Introduction: Occurence of vitiligo lesions is caused by the destruction of melanocytes in affected skin and therefore by the reduction of pigment melanin content. Questions remain about the presence of residual melanocytes in the depigmented skin and optimal methods of their identification. Methods: Skin biopsy samples from 16 patients with non-segmental vitiligo and from 10 healthy volunteers were investigated for Melan-A (А103 clone)+ melanocytes expression by immunohistochemical analysis and for melanin by histochemical studies with section staining by Fontana-Masson method. Results: For some patients including those with long-standing disease (up to 40 years) Melan-A+ cells and melanin granules were detected in depigmented skin as indication that the residual melanocytes are preserved in vitiligo lesions. More than threefold decrease of Melan-A+ melanocytes amount was revealed in perilesional normally pigmented skin of vitiligo patients (P < 0.001) compared with the skin of healthy volunteers. Clinically intact skin involvement in the pathological process should be taken into consideration if local treatment methods are prescribed. Conclusion: In some vitiligo patients the residual melanocytes are preserved in depigmented skin. Melan-A marker is useful for identification of melanocytes in vitiligo patients' skin.

Vitiligo is a common polygenic autoimmune disease in which the foci of depigmentation are formed on the skin and/or mucous membranes as a result of the death of melanocytes. There are several hypotheses for the pathogenesis of the disease, the leading role among them is played the autoimmune hypothesis. This review summarizes the available literature data on the prevalence and structure of comorbid endocrine autoimmune pathology in vitiligo patients. In most studies conducted in Europe, America and Asia the prevalence of autoimmune thyroid diseases (including autoimmune thyroiditis and Graves disease), diabetes mellitus and autoimmune adrenal insufficiency was higher in vitiligo patients than in the general population. The results of some studies indicate a frequent association of vitiligo with autoimmune polyglandular syndromes. In the structure of comorbid pathology the highest prevalence was in autoimmune thyroid diseases. A number of studies have established a higher prevalence of autoimmune endocrine diseases in women, as well as in nonsegmental vitiligo patients and in cases of family history of vitiligo and/or other autoimmune diseases. In addition, it was shown that the prevalence of endocrine diseases increases with increasing area of depigmentation. The data obtained justify the advisability of conducting a timely examination of vitiligo patients with the aim of early detection of comorbid diseases and the appointment of appropriate treatment. Further studies are needed to investigate the effect of the identified associations on the course of vitiligo and comorbid endocrinopathies, as well as the effectiveness of therapy and the quality of life of patients.

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