 161, 163, 165, 183 Graft Rejection, 161, 165 Grafting, 19, 25, 28, 33, 40, 46, 53, 55, 56, 103, 161, 188 Graft-versus-host disease, 161, 183 Granuloma, 97, 161 Granuloma Annulare, 97, 161 Grasses, 159, 161 Gravis, 31, 161 Growth, 8, 10, 33, 84, 92, 116, 140, 141, 142, 143, 148, 157, 158, 159, 161, 164, 167, 168, 171, 174, 175, 176, 180, 189, 191, 192, 193, 195 Growth factors, 8, 33, 161 Guanylate Cyclase, 161, 176 H Hair follicles, 15, 41, 90, 161, 189, 195 Haptens, 140, 161 Headache, 92, 162

Headache Disorders, 162 Heart failure, 162, 176 Heliotherapy, 3, 162 Hemoglobin, 141, 146, 157, 162, 168 Hemoglobinuria, 116, 162 Hemolytic, 158, 162, 165 Hemorrhage, 152, 162, 190 Hemostasis, 162, 166 Hepatitis, 162, 194 Hepatocytes, 162 Hereditary, 16, 86, 98, 125, 142, 155, 162, 179, 185 Heredity, 99, 139, 160, 162 Herpes, 4, 92, 162 Herpes Zoster, 162 Herpetiformis, 25, 162 Heterodimers, 163, 166 Heterogeneity, 10, 140, 163 Histocompatibility, 35, 163 Homeostasis, 7, 163 Homologous, 140, 163, 173, 187 Hormonal, 97, 144, 152, 163 Hormone, 17, 20, 37, 55, 64, 66, 86, 87, 145, 151, 152, 153, 157, 160, 163, 166, 172, 182, 186, 191, 192 Horny layer, 157, 163 Host, 7, 140, 163, 164, 165, 193, 194 Humoral, 15, 31, 161, 163 Humour, 163 Hybrid, 163 Hybridization, 163 Hybridomas, 163, 167 Hydrogen, 38, 73, 139, 144, 147, 153, 161, 163, 169, 173, 175, 176, 177, 183 Hydrogen Peroxide, 38, 73, 147, 161, 163, 169 Hydrolysis, 89, 149, 156, 163, 181, 183 Hydrophobic, 163, 169 Hydroxylysine, 150, 163 Hydroxyproline, 150, 164 Hyperalgesia, 92, 93, 164 Hyperpigmentation, 12, 36, 54, 81, 137, 164 Hyperplasia, 164, 169 Hypersensitivity, 38, 164, 186 Hypertension, 162, 164 Hyperthyroidism, 62, 164 Hypogonadism, 98, 164 Hypopigmentation, 36, 96, 164 Hypoplasia, 155, 164 Hypothyroidism, 31, 164

202 Vitiligo

I Id, 68, 75, 126, 134, 136, 164 Idiopathic, 26, 37, 64, 164, 184, 186 Immune response, 14, 15, 16, 42, 64, 142, 144, 152, 161, 164, 165, 170, 190, 191, 193, 194 Immune system, 9, 15, 16, 124, 142, 144, 145, 164, 165, 170, 173, 179, 193, 195 Immune Tolerance, 15, 164 Immunity, 13, 18, 19, 31, 54, 164, 165 Immunization, 164, 165 Immunoblotting, 26, 165 Immunodeficiency, 36, 59, 116, 165 Immunogenic, 16, 165 Immunoglobulin, 142, 165, 173 Immunohistochemistry, 9, 165 Immunologic, 8, 96, 148, 164, 165, 184 Immunology, 13, 15, 18, 20, 36, 46, 60, 140, 165 Immunosuppressive, 160, 165, 191 Immunosuppressive therapy, 165 Immunotherapy, 16, 44, 145, 165 Impairment, 45, 65, 143, 165, 172 Impetigo, 97, 165 Implant radiation, 165, 167, 184, 195 In situ, 9, 81, 165 In Situ Hybridization, 9, 165 In vitro, 12, 15, 16, 33, 38, 73, 90, 165, 181, 191 In vivo, 12, 15, 17, 33, 38, 64, 73, 165, 177, 191 Incubation, 7, 165 Indicative, 95, 165, 178, 194 Induction, 8, 141, 165 Infancy, 165 Infantile, 98, 165 Infarction, 145, 151, 166, 172 Infection, 4, 22, 59, 90, 144, 145, 148, 152, 156, 157, 158, 165, 166, 168, 170, 175, 186, 188, 190, 193, 194, 195 Infertility, 65, 166 Infiltration, 166, 195 Inflammatory bowel disease, 6, 166 Infusion, 32, 166 Initiation, 16, 53, 74, 166 Innervation, 8, 166 Inorganic, 143, 149, 166 Insulator, 166, 173 Insulin, 6, 10, 97, 98, 166, 168 Insulin-dependent diabetes mellitus, 98, 166 Integrins, 8, 166

Intercellular Adhesion Molecule-1, 37, 166 Interleukin-2, 42, 167 Interleukin-6, 39, 167 Interleukin-8, 37, 167 Internal Medicine, 96, 167, 186 Internal radiation, 167, 184, 195 Interpersonal Relations, 125, 167 Interstitial, 6, 146, 158, 167, 174, 195 Intestinal, 147, 167, 170 Intestine, 146, 167, 185, 188, 190 Intracellular, 166, 167, 172, 176, 183, 187 Intramuscular, 82, 167, 178 Intravenous, 166, 167, 178 Intrinsic, 8, 39, 84, 140, 145, 167 Invasive, 164, 167 Invertebrates, 167, 171 Involuntary, 144, 157, 167, 174, 176, 188 Ions, 144, 154, 155, 163, 167 Iris, 142, 151, 167 Irradiation, 34, 41, 43, 51, 59, 75, 85, 167, 195 Ischemia, 144, 168 Islet, 6, 168 J Joint, 143, 159, 168, 177, 191 K Kb, 112, 168 Keloid, 88, 168 Keratin, 168 Keratinocytes, 7, 8, 12, 40, 85, 90, 167, 168 Keratosis, 88, 89, 139, 168 Kerosene, 86, 168 Kidney Disease, 112, 117, 168 L Labile, 150, 168 Laminin, 145, 168 Leg Ulcer, 58, 168 Lens, 147, 151, 168, 185 Leprosy, 11, 35, 168 Lesion, 28, 161, 168, 170, 187, 193 Lethal, 83, 144, 168 Lethargy, 164, 168 Leucine, 145, 168 Leucocyte, 168, 169 Leukaemia, 32, 169 Leukemia, 116, 152, 169, 182 Leukocytes, 146, 148, 169, 173, 179 Library Services, 134, 169 Lichen Planus, 8, 19, 47, 88, 91, 169 Ligament, 169, 183 Ligands, 9, 92, 166, 169 Linkage, 9, 11, 42, 45, 60, 169

Index 203

Linkage Disequilibrium, 9, 60, 169 Lip, 19, 169 Lipid, 24, 66, 93, 143, 154, 166, 169, 173, 177 Lipid Peroxidation, 66, 169, 177 Lipoprotein, 80, 169, 170 Liposomal, 85, 169 Liposomes, 85, 169 Lipoxygenase, 93, 143, 169 Liver, 12, 56, 75, 99, 143, 145, 152, 156, 159, 162, 170, 172, 186 Localization, 19, 165, 170 Low-density lipoprotein, 169, 170 Lupus, 6, 8, 9, 22, 116, 170, 191 Lupus Nephritis, 6, 170 Lymph, 28, 156, 163, 170, 173, 186, 190 Lymph node, 170, 173, 186 Lymphadenopathy, 28, 170 Lymphatic, 156, 166, 170, 172, 176, 189 Lymphatic system, 170, 189 Lymphocyte, 24, 32, 54, 73, 142, 170, 171 Lymphoid, 142, 168, 170 Lymphokine, 47, 170 Lymphoma, 88, 116, 170, 173 M Macrophage, 39, 170 Major Histocompatibility Complex, 54, 170 Malabsorption, 116, 147, 170 Malignancy, 139, 170 Malignant, 37, 50, 87, 116, 142, 158, 171, 173, 174, 184, 186 Malnutrition, 144, 171, 173 Manifest, 15, 171 Man-made, 147, 171 Meat, 89, 171 Meat Products, 89, 171 Mediate, 16, 154, 171 Mediator, 10, 167, 171, 181 Medical Records, 171, 186 MEDLINE, 113, 115, 117, 171 Megaloblastic, 159, 171 Melanin, 12, 15, 17, 20, 44, 82, 85, 86, 92, 97, 153, 164, 167, 171, 179 Melanoblasts, 171, 180 Melanoma, 5, 7, 8, 14, 16, 19, 24, 26, 27, 36, 37, 44, 50, 53, 60, 63, 87, 90, 116, 122, 171 Melanophores, 80, 171 Melanosis, 139, 171 Melanosomes, 15, 85, 171 Membrane Proteins, 169, 171 Memory, 87, 172

Mental Retardation, 98, 116, 118, 172 Mesenchymal, 157, 172 Metabolite, 35, 172, 180 Metamorphosis, 144, 172 Metastasis, 172 Metastatic, 6, 172 Methionine, 145, 172, 190 Methyltransferase, 19, 62, 172 MI, 55, 62, 88, 138, 172 Microbe, 172, 192 Microorganism, 149, 172, 178, 195 Microscopy, 82, 145, 172 Microsome, 73, 172 Migration, 34, 84, 167, 172, 180 Mineralocorticoids, 140, 152, 172 Mitosis, 143, 172 Modification, 90, 160, 172, 184 Molecular, 5, 7, 8, 10, 11, 12, 15, 46, 93, 95, 113, 115, 141, 145, 150, 169, 172, 181, 186 Monitor, 173, 176 Monoclonal, 6, 41, 86, 152, 163, 165, 167, 173, 184, 186, 195 Monoclonal antibodies, 41, 86, 152, 165, 173, 186 Monocytes, 167, 169, 173 Mononuclear, 45, 62, 65, 158, 161, 173 Monotherapy, 67, 173 Morphological, 140, 155, 159, 171, 173 Morphology, 12, 173 Motility, 84, 92, 173 Mucosa, 11, 147, 170, 173 Multiple sclerosis, 6, 173 Multivalent, 144, 173 Muscle Fibers, 173 Muscular Atrophy, 117, 173 Muscular Dystrophies, 155, 173 Myasthenia, 31, 173 Mycosis, 39, 60, 75, 83, 88, 173 Mycosis Fungoides, 39, 60, 75, 83, 88, 173 Myelin, 173 Myocarditis, 51, 173 Myocardium, 172, 173, 174 Myopia, 98, 174, 185 Myositis, 51, 174 Myotonic Dystrophy, 117, 174 N Naevus, 30, 174 Naloxone, 145, 174 Naphthoquinones, 154, 174 Nearsightedness, 174 Necrobiosis Lipoidica, 97, 174 Necrolysis, 7, 8, 174

204 Vitiligo

Necrosis, 143, 158, 166, 172, 174, 186 Need, 3, 83, 90, 97, 103, 128, 149, 174, 192 Neon, 34, 174 Neonatal, 16, 174 Neoplasia, 116, 174 Neoplasm, 174, 186, 193 Neoplastic, 141, 163, 170, 174 Nephritis, 6, 174 Nephropathy, 168, 174 Nephrosis, 174 Nephrotic, 20, 174 Nephrotic Syndrome, 20, 174 Nerve Fibers, 44, 175 Nerve Growth Factor, 9, 175 Nervous System, 81, 117, 140, 148, 171, 175, 190 Neural, 8, 96, 140, 163, 171, 175, 180 Neural Crest, 8, 171, 175, 180 Neurologic, 127, 175 Neuronal, 47, 93, 175, 179 Neurons, 8, 93, 153, 159, 175 Neuropathy, 92, 175 Neuropeptide, 42, 47, 175 Neuroretinitis, 175, 185 Neurotransmitters, 175 Neutrons, 140, 167, 175, 184 Neutrophil, 167, 175 Nevus, 18, 19, 175 Nickel, 51, 67, 175 Night Blindness, 175, 185 Nitric Oxide, 7, 176 Norepinephrine, 140, 154, 176 Nuclear, 8, 20, 85, 87, 144, 155, 158, 159, 171, 174, 176 Nuclei, 93, 141, 155, 160, 172, 175, 176, 177, 183 Nucleic acid, 85, 160, 163, 165, 176 Nucleic Acid Hybridization, 163, 176 Nucleus, 143, 144, 149, 152, 153, 158, 159, 173, 175, 176, 183, 190, 191 Nystagmus, 98, 176 O Ocular, 48, 50, 75, 88, 99, 174, 176 Oedema, 58, 176 Oncogene, 116, 176, 189 Oncogenic, 166, 176 Opacity, 147, 153, 176 Opsin, 176, 185 Optic cup, 142, 176 Optic Nerve, 175, 176, 185 Orbit, 158, 177, 179 Organelles, 152, 171, 173, 177

Osteoarthritis, 92, 177 Osteoclasts, 144, 177 Osteopetrosis, 45, 177 Oxidants, 56, 177 Oxidation, 51, 139, 142, 143, 161, 169, 177 Oxidation-Reduction, 177 Oxidative Stress, 15, 29, 39, 63, 177 P Palate, 149, 177 Palliative, 177, 191 Pancreas, 166, 168, 177, 178 Pancreatic, 116, 178 Pancreatic cancer, 116, 178 Parenteral, 6, 178 Parotid, 178, 186 Paroxysmal, 116, 162, 178 Patch, 153, 178 Pathogen, 165, 178 Pathogenesis, 5, 14, 15, 45, 48, 98, 178 Pathologic, 139, 143, 145, 151, 164, 178, 183 Pathologic Processes, 143, 178 Pathophysiology, 10, 178 Patient Advocacy, 127, 178 Patient Compliance, 51, 178 Patient Education, 124, 132, 134, 138, 178 Pedigree, 10, 178 Pelvic, 178, 183 Pemphigus, 6, 139, 178 Peptide, 6, 14, 32, 54, 84, 88, 145, 158, 168, 178, 181, 183, 192 Peptide T, 54, 178 Perception, 93, 151, 178 Pericardium, 178, 191 Perinatal, 9, 178 Perioral, 74, 103, 179 Periorbital, 21, 179 Peripheral blood, 24, 45, 65, 179 Peripheral Nerves, 168, 179 Peritoneal, 143, 176, 179 Peritoneal Cavity, 143, 176, 179 Pernicious, 65, 67, 71, 98, 171, 179 Pernicious anemia, 65, 67, 71, 98, 179 Peroxidase, 12, 143, 169, 179 Peroxide, 179 Petrolatum, 156, 179 Petroleum, 168, 179 Phagocyte, 177, 179 Pharmaceutical Preparations, 158, 179, 182 Pharmacologic, 141, 179, 192 Phenolphthalein, 156, 179 Phenotype, 7, 179

Index 205

Phenylalanine, 38, 41, 43, 50, 51, 64, 65, 67, 77, 179 Phospholipids, 158, 169, 179 Phosphorus, 146, 179 Phosphorylated, 154, 180 Photochemotherapy, 3, 27, 41, 51, 52, 60, 65, 74, 75, 83, 124, 180 Photosensitizing Agents, 180 Phototherapy, 47, 56, 65, 101, 102, 180 Physical Examination, 3, 180 Physiologic, 145, 180, 182, 184, 193 Physiology, 180 Piebaldism, 29, 30, 95, 180 Pigmentation, 7, 11, 13, 80, 86, 87, 90, 92, 98, 125, 126, 164, 171, 174, 180, 188 Pilot study, 46, 55, 180 Pituitary Gland, 151, 158, 180 Placenta, 83, 180, 182 Planets, 180, 194 Plants, 140, 147, 160, 173, 176, 180, 186, 192 Plasma, 30, 35, 42, 49, 142, 145, 148, 160, 162, 172, 180, 187 Plasma cells, 142, 180 Platelet Aggregation, 141, 176, 180, 181 Platelet Factor 4, 167, 181 Platelets, 143, 145, 176, 180, 181 Platinum, 149, 181 Pleural, 176, 181 Pleural cavity, 176, 181 Polycystic, 117, 181 Polymerase, 4, 181 Polymerase Chain Reaction, 4, 181 Polymorphic, 11, 52, 181 Polymorphism, 9, 19, 62, 181 Polypeptide, 86, 87, 141, 150, 157, 163, 181 Polysaccharide, 142, 181, 183 Posterior, 144, 149, 154, 167, 177, 181 Postnatal, 15, 181 Potentiate, 65, 74, 181 Practicability, 181, 192 Practice Guidelines, 114, 182 Preclinical, 14, 182 Precursor, 143, 154, 155, 156, 176, 179, 182, 193 Prevalence, 11, 35, 39, 52, 91, 182 Prickle, 139, 168, 182 Progesterone, 182, 189 Progression, 141, 182 Progressive, 11, 15, 28, 58, 99, 116, 148, 149, 154, 161, 173, 174, 177, 182, 185, 193 Proline, 150, 164, 182

Promoter, 7, 12, 182 Promyelocytic leukemia, 182, 193 Prone, 97, 182 Prophylaxis, 85, 88, 182, 193 Propylene Glycol, 85, 182 Prostaglandin, 56, 182 Prostaglandins A, 182, 183 Prostate, 116, 183 Protein C, 141, 143, 168, 169, 183 Protein S, 96, 117, 145, 160, 183 Proteinuria, 174, 183 Proteoglycans, 145, 183 Proteolytic, 150, 183 Protons, 140, 163, 183, 184 Pruritic, 155, 169, 183 Pruritus, 97, 183 Psoralen, 3, 19, 27, 40, 43, 48, 52, 64, 67, 82, 83, 125, 183 Psoriasis, 23, 34, 52, 58, 82, 83, 85, 88, 91, 92, 122, 123, 149, 180, 183, 193 Psychic, 183, 187 Psychomotor, 40, 58, 183 Public Policy, 113, 183 Publishing, 17, 126, 184 Pulmonary, 6, 184, 194 Pulse, 50, 58, 173, 184 Purulent, 184 Pustular, 139, 162, 165, 184 Pyoderma, 88, 184 Pyoderma Gangrenosum, 88, 184 Q Quality of Life, 184, 191 Quiescent, 184, 195 R Race, 81, 92, 172, 184 Radiation, 8, 47, 58, 80, 82, 90, 92, 156, 158, 159, 164, 167, 171, 180, 184, 191, 195 Radiation therapy, 47, 158, 167, 184, 195 Radioactive, 7, 163, 165, 167, 171, 173, 176, 184, 195 Radiolabeled, 146, 167, 184, 195 Radiotherapy, 146, 167, 184, 195 Randomized, 6, 18, 155, 184 Receptor, 9, 10, 16, 17, 20, 37, 42, 86, 87, 90, 92, 93, 142, 149, 151, 154, 161, 178, 184 Recombinant, 17, 184, 194 Rectum, 154, 159, 166, 183, 185 Red Nucleus, 144, 185 Refer, 1, 146, 150, 162, 170, 175, 185 Refraction, 174, 185, 189 Refractive Power, 174, 185 Regeneration, 62, 89, 158, 185

206 Vitiligo

Regimen, 155, 178, 185 Relapse, 81, 185 Reliability, 12, 185 Resolving, 75, 185 Retina, 148, 149, 168, 174, 175, 176, 185, 186 Retinal, 21, 62, 98, 151, 176, 185 Retinal pigment epithelium, 21, 185 Retinitis, 98, 185, 186 Retinitis Pigmentosa, 98, 185 Retinoblastoma, 116, 185 Retinoid, 62, 64, 185 Retinol, 89, 185 Retinopathy, 98, 186 Retinyl palmitate, 64, 186 Retrospective, 52, 67, 75, 186 Retrospective study, 52, 186 Rheumatic Diseases, 92, 186 Rheumatism, 186 Rheumatoid, 6, 177, 186 Rheumatoid arthritis, 6, 186 Rheumatology, 6, 186 Rhinitis, 186 Rituximab, 6, 186 Rod, 34, 99, 186 Rubber, 49, 65, 139, 186 S Salivary, 152, 178, 186, 190 Salivary glands, 152, 186 Saponins, 186, 190 Sarcoidosis, 23, 186 Sarcoma, 71, 159, 186 Scleroderma, 7, 28, 158, 186 Sclerosis, 6, 97, 117, 122, 173, 186 Screening, 4, 5, 16, 98, 149, 187 Sebaceous, 187, 195 Secretion, 139, 152, 157, 163, 164, 166, 172, 187, 194 Segmental, 19, 24, 26, 34, 39, 44, 53, 55, 58, 65, 66, 187 Segmentation, 187 Segregation, 60, 144, 187 Seizures, 127, 178, 187 Selenium, 38, 64, 187 Semen, 76, 183, 187 Senna, 147, 187 Sensibility, 141, 164, 187 Sequence Homology, 178, 187 Sequencing, 181, 187 Serum, 16, 24, 39, 60, 66, 98, 141, 142, 150, 164, 170, 172, 187 Sex Determination, 117, 187

Shedding, 89, 187 Shock, 187, 192 Side effect, 82, 90, 105, 140, 145, 187, 191, 192 Signs and Symptoms, 185, 187 Skeleton, 168, 182, 188 Skin graft, 18, 22, 55, 90, 188 Skin Physiology, 7, 188 Skin Pigmentation, 13, 15, 82, 84, 188 Skin Transplantation, 90, 188 Small intestine, 149, 155, 163, 167, 188 Smallpox, 188, 193 Sneezing, 187, 188 Social Behavior, 80, 81, 188 Social Problems, 13, 188 Social Support, 55, 188 Soft tissue, 158, 159, 188 Solvent, 158, 168, 182, 188 Soma, 188 Somatic, 40, 58, 85, 155, 163, 172, 188 Somatic mutations, 85, 188 Specialist, 128, 154, 188 Specificity, 140, 143, 188 Spectrum, 15, 21, 85, 189 Sperm, 141, 149, 188, 189 Spinal cord, 148, 159, 175, 179, 189 Spinous, 157, 168, 189 Spleen, 57, 152, 170, 186, 189 Splenomegaly, 177, 189 Sporadic, 185, 189 Squamous, 8, 46, 54, 55, 157, 189 Squamous cell carcinoma, 8, 46, 54, 55, 157, 189 Squamous cells, 189 Staphylococcus, 165, 189 Staphylococcus aureus, 165, 189 Stasis, 75, 189 Statistically significant, 4, 189 Stem Cell Factor, 9, 149, 189 Sterility, 166, 189 Steroid, 37, 64, 152, 186, 189 Stimulus, 166, 167, 190 Stomach, 60, 93, 144, 154, 157, 160, 163, 179, 188, 189, 190 Strand, 85, 181, 190 Streptococci, 165, 190 Streptococcus, 157, 158, 190 Stress, 12, 16, 51, 147, 177, 186, 190, 193 Stroke, 39, 112, 190 Styrene, 186, 190 Subacute, 166, 190 Subarachnoid, 162, 190

Index 207

Subclinical, 166, 187, 190 Subcutaneous, 148, 155, 176, 178, 190 Submaxillary, 157, 190 Subspecies, 188, 190, 194 Substance P, 55, 172, 187, 190 Suction, 33, 46, 190 Sulfur, 86, 172, 190 Sun protection factor, 97, 190 Sunburn, 81, 85, 97, 137, 190, 191 Supportive care, 125, 191 Suppression, 149, 152, 191 Suppurative, 148, 191 Symphysis, 183, 191 Systemic lupus erythematosus, 6, 9, 29, 60, 170, 191 Systemic therapy, 55, 66, 191 T T cell, 15, 16, 26, 27, 38, 42, 44, 46, 63, 64, 88, 167, 191 Tacrolimus, 18, 22, 53, 54, 55, 56, 101, 191 Telangiectasia, 117, 137, 191 Teratogenic, 191, 193 Thalamic, 144, 191 Thalamic Diseases, 144, 191 Therapeutics, 6, 108, 191 Thermal, 154, 175, 181, 191 Threonine, 178, 191 Thrombosis, 145, 166, 183, 190, 191 Thyroid, 20, 32, 34, 37, 55, 64, 66, 125, 164, 191, 192 Thyroid Gland, 164, 191, 192 Thyroiditis, 20, 98, 192 Thyrotropin, 164, 192 Thyroxine, 179, 192 Tin, 89, 181, 192 Tissue, 12, 15, 16, 42, 89, 91, 92, 140, 142, 143, 144, 145, 148, 149, 151, 154, 155, 156, 158, 159, 161, 164, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 179, 180, 181, 185, 187, 188, 189, 191, 192, 193, 195 Tolerance, 32, 139, 160, 192 Tonicity, 155, 192 Toxic, iv, 7, 8, 13, 81, 152, 156, 161, 164, 175, 187, 190, 192 Toxicity, 11, 154, 192 Toxicology, 114, 192 Toxins, 13, 142, 156, 166, 173, 192 Trace element, 175, 192 Trachea, 146, 191, 192 Transfection, 8, 145, 192 Translocation, 8, 192

Transmitter, 139, 154, 171, 176, 192 Transplantation, 33, 45, 95, 149, 164, 170, 192 Trauma, 16, 97, 164, 174, 192 Treatment Outcome, 25, 192 Trees, 141, 186, 192 Tremor, 193 Tretinoin, 23, 62, 193 Tryptophan, 150, 193 Tuberculosis, 170, 193 Tuberous Sclerosis, 117, 122, 193 Tumour, 18, 159, 193 U Ulcer, 148, 155, 168, 193, 194 Ulceration, 92, 168, 193 Ulcerative colitis, 166, 184, 193 Unconscious, 153, 164, 193 Urethra, 183, 193 Urinary, 160, 193 Urine, 145, 157, 162, 183, 193 Urogenital, 160, 193 Urticaria, 88, 193 V Vaccination, 14, 17, 193 Vaccine, 14, 193 Vaccinia, 17, 193 Vaccinia Virus, 17, 193 Vacuoles, 144, 177, 194 Vagina, 153, 194 Varicella, 4, 194 Varicose, 168, 194 Variola, 193, 194 Vascular, 92, 149, 156, 162, 166, 176, 180, 191, 193, 194 Vasodilation, 93, 194 Vasodilators, 176, 194 Vasomotor, 92, 194 Vector, 194 Vein, 141, 167, 176, 178, 194 Venous, 145, 146, 168, 176, 183, 194 Ventricle, 184, 194 Venus, 21, 194 Vesicular, 162, 188, 194 Veterinary Medicine, 113, 194 Villous, 147, 194 Viral, 4, 23, 156, 160, 176, 194 Viral Hepatitis, 23, 194 Virulence, 144, 192, 194 Virus, 4, 36, 37, 59, 148, 152, 160, 161, 188, 191, 194, 195 Viscera, 173, 188, 194 Visceral, 92, 93, 194

208 Vitiligo

Visual field, 185, 194 Vitro, 12, 15, 52, 90, 195 Vivo, 12, 15, 195 Vulgaris, 21, 23, 40, 57, 58, 139, 195 W Wart, 168, 195 White blood cell, 142, 169, 170, 175, 180, 191, 195 Windpipe, 191, 195 Wound Healing, 149, 158, 166, 195

X Xenograft, 142, 195 Xenon, 54, 57, 195 X-ray, 159, 167, 171, 176, 184, 195 X-ray therapy, 167, 195 Y Yeasts, 159, 179, 195 Z Zoster, 4, 195

Index 209

210 Vitiligo

Index 211

212 Vitiligo

Vitiligo - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Influenza A - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hepatitis A Vaccine: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Foot and Mouth Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Butternut Squash: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Facial Paralysis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Wine - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Breast Augmentation - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Premenstrual Dysphoric Disorder - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Anagrelide: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Peanut Allergy: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Cauda Equina Syndrome - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Magnesium Citrate: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Lipomas - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Barbiturates - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Cephalexin - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Body Dysmorphic Disorder: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Lymphedema - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Dermabrasion: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Septra: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Vaginitis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Feet - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Glioblastoma Multiforme - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Female Infertility - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Living Will - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hip Pain: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Benzene - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Marburg Virus: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Erythema Multiforme - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Alopecia Areata - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Endometritis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Vitiligo - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Influenza A - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hepatitis A Vaccine: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Foot and Mouth Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Butternut Squash: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Facial Paralysis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Wine - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Breast Augmentation - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Premenstrual Dysphoric Disorder - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Anagrelide: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Peanut Allergy: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Cauda Equina Syndrome - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Magnesium Citrate: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Lipomas - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Barbiturates - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Cephalexin - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Body Dysmorphic Disorder: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Lymphedema - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Dermabrasion: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Septra: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Vaginitis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Feet - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Glioblastoma Multiforme - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Female Infertility - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Living Will - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hip Pain: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Benzene - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Marburg Virus: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Erythema Multiforme - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Alopecia Areata - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Endometritis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Recommend Documents