Vitiligo: A Monograph on the Basic and Clinical Science - Hardcover

Hardcover

ISBN 10: 0632050713 ISBN 13: 9780632050710

Publisher: Blackwell Pub, 2000

Synopsis

This monograph is a comprehensive expose of the disorder vitiligo. The book introduces the topic with a presentation about its cultural effects in the Middle East where vitiligo is exceptionally disabling to the affected person. Nehru as Prime Minister of India stated that vitiligo was a major impediment to the successful development of India. The book includes sections on the definition of vitiligo based on a consensus of world experts on vitiligo. There is a complete description of its clinical manifestations including the extracutaneous sites by world experts. Differentiation of vitiligo from other forms of depigmentation associated with malignancies is included with sufficient photographs to document differences. A section will present the physiological changes associated with depigmentation - a little known phenomena. The complete histology, differential diagnosis and animal models are major sections. The animal models are important in formulating theories about the causes of vitiligo. Most clinicians will find this section very informative. The book finishes with a thorough treatise on the principles of therapy.

About this title

Reviews

This book is a timely, comprehensive monograph about a highly noticeable condition characterized by enlarging areas of cutaneous depigmentation. Current therapies are generally unsatisfactory, and recent advances justify this up-to-date review. The book has a foreword by Aaron B. Lerner of Yale University, founder and developer of modern pigment-cell biology and a pioneer in basic and clinical research in this largely ignored field.

The monograph is well organized, and the excellent choice of topics provides a balanced view of the basic and clinical sciences. The 33 chapters are by recognized experts in the field and are organized into five sections, covering general topics, clinical presentation, pathogenesis (including theories on depigmentation), treatment, and other topics (including depigmentation conditions other than vitiligo and animal models of the disease).

Part 1 contains an interesting chapter on the historical and cultural aspects of vitiligo and ends with a chapter on the genetic aspects of vitiligo vulgaris. Several chapters in part 2 deal with the different clinical forms of vitiligo. The discussions are highlighted by very high quality photographs that convey the range of clinical presentations. This part, which ends with the differential diagnosis of vitiligo, should help both general practitioners and dermatologists.

Part 3 covers the pathogenesis of vitiligo. There is no dearth of information in this section, which finds room for genetic, autoimmune, autocytotoxic, neural, and biochemical theories. Particularly intriguing are the chapters on the autocytotoxic hypothesis with respect to the disappearance of melanocytes and on the potential role of pteridines as mediators of depigmentation. The discussion of pathogenesis revolves around a common element -- the cytotoxicity of intermediates of melanogenesis -- but it also mentions the recent newcomers in this field: melatonin and its receptor.

Part 4 covers therapeutic approaches to vitiligo. There are detailed evaluations of photochemotherapy with psoralen compounds in conjunction with ultraviolet A radiation; steroid treatment; epidermal and dermo-epidermal grafting; and transplantation of cultured melanocytes. This assortment of therapies indicates that no single method provides perfect treatment and that, for the most part, the adverse effects are minimal. Nevertheless, cosmetic approaches, such as micropigmentation of small vitiliginous areas or pharmacologic depigmentation for extensive vitiligo, are the treatments of choice. Success in repigmentation has been reported with topical pseudocatalase and calcium in combination with low doses of ultraviolet B radiation. The last chapter in part 4 discusses alternative therapies for vitiligo, but it recites facts and is short on interpretation and recommendations.

Finally, part 5 covers a variety of topics that are peripherally related to vitiligo. Although each chapter in this part of the book is exhaustive, the random grouping of topics interferes with the flow of reading. Better organization and more background information would be desirable for an audience of practicing dermatologists.

Since readers of this book should have a basic knowledge of biochemistry, pathology, and immunology, it is probably not suitable for most patients. However, I highly recommend it to general practitioners, dermatologists, and dermatopathologists. It presents updated information on melanin pigmentation and on recent advances in therapy, without excluding the more traditional clinical approaches to the diagnosis and management of this disease. In addition, the graphs and tables are exceptional in quality and scope. In general, this book is an excellent source of information on all aspects of vitiligo and fills a gap in the medical literature.

Andrzej Slominski, M.D., Ph.D.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Edition details

• Publisher: Blackwell Pub
• Publication date: 2000
• Language: English
• ISBN 10: 0632050713
• ISBN 13: 9780632050710
• Binding: Hardcover
• Edition number: 1
• Number of pages: 306
• Editor: Hann Seung-Kyung M.D., Nordlund James M.D.