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History of Vitiligo

Vitiligo is a disease that was observed very early in history, and most ancient civilizations and religions had some type of reference about lack of pigmentation. One of the earliest terms was "Kilas" in the Rig Veda, which was meant as similar to a white spotted deer.

The Ebers Papyrus in 1550 BC mentioned two forms of depigmentation that could be interpreted as leprosy or depigmentation resembling vitiligo. By 1400 BC white leprosy spots were called Sveta khushtha in the Atharva Veda and in 1200 BC Japanese Shinto prayers described depigmentation in the Amarakosa. Around 600 BC, the Ashtanaga hridaya explained prognostic factors of depigmentation.

In 250 BC, Ptolemy II translated the Bible from Hebrew into Greek and in the Leviticus XIII (Old Testament), the word Zara'at used for different skin conditions was translated as "lepros" (scales) that was misinterpreted later on as leprosy and other hypopigmented disorders defined as unclean diseases. In 200 BC, the Indian Manu Smriti described "Sweta Kushtha" meaning "white disease" probably referring to vitiligo. Herodotus (484-425), the Greek historian, claimed that foreigners 'had sinned against the sun' and must leave the country. Years later, the term vitiligo was perhaps derived from the latin word vitelius and used to describe the white flesh of calves, and finally the word vitiligo was attributed to Celsus in his classic Latin book De Medicina in the first Century AD.

Many centuries went by and vitiligo continued to be one of the most important depigmentation ailments worldwide provoking discrimination or segregation in certain cultures, where affected individuals were unable to get jobs or even become married most probably based upon ancient religious beliefs.

After the middle ages, around 1533, Andreas Vesalius called the attention about the skin having two layers. Several decades later, Jean Riolan the Younger (1580-1657) separated the skin of a black subject into the upper black layer (horny layer) and the lower white layer "as snow" (dermis). In 1665, Marcello Malpighi proposed that skin colour was mainly determined by the granules of stratum mucosum, not those of stratum corneum or dermis.

Finally, Giosue Sangiovanni in 1819 was the first to describe melanocytes in the squid, which he termed as 'chromatophores'. In 1837, Friedrich Henle also identified pigment producing cells in human epidermis, as identical to pigment cells of the eye. In 1879, Moritz Kaposi was one of the first to observe lack of pigment granules in the rete pegs of vitiligo. To close this chain of historical events, Bruno Bloch in 1917 described the DOPA reaction demonstrating the melanin synthesizing enzyme tyrosinase within the melanocyte.

In summary, around 4000 years of known history elapsed from the time man became aware of disturbing white spots on the skin until the melanocyte was finally identified as the responsible actor for depigmentation and other pigmentary disorders.

Abstract from “vitiligo and the melanocyte reservoir” by Rafael Falabella, M.D., Department of Dermatology, Universidad del Valle.

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