Vitiligo

The alkaloid reserpiae [50-55-5] which is isolated from the roots of Kauwoljia serpentina T., contains a gaUate trimethyl ether moiety. Reserpiae is used as an antihypertensive and a tranquilizer. A vinylogue of reserpiae, rescinnamine [24815-24-5] is also an antihypersensitive (75). Methoxsalen [298-81-7] (8-methoxypsoralen 7JT-9-methoxy-furo [3,2- ] [l]benzopyran-7-one) (21), a furocoumatia that occurs ia plants, eg, l eguminosae and Umbelliferae is used ia the treatment of vitiligo, as a suntanning promoter, and as a sunburn protectant. It is also available by synthesis (76). 

Vitiligo and Pigmentation Institute of Southern California and Division of Dermatology, Department of Medicine, David Geffen School of Medicine,... 

Hyperpigmentation of skin (usually around creases, pressure areas, areolas, genitalia, and new scars) and mucous membranes. Dark freckles and patches of vitiligo may be present. Hyperpigmentation, owing to increased ACTH levels, occurs in primary adrenal insufficiency. 

Vesicle Vitiligo Small sac containing fluid a small blister A skin disease characterized by the formation of light-colored (pigment-free) patches... 

Pearl E. Grimes, MD Vitiligo and Pigmentation Institute of Southern California and Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, 5670 Wilshire Blvd., Suite 650, Los Angeles, CA 90036, USA... 

The hypocrellins (7-9) are Class B perylenequinones that have also been the subject of much investigation due to their biological activity, having been used in Chinese folk medicine for the treatment of vitiligo, psoriasis, and other diseases for... 

Psoralen, or derivatives of 9-methoxy-7H-furo[3,2-g]chromen-7-one tricyclic ring structures, are used as photoreactive groups in crosslinkers, biotinylation compounds, and nucleic acid probes. Psoralens have been used for many years as photochemotherapy agents for treatment of psoriasis and vitiligo (Smith and Barker, 2006). Psoralens react when exposed to UV light... 

Psoralens, or furocoumarins, are a class of heterocyclic aromatic compounds used in photochemotherapy treatment of a variety of skin diseases such as psoriasis, vitiligo, mycosis fungoides, polymorphous light eruption, and more [68-71]. The compounds are present in numerous plants throughout the world. In photoche-... 

At about the same time far to the east in India, physicians were prescribing a strikingly similar regimen for the same condition. Their medication for vitiligo was an infusion of the seeds and roots of a plant known locally as bavachee (Psoralea corylifolia). Patients drank the infusion or applied it directly to their skin. After treatment, Indian patients also exposed their patches of vitiligo to the sun. 

For the Indians, vitiligo was a serious condition. The Atharva Veda, a sacred Hindu text written no less than thirty-four hundred... 

Furanocoumarlns have a number of scientifically interesting and even economically and medicinally Important actions. They are effectively used in human medicine in the treatment of vitiligo (skin depigmentation, leukoderma) ( ) and psoriasis (10,11), and have shown promise against certain other human maladies (12-15). Plants that contain furanocoumarlns are known to cause acute photosensltlzatlon (phytophotodermatltls) in man (2,16). 

Tacrolimus is used in situations where cyclosporine has been shown to be ineffective or cannot be used because of toxicity or otherwise. It is also used in a topical preparation in the treatment of severe atopic dermatitis, severe refractory uveitis after bone marrow transplants and in vitiligo. 

Both topical and systemic PUVA are useful in some patients with vitiligo, although repigmentation is rarely complete. Other skin diseases for which PUVA may be helpful include atopic dermatitis, dyshidrotic eczema, and polymorphous light eruption. 

Vitiligo PO 20 mg 2-4 hr before exposure to UVA light. Give at least 48 hr apart. Topical Apply 1 -2 hr before exposure to UVA light, no more than once weekly. 

Mecfianism of Action The mechanism of action is not fully understood. Monobenzone maybe converted to hydroquinone, which inhibits the enzymatic oxidation of tyrosine to DOPA it may have a direct action on tyrosinase, or it may act as an antioxidant to prevent SH-group oxidation so that more SH groups are available to inhibit tyrosinase. Therapeutic Effect Depigmentation in extensive vitiligo. 

Vitiligo Topical Apply 2-3 times/day to affected area. 

Useful in the treatment of vitiligo, a skin pigment disorder Tyrosine Improves cognitive function helps reduce the effects of stress and... 

Methoxypsoralen 188 is a naturally occurring linear furocoumarin found in citrus fruit rind and celery and parsley leaves. The use of oral or topical 5-methoxypsoralen plus UVA irradiation in the management of the skin disorders psoriasis and vitiligo was the subject of a medically oriented review <1998MI667>. 

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