Key points.
Is vitiligo a separate disease? Is vitiligo treated as a separate disease?
Or conversely, does vitiligo include a range of different diseases with different causes, all of which manifest as white patches on the skin and require different treatments?
Can genetic research lead to the discovery of a cure for vitiligo?
Can people with vitiligo have the financial resources to benefit from effective treatments?
What can be done with the Cloud Medical Research Management (MRM)?
New hope in vitiligo treatment and cure?
Answer.
This is the only section in this manual where all the bullet points end with a question mark.
The phrase “the cause of vitiligo remains unclear” is always followed by the phrase “because the process by which the white patches of skin develop may be different in each patient.”
In other words, the production, release, and removal of skin pigment in the same skin blemish in different individuals diagnosed by dermatologists as “vitiligo” may be influenced by several different mechanisms.
Therefore, perhaps there is not only one form of vitiligo, but more than one form of “vitiligo” affecting different individuals that present with similar or identical skin or mucosal white patches.
This notion does not include “cutaneous leukoplakia”, such as those with a known cause of cutaneous leukoplakia.
This suggests that different types of vitiligo require different treatment modalities and ultimately have different prognoses.
This also suggests that today’s “combination of treatments” is the most reasonable for any case.
It is difficult to say that genetic studies can directly discover a cure for vitiligo. Most likely, this will not happen soon. Only 23% of twins with the same genes develop vitiligo at the same time, suggesting that environmental and non-genetic factors have an important impact on vitiligo.
Genetic studies may help us to distinguish between different subgroups that develop skin/mucosal leukoplakia and assist physicians to diagnose vitiligo with different treatments and possibly achieve a completely different prognosis. This is currently the best target for genetic testing of vitiligo patients and has good promise. In addition, genetic studies may be useful in predicting treatment outcomes so that the best treatment can be selected for a particular patient.
When choosing a treatment plan, the cost and feasibility of treatment must be considered. The vast majority of current vitiligo patients have a relatively heavy financial burden in choosing the right treatment plan.
This problem will become even worse in the recent past due to the economic recession in many countries and the increased costs associated with effective vitiligo treatment.
Thus the effectiveness of vitiligo treatment is influenced by the interplay of multiple factors, including the identification of the specific manifestations of vitiligo (classification and genetics), the assessment of the biological pathways inherent in each patient that produce the white patches of skin (pathophysiology), and ultimately the selection of the appropriate treatment (expectation of cure).
The last topic is (and perhaps more evident in the future) the necessity to consider the cost and the feasibility of treatment for vitiligo, a chronic disease that can develop in all populations.
Most people with vitiligo have financial difficulties in receiving reasonable treatment.
The problem of vitiligo treatment and cure is a complex puzzle but we have a sound basic understanding of it.
Completing the remaining part of this puzzle requires the scientific community, vitiligo patient associations, and vitiligo foundations to join forces and contribute to the effort to overcome vitiligo and solve this puzzle.