Wu C S, Yu H S, Chang H R, Yu C L, Yu C L, Wu B N
Department of Dermatology, Kaohsiung Medical University, 100 Shih Chuan 1st Road, Kaohsiung, Taiwan.
J Dermatol Sci. 2000 May;23(1):53-62. doi: 10.1016/s0923-1811(99)00090-0.
It has been proposed that two types of vitiligo exist from the physiological and clinical points of view. Nonsegmental-type vitiligo is associated with autoimmune diseases while segmental-type vitiligo results from the dysfunction of sympathetic nerves in the affected area. Using laser Doppler flowmetry and iontophoresis for cutaneous microcirculatory assessments, we evaluated these two types of vitiligo in regard to their physiological changes. Ten patients with facial stable stage segmental-type vitiligo and ten stable nonsegmental-type vitiligo patients were selected for this study. Our results revealed that a nearly threefold increase in cutaneous blood flow was noticed in segmental-type vitiligo as compared to contralateral normal skin. In contrast, a 1.4-1.5 times difference was found among nonsegmental-type vitiligo, lesion side clinically normal skin and contralateral normal skin. There was a significant increase in cutaneous alpha- and beta-adrenoceptor response in segmental-type vitiligo lesions. However, no change in plasma catecholamines or adrenoceptor densities on blood cells was noticed. Our findings suggest that a dysfunction of the sympathetic nerves exists in the affected skin and plays a role in the pathogenesis of segmental-type vitiligo.
从生理和临床角度来看，有人提出白癜风存在两种类型。非节段型白癜风与自身免疫性疾病相关，而节段型白癜风是由患部交感神经功能障碍引起的。我们使用激光多普勒血流仪和离子导入法进行皮肤微循环评估，从生理变化方面对这两种类型的白癜风进行了评估。本研究选取了10例面部稳定期节段型白癜风患者和10例稳定期非节段型白癜风患者。我们的研究结果显示，与对侧正常皮肤相比，节段型白癜风患者的皮肤血流量增加了近三倍。相比之下，非节段型白癜风患者、皮损侧临床正常皮肤和对侧正常皮肤之间的差异为1.4至1.5倍。节段型白癜风皮损中的皮肤α和β肾上腺素能受体反应显著增加。然而，血浆儿茶酚胺或血细胞上的肾上腺素能受体密度没有变化。我们的研究结果表明，患部皮肤存在交感神经功能障碍，并且在节段型白癜风的发病机制中起作用。
