I recently attended the first
international symposium on vitiligo in Rome, Italy, where many vitiligo experts came together to discuss our research in vitiligo, as well as what we should focus on next. Dr. Richard Spritz, who has done wonderful work on the
genetics of vitiligo, said that he was frustrated that papers published on vitiligo still start with, “The cause of vitiligo is unknown. There are many hypotheses as to the true cause. . .”. He finds this frustrating because we know SO MUCH about what causes vitiligo. I then got up to the podium and agreed, saying that whoever writes those sentences must have missed all of the papers that have been published in the past 30 years.
In fact, we know more about what causes vitiligo than any other autoimmune disease, including diabetes, thyroiditis, lupus, and others. It’s true that there have been many different ideas in the past about what causes vitiligo, from autoimmunity to cellular stress, chemicals, nerves, and genetics. And many scientists have spent a long time arguing about which one was correct. It turns out that most of them are correct, and work together to cause the clinical disease we call vitiligo. Have you ever heard the story about the blind men and the elephant? It describes a situation in which 3 blind men stumble upon an elephant and attempt to determine what it is, simply by touching it. One at the trunk believes it is a snake, another at the tusk claims it is a piece of rock, and the third at the leg argues that it is a pillar. At first they argue vehemently, but once they discuss and move around to examine it from the others’ perspectives, they collaborate to realize that each of them was correct in describing part of the whole, and that together they could discover the bigger truth.
