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In This Issue

Director's Message:

Support VSI

Embracing Diversity:
Making a Difference

Medicare Coverage for
Vitiligo Treatments

What's On Your Mind?

Medical News Updates

Bibliography and Sources

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VSI Medical and Scientific
Advisory Committee

  • Pearl E. Grimes, M.D., Committee Chair
  • Ted A. Grossbart, Ph.D.
  • Sancy A. Leachman, M.D.
  • I. Caroline Le Poole Ph.D.
  • Mauro Picardo, M.D.
  • Nanette B. Silverberg, M.D.
  • Richard A. Spritz, M.D.
  • Alain Taieb, M.D., Ph.D.
  • Wiete Westerhof, MD, Ph.D.

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Message From the Executive Director


Dear VSI Members, Friends, and Donors,

In recent weeks we’ve had an influx of requests for support from those experiencing the social stigma that vitiligo brings to so many in the South Asian countries. I am told that in some regions of India, if a single member of a family develops vitiligo, the entire family is often ostracized. Developing vitiligo after marriage can be grounds for divorce.

In America, though the stigma is not as great, many with vitiligo still feel shunned, and experience emotional and social isolation. Whatever became of America, the “melting pot” where all cultures and ethnicities come together as one?

In thinking about the many facets of diversity and acceptance, I began mulling over at what age/stage humans begin to notice differences, and when and why that begins to translate into prejudice/discrimination-based behavior, and how much of that is innate vs learned.

According to Penn State Extension:

  • At about 2 years of age, children begin to notice gender and racial differences.
  • At 2 ½ or so, children learn gender labels (boy/girl) and the name of colors – which they begin to apply to skin color.
  • Around 3 years of age, children notice physical disabilities.
  • At about 4-5 years, they start to display gender-appropriate behavior and become fearful of differences.

It’s normal to be afraid of something new or different, but just because something is new or different doesn’t necessarily mean that it is dangerous, bad, or needs to be avoided.

The process involved with learning to distinguish between difference and danger is somewhat more complicated. Some elements are learned through personal experience, others by bias interference.

My daughter teaches kindergarten in Metro Nashville, Tennessee, in a classroom primarily comprised of refugee children. The students in her school hail from nearly 20 countries. They celebrate diversity each and every day of the year. Each morning, my daughter’s classroom begins with a child saying “Good Morning” in his/her native language, then going around the circle, each child repeating the phrase. Throughout the year they learn about each other’s cultures, how each may say or do things differently, and how that makes them unique, and special in a very positive way. They learn to care about, support, and respect one another.

Even when they are not in the classroom, such as at lunch, on the playground, or even on the bus, if they see one of their classmates being picked on by another child, they all come to the rescue.

My daughter often provides assistance to her student’s families, providing transportation to and from the grocery store, and taking them to the library, or movies, etc. One day this summer, when she arrived at the apartment complex of one of her students, there was a big crowd, a large blow-up jumping house, and tables with presents, party favors, and cake. She saw quite a few of her students, but no one from the family of the child she was coming to visit, so she made her way to their apartment. When she arrived, she asked about the big party in the parking lot. The children very excitedly told her it was a birthday party for another of their classmates. She wasn’t going to ask why they had not been included, but the children quickly volunteered that the dark brown people don’t play with the light brown people…. which broke my daughter’s heart.

At school, they all play together, and respect, and care about each other. Where is the disconnect?

People just want to be listened to and understood. Take time to listen, with understanding and empathy. Like the strength of the mustard seed, change will come, one person at a time.

We may not be able to change the world by ourselves, but we can each do our own part.

“Be the change you wish to see in the world.”
Mahatma Gandhi


Support VSI’s Work to Conquer Stigma
and Increase Diversity Awareness

So Many People Count on the Support and Services Provided by VSI

VSI Depends on the Support of the Community it Serves

Can We Count on You?

One-Time Donation



Jackie Gardner
Executive Director


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Embracing Diversity:
Making a Difference

Each year as fall approaches, VSI begins receiving requests for information and support from parents of children with vitiligo. For first-time students or those just moving up a grade level, there are steps you can take to help ensure a positive start to a new school year.

While this article is primarily centered on diversity education in the classroom, it also provides positive tips and ideas to help those who might be struggling with personal acceptance that can be used by all ages, anywhere, and any time.

Whether you’re a student, parent, teacher, neighbor, or co-worker, everyday interactions are opportunities to help others understand that we all have differences. Diversity education is applicable from pre-school to the workplace and beyond to the broader community life.

VSI would like to thank Lori Mitchell, a long-time VSI member for her outstanding work in diversity education. A great deal of the following material was based on an article entitled “Making a Difference at The Start, and All Through the School Year,”written by Lori Mitchell when her daughter April was entering kindergarten.

Lori is an author and graphic artist, and has written and illustrated several children’s books, the most well-known being Different Just Like Me that she wrote for April, and to help children and adults alike learn to appreciate and respect diversity.

Lori and April have been members of VSI since its inception.
April is the little girl pictured on VSI’s home page

Making a Difference at School

I find that more and more teachers have questions about how to integrate a child with special needs into the class socially. Some parents think the teacher will handle the introduction; however, with privacy laws and regulations such as the Family Educational Rights and Privacy Act Regulations (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA), most school districts prohibit teachers from discussing any child’s special circumstances without first receiving permission from the parents. So days, even weeks, can go by and the child doesn't get the help he/she needs.

Look for ways to start the conversation

Experience has shown that the earlier the child is properly introduced to the class, the sooner he/she is understood and accepted. If it's left, even for a day, teasing and misunderstandings may prevail.

VSIThere are as many different ways to introduce a child with a special situation into the class as there are students, but the process begins with a conversation between the teacher, the parents, and the child. The teacher may have wonderful ideas and experience or she may want ideas from the parents. Honesty seems to work the best, no matter what the approach.

In our family, kindergarten was slowly approaching and my husband and I agonized over what to do for our daughter April, who had vitiligo covering about 60% of her body.

Get a Head Start

Because April wouldn't know anyone at her new school, VSII put an ad in the small local paper asking if anyone soon to be going to her new school, would like to join our playgroup at the local park once a week. She made a handful of friends who joined her when she started kindergarten.

On orientation day there were kids and parents pointing and whispering, so we knew there would be questions at school. I didn't know that I could have spoken with April’s teacher to ask for help. I thought her teacher had enough going on and we should just handle this ourselves.

We didn’t want to bring April up in front of her new classmates to point out her vitiligo, as she has always been very shy and never wanted much attention drawn to her. We thought about having her go out of the room while we talked about her skin, but that seemed wrong. We felt it would send the message that she was ashamed of her condition, or that it had to be a secret. So what were we to do?

On the first day of school, we dressed April in colorful tights and a long sleeve shirt to cover the most noticeable part of her vitiligo. We typed up a letter as if April had written it that told all about what vitiligo was and wasn't. There was a picture of April and her signature. It not only told about April’s skin, it also told about her pet cat, a few of April’s favorite things to do, as well as her favorite foods.

This way it wasn't just about her condition,
it also introduced April as a person and friend

We sent it home for the parents to read to their children. The next day April wore her usual shorts and T-shirt. There were a few friendly questions, but from then on she was just another kid in class.

Click here to see April’s letter

Little Things Can Make a Big Difference

VSIOnce I had a chance to talk with her teacher, I realized she wanted to be involved and welcomed the opportunity to help in any way she could. She did a very simple thing that made a big difference. She put her arm around April. That simple act showed the kids that she liked April but also that her vitiligo was not contagious.

 In first grade, April's teacher invited her to help set up the classroom about a week before school started so she could see where she would be sitting and she could get to know the teacher. That helped April feel more at ease on the first day of school. It seemed so simple, but it made a big difference.


Bring Baby Pictures

My friend’s daughter had a rare, progressive, neurological condition causing her to gradually lose her ability to walk and talk. At the beginning of each school year, her mom would visit and explain the condition to her classroom. She even brought pictures from when she was younger and could still walk and talk. Once the other kids saw that she was just like them at one time, they could relate to her better.

Importance of Communication

In fourth grade, I didn't think I needed to talk to April's teacher. A few weeks into the school year, April came home and told me two boys had been calling her and her friend bad names. I realized I needed to make sure that her teacher knew I wanted to be informed of anything like this. It’s important to keep communication open with your child. Ask them how their day went and watch for any signs or changes in their personality.

April usually told me if anyone said anything about her vitiligo. I would try to just listen and let her figure out what she wanted to do about it. I think that helped her to feel like she had more control. I wasn’t going to be there every time someone said something to her so she would have to know, and feel confident, that she could deal with it on her own. If she asked for ideas, I would suggest something, but I would usually let her go through a list of her own ideas first.

Practice at Home: Role play

VSII found that role playing with April helped prepare her to know how to respond in different situations. Sometimes we would use stuffed animals as the bully and as April. I would be the bully and say that April was a tomato. She would laugh. I asked if she thought she was a tomato and she would say of course not. The point was that anyone can say anything, but that doesn't make it true.


Anyone can say anything; that doesn’t make it true!
Only if you accept it and decide they are right can it hurt you.

We had to practice so she would know that she wasn't any of those things that anyone called her. We talked about how much her family and friends loved her just the way she was. We also talked about bullies and some of the reasons they might be teasing her. It could be that they were scared of catching vitiligo. It could be that they were being teased at home or they didn't feel good about themselves. We emphasized that their behavior very rarely had anything to do with the person they were teasing.

The point of role play is not to come up with the one
and only perfect reply to any teasing…

There will be different situations and your child will have to think on his/her feet. The point is to have the discussion with your child before the bully does. The bully will zero in on any shame the child might be feeling. If you can role play and have an open, honest discussion, that shame is diminished, if not totally dissolved.

Let Your Child be Your Guide

Some children will be more outgoing than others. Talk with your child and provide a few ideas on what to say to the other children. Nothing formal is needed, just a few simple and honest responses, such as:

I have vitiligo
It’s just two colors of skin, like some people have freckles
It's not contagious

It shows that there's nothing to be ashamed of and there are no secrets. Most of the time the other kids in class just want to know more about the condition, and once they do, they feel more comfortable and know what to expect.

Other Ways to Help Your Child Explain:

April came up with the idea of handing out cards explaining her vitiligo. On each card she printed, "I'm just like you; I just have two colors of skin. I’m not contagious and it doesn’t hurt." April decorated them with stickers on the back and included VSI’s website address.

The cards were a big hit, and I think made her feel like she had a little more control over the situation. As April got older she became more comfortable answering questions about vitiligo, but she still kept the cards, just in case.

If your child doesn't want to say anything about their condition, don't force them to. If a child is too young or just uncomfortable to speak for themselves, there are many fun classroom games and exercises that can be used for diversity education.

Classroom Diversity Education

As a parent, if you have the time, VSIyou may want to offer to lead a discussion on diversity in your child’s classroom. Even if you only have 15 or 20 minutes, it's worth the time. Diversity education is now required in Common Core, so your teacher might just be happy to let you fill that requirement.

Discussions on diversity help all of the students. To prevent any one child from feeling singled out, you can talk to the class about differences in a general way, or have a day where each student gets a few minutes to tell something unique about themselves.

Frequently, the students in April’s class shared personal stories about their family members that had some kind of difference and they asked questions to help them understand how to deal with different situations. For many students, this was their first opportunity to share this information. Every child in class has felt different at one time in their life and it's usually a great relief for them to know they weren’t the only one.

Same and Different Classroom Exercises

Helping children understand that they are each different in some ways and alike in others helps them become more accepting of differences as they go through life.

Ask your child's teacher if in the first week or two of school they could have a day when every child shares things they like and like to do, and something unique about themselves and or their family. One child might explain that they just lost a tooth, another might bring a picture of a new baby sibling. They can share their favorite colors or season, or that they like to play outside or go to the zoo, or whatever they’d like, and things they like to do.

When it is your child's turn, encourage him/her to share that he/she has vitiligo, telling the other children that it does not hurt, and is not contagious; it's just two colors of skin. Your child could also share things like his/her favorite color, favorite vacation, favorite holiday, etc. You can then step in and point out that each child is different in some ways and alike in others, explaining that this is what makes them special.

Ask the Children to Raise Their Hand:

If They Have:
blonde hair
brown hair
a brother
a sister


If They Like to:
eat pizza
eat broccoli
go to the movies
go swimming on a hot day


Bring in pictures of two similar objects that have differences, like fish.


Have the children list ways the fish are:

The Same
fins, mouth, swim

eyes, color, shape



Ask students to line up, or if class size is large,
first break into two groups, then line up.

Start by saying one thing about yourself that makes YOU different from the person on your right. Go down the row and have each child say something that makes them different from the person to their right. When you get to the end, start over and have them say one thing that makes them the same as the person on their right. Remind them before you start that you want to come up with as many different ideas as possible and try not to have any repeats. Make sure that when they are saying what’s different or the same that they say “I,” not “YOU,” as in “I” am different because I have blue eyes and yours are brown.”

Never Judge a Book by Its Cover

Take a plain brown bag, crumple it up and fill it with lollipops, then tie it with some old string. Now fill a beautiful gift bag with toilet paper and tie it with ribbons and bows. Ask the students to pick a bag. Once the bags are opened, ask them how they think this relates to people.

The children will soon begin to understand that each one of them are different in some ways and alike in others. Within a week or so, most will forget about differences, and get on with playing and learning.

April’s Thoughts as a Child

As I was writing this article, I asked April (at the time, around 12 years old) what she would want to share, and this is what she said:

I have made a few discoveries while living with vitiligo. One is that I'm not the only one in the world that is different. Every kid in my class has something that makes them different. I think I used to wonder why I was the only one that had to be different, but now when I really take a look at everyone around me, I can see that no one is perfect. The second thing I figured out was that, so far, there's very little I can do about my vitiligo.

The only choice I have is how I deal with it. I can be really angry and bothered by it,
or I can choose to make the best of it and accept that this is the way it is.

I'm going to have vitiligo whether I'm happy about it or not. Why not choose to be okay with it and focus on the good stuff in my life? If someone teases me, I'm not going to let him or her ruin my day. Some person I don't even know cannot decide what I think of myself. I have lots of friends and family members that love me just the way I am, and they count much more than some rude goof ball.

Another discovery is that I am more than just my vitiligo.

I'm talking about it a lot now because that's what this is about, but normally I don't really talk about it or think about it all day. I have lots of other things to think about, like my cat, drawing, singing, playing piano, my friends, swimming, homework, and shopping.

April Today

Growing up with the love, support, and guidance of her parents, coupled with a mother dedicated to imparting diversity education to all those in her path, April Mitchell is now a beautiful and well-adjusted young lady.

Many of you have seen the model Chantelle/Winnie Harlow in the media (she competed on cycle 21 of America’s Next Top Model). She, too, has become an inspiration to many for never letting vitiligo stand in the way of her dreams. April, also quite interested in fashion, had been following Chantelle’s Instagram, and was surprised when one day the cover of her mom’s book, Different Just Like Me, appeared on her Instagram. Chantelle shared stories of being bullied as a child, and said that when she was only 7 years old, her grandmother had given her a copy of the book which really helped and inspired her as a child. April contacted Chantelle via Instagram and the next thing you know they had the opportunity to meet.

Chantelle told April she almost felt like they were sisters.

They took a moment to pose with their hands over the book.

Different Just Like Me can be found in most
libraries or purchased directly from

The book shows how we are all different, yet still very much alike. It is recommended for kindergarten through third grade, but the lessons and activities have been used in classes all the way up to 10th grade. Lori Mitchell donates ten percent of the book proceeds to Vitiligo Support International.

For additional information and classroom resources visit: Different Just Like Me

VSI Director Jackie Gardner visiting
with April and Lori at a vitiligo conference.

We hope that this article has helped you consider not only the ways that you might evoke positive change in the preconceived notions of others, but that you also keep your own mind open to personal changes you might need to make to improve in your role as a vitiligo ambassador for diversity awareness and acceptance.


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Calling all Medicare Vitiligo Patients!

VSIVSI regularly hears from patients from all over the United States who have been denied insurance coverage for their vitiligo treatment. VSI has been fighting this battle on a national level for several years. While we are definitely making progress, it’s been a slow road.

Part of the problem is that currently there is no accepted standard for coverage of vitiligo treatments. Each company has their own policies and guidelines, many times based on outdated and incorrect information.

What most people may not realize is just how much private insurance coverage can be affected by Medicare policies. Over 55 million Americans are now covered by Medicare or Medicare Advantage, making it the nation’s largest health insurance program. Consequently, many, if not most, insurance providers establish their baseline standards and procedures to follow the Medicare model.

Medicare has agreed to meet with us – but requires that we bring Medicare letters of denial for a vitiligo treatment.

If you are reading this newsletter and you, or someone you know, was denied coverage for a vitiligo treatment by Medicare, please contact VSI immediately. You could help make a difference for future insurance coverage for ALL vitiligo patients! Click Here to Contact VSI

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What's On Your Mind?

Q. Will my brother’s children get vitiligo?

I live in India, and my brother wants to marry a girl whose mother has vitiligo on almost all of her body. In our country, vitiligo carries a very negative stigma. Because of this, our family is hesitant to go ahead with (approve of) this relation.

We just want to know is this a genetic problem? If my brother marries this girl, will their children develop vitiligo?

Please guide us.

  1. While vitiligo is a genetic autoimmune disease, having the genes does not necessarily mean that a person will develop vitiligo. We know from research that there are many non-genetic (environmental) factors involved as well, such as infections and viruses, physical and emotional stress, skin trauma, and exposure to certain chemicals.

    Each person inherits different combinations of genes from their parents, just as they do for height and intelligence. This, combined with the environmental factors, probably explains why only 5% to 7% of children will get vitiligo even if their parent has it.

    Even identical twins, with identical DNA, both develop vitiligo less than one-fourth of the time. Maybe one twin experienced a great deal of emotional stress, such as the death of a very close friend, and developed vitiligo at age 20. The other twin could develop vitiligo later in life, or never.

    At this time, it’s impossible to predict who will, or will not develop vitiligo. However, we know from research that the incidence of vitiligo is somewhere between 1 and 2 percent of the population. That means that at least 98 percent of the population does not have vitiligo.

Q. Should I get a flu shot?

I’m 65 years old and have vitiligo. I’m concerned because I’ve heard that if you have a weakened immune system you should not get a flu shot, but my mother died of flu complications last year. I’m afraid if I don’t get the flu shot, I could become very sick, or even worse, die like my mother.

Does having an autoimmune disease like vitiligo mean that I have a weakened immune system? I don’t know what to do.

  1. There are two misconceptions with the idea that having an autoimmune disease means you have a weakened immune system and shouldn’t get a flu shot.

    1. Having an autoimmune disease doesn’t necessarily mean that you have a weakened immune system.

    2. Having a weakened immune system does not mean you should not get a flu shot!

    First, let’s address the idea that if you have an autoimmune disease like vitiligo, you have a weakened immune system.

Autoimmune vs. Immune Deficient


Immune deficiency (or immunodeficiency disorders) reduces the ability of your body’s immune system to defend itself from foreign cells such as bacteria, viruses, parasites, or disease, such as cancer. An example of an immunodeficiency disorder would be HIV (human immunodeficiency virus), which can lead to the disease AIDS (acquired immunodeficiency syndrome).




Autoimmune diseases are the result of the other side of immune dysfunction, whereby the immune system becomes overactive or hyper-responsive to very specific cells that are naturally present within its own body. In the case of vitiligo, your body’s immune system is attacking your melanocytes, which are your pigment-making cells.


Now let’s address the misconception that those with a weakened immune system should not get a flu shot.

The opposite is actually the case. Those who DO have a weakened immune system are among those considered to be at highest risk of developing serious flu-related complications and should take all preventive measures to avoid contracting the flu, including receiving the flu vaccine.

Who Should Get a Flu Shot?

According to the Centers for Disease Control (CDC), all age groups are susceptible to influenza and “everyone 6 months and older is recommended for annual flu vaccination with rare exception.” Those listed below are considered among the highest risk of developing serious flu-related complications.

Children younger than 5, but especially children younger than 2 years old
Adults 65 years of age and older
Pregnant women (and women up to two weeks postpartum)

Those with medical conditions such as:
Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids or chemotherapy)

Endocrine disorders, including the following often associated with vitiligo: Hypo- and Hyper- Thyroid Disease, Hashimoto’s Thyroiditis, Graves’ Disease, Type 1 Diabetes, Addison’s Disease, Adrenal Disorders, and Metabolic Syndrome

Click here for a complete list of those considered at high risk.
Click here for a complete list of endocrine disorders.

The Two Primary Types of Flu Vaccine:
Flu Shot and Nasal Spray

The flu shot is an inactivated (killed) vaccine. The inactivation process destroys its ability to cause the virus, and activates the development of protective antibodies that increase your resistance to the virus.

Who Should NOT Get a Flu Shot?

  • Children under the age of 6 months

  • People who are sick or not feeling well

  • Anyone who has ever had Guillain-Barré Syndrome (also called GBS) should talk with their doctor prior to getting a flu shot

  • Anyone with severe allergies to the flu vaccine, or any of the vaccine ingredients, such as gelatins, antibiotics, or eggs.

Because vaccines are developed by being injected into chicken eggs to incubate, if you have an allergy to eggs, you should discuss the options with your physician. There is an alternative formula called Flublok that does not use the influenza virus or chicken eggs in its manufacturing process.

VSIThe nasal spray, also referred to as the live attenuated influenza vaccine (LAIV), contains a live form of the flu virus that has been modified/weakened so that it cannot cause the flu virus. This is sold under the trade name FluMist in the United States and Canada, and Fluenz in Europe.

Due to a significant decline in the effectiveness, particularly the H1N1 component, the CDC removed the Flumist from its list of recommended vaccines for the past 2 flu seasons. However, in February 2018, by a 12-to-2 margin, the CDC vaccine panel voted to restore its status to the approved list.

Who Should NOT Get the Live Attenuated Nasal Vaccine?

According to the CDC: “Some people should not get LAIV because of age, health conditions, or other reasons. Most of these people should get an injected flu vaccine instead. Your healthcare provider can help you decide.”

Tell the provider if you or the person being vaccinated:

  • have any allergies, including an allergy to eggs, or have ever had an allergic reaction to an influenza vaccine

  • have ever had Guillain-Barré Syndrome

  • have any long-term heart, breathing, kidney, liver, or nervous system problems

  • have asthma or breathing problems, or are a child who has had wheezing episodes

  • are pregnant

  • are a child or adolescent who is receiving aspirin or aspirin-containing products

  • have a weakened immune system

  • will be visiting or taking care of someone, within the next 7 days, who requires a protected environment (for example, following a bone marrow transplant)

Because you noted that you are age 65, which puts you in the high risk group, there is another option you could consider. There is an alternative vaccine specifically for individuals 65 years and older that goes by the name Fluzone High-Dose (also Fluzone Intradermal Quadrivalent, and Fluzone Quadrivalent).

According to the CDC: “People 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, it’s estimated that between 71 percent and 85 percent of seasonal flu-related deaths, and between 54 percent and 70 percent of seasonal flu-related hospitalizations, have occurred among people 65 and older.”

Because human immune defenses weaken with age, and aging decreases the body’s immune response, this high dose vaccine was developed to create a stronger immune response. It has four times the amount of antigen (the part of the vaccine that prompts the body to make antibodies) contained in regular flu shots.

The bottom line is that the decision as to whether or not you should get a flu shot is one best made between you and your health care provider.

The above information is provided for informational purposes and not intended as medical advice. Each person’s health is unique to their own set of circumstances. All medical decisions should be discussed with your health care provider.

For additional information, see VSI’s Newsletter Article: Vitiligo and Vaccines


Medical News Updates

Highlights of recently-published medical
articles on vitiligo and its treatments

 Increased Perceived Stress in Vitiligo Patients
and its Implications in Vitiligo Pathogenesis

Dr. Caroline LePoole and researchers from Loyola University in Chicago IL have been studying the effects of emotional and psychological stress on vitiligo for many years. They have conducted multiple surveys in which many VSI members have participated. They’ve also delved deeply into the scientific causes and pathways that could tie emotional stress to the onset or worsening of vitiligo.

This same group of Loyola researchers has for many years been studying the inducible heat shock protein 70 (HSP70i), a protein released by cells (like melanocytes) when under stress and known to play a pivotal role in the pathogenesis (development) of vitiligo.

You may recall a report in VSI’s Summer 2013 Newsletter after they developed a modified HSP70i protein.

Discovering that HSP70i levels are elevated in mice during psychological stress, they introduced the modified version of the protein into vitiligo-prone mice. This resulted in the interruption of the autoimmune response, both preventing the development of vitiligo and significantly restoring existing pigment loss.

Noting that the initial development or progression of vitiligo often follows an episode of emotional or psychological stress, Dr. LePoole et al. conducted a survey to investigate the perceived stress levels in vitiligo patients, this time comparing the results to age and gender matched controls.

They administered the Perceived Stress Scale -10 (PSS-10) to 104 vitiligo patients and 25 controls. First developed in 1983 by Sheldon Cohen and colleagues, the PSS-10 has since become one of the most widely used tests for measuring psychological stress.

The PSS -10 is a 10 item questionnaire that predicts biological markers of stress as well as increased risk of disease. Higher scores demonstrate links to chronic stress and markers of shorter life expectancy, higher cortisol levels, depression, and other symptoms of immune suppression.

Their Results:

Vitiligo patients had much greater stress levels than their matched controls, also exceeding
the cutoff value of 18 for identifying stressed individuals in the general population.

The Average PSS Scores

Vitiligo Patients: 19.8
Matched Controls: 13.8

The scores did not correlate with disease duration or activity, meaning the responses were not higher (or lower) based on how long the patients had been affected by vitiligo, or whether their vitiligo was stable or active.

Their research and understanding of the interrelationship between emotional stress, HSP70i, and vitiligo in mice leads them to believe that the same pathways and responses may also apply in humans.

The process of introducing foreign genetic material, such as a mutant protein, into humans is a relatively new technique falling under the category of gene therapy. The U.S. Food and Drug Administration (FDA), regulates this type of research with comprehensive federal laws, regulations, and guidelines.

Though not yet tested in humans, the findings of their modified HSP70i continues to suggest potential value in treating, or even preventing vitiligo in humans. VSI will continue to monitor this news and report any updates in future newsletters.

Click here to take the PSS-10 and find your stress level.



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Earn Funding for VSI with Amazon and eBay

Online Shopping Can Benefit VSI!

Amazon Shopping for VSI

With thousands of items in addition to books, is a one stop-shopping center! Simply shop through the above link (bookmark it for easy reference) and VSI will earn fees, based on a percentage of the sale. The more items purchased by members, the higher the percentage!

Tobi Cares Donation Program

Tobi is an online women's clothing design label that brings LA style from its design studio direct to its online clothing store at  Go to Tobi Cares and sign up for VSI to receive 1% of your purchase amount.

iGIVE SHOPPING offers access to free shipping deals and exclusive coupons, on top of the great deals you'll find every day through its network of 1,000+ stores, including Pottery Barn, REI, Staples, Petco, Expedia, Best Buy, QVC and many more. Best of all, up to 26% of your purchase at each store is donated to VSI at no cost to you! Let friends and family know so they can support VSI, too. Click register for iGive to get started today, and download the iGive button to automatically benefit VSI whenever you go to an included store.


GoodSearch and Goodshop, like iGive, offers coupons, discounts, and donations to VSI through its network of over 5,000 stores. Just click the link above to get the savings started and the donations flowing!

* Vitiligo Support International Inc. (VSI) is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to


Support VSI Through Ebay


Support VSI with eBay!

Do you sell items on eBay, or want to hold an online garage sale? If so, consider donating a percentage of your proceeds to VSI through eBay’s Giving Works program! It’s easy – when you list an item through a Giving Works listing, choose to send 10-100% of the final sale price to VSI. Your listing will have a special placement and designation. You’ll receive a proportional fee credit from eBay, and will also receive a tax donation receipt when the donation is deducted from your funds received. It’s a great opportunity to make some money for yourself and for VSI, so clean out those closets and garages and get selling! 

To Learn More About VSI's Giving Works: Click here

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