Art Devany has made the point for years that aesthetics are key indicators of health status and have potent evolutionary underpinnings. Here is a classic example of this concept with regards to the skin condition vitiligo. For those unfamiliar with the condition, vitiligo is a loss of pigmentation in sections of the skin.

 This first paper points to vitiligo occurring amidst several other autoimmune conditions:

 
Vitiligo: a sign of systemic disease.

Huggins RH, Janusz CA, Schwartz RA.

Dermatology, New Jersey Medical School, Newark, New Jersey 07103-2714, USA. hugginri@umdnj.edu

Vitiligo reflects a systemic process that has important implications beyond the skin. These include other autoimmune diseases and ocular and neurological abnormalities. Alezzandrini syndrome and Vogt-Koyanagi-Harada syndrome particularly exemplify this relationship. In addition, vitiligo may be confused with other systemic disorders, including tuberous sclerosis, progressive systemic sclerosis (scleroderma), melanoma, and, in endemic regions, leprosy. We describe these associations and emphasize the importance of depigmenting disorders.

 This second paper shows a treatment with broad action that addresses not only aspects of autoimmunity but also conditions directly linked to hyperinsulinism such as Acne Vulgaris:

Inhibition of IFN-gamma as a method of treatment of various autoimmune diseases, including skin diseases.

Skurkovich B, Skurkovich S.

Pediatric Infection Disease, Rhode Island Hospital, Providence, RI 2903, USA. Bskurkovich@pol.net

We pioneered anticytokine therapy (ACT) for autoimmune diseases (ADs). In 1974, we proposed that hyperproduced interferon (IFN) can bring AD and anti-IFN can be therapeutic. In 1989, we proposed removing tumor necrosis factor (TNF)-alpha together with certain types of IFN to treat various ADs. We found IFN in patients with different ADs and conducted the first clinical trial of ACT in 1975. Anti-IFN-gamma and anti-TNF-alpha work in similar ways, but the latter brings serious complications in some patients. We obtained good, sometimes striking, therapeutic effects treating many different Th-1-mediated ADs with anti-IFN-gamma, including rheumatoid arthritis, multiple sclerosis (MS), corneal transplant rejection, and various autoimmune skin diseases such as psoriasis, alopecia areata, vitiligo, acne vulgaris, and others. Anti-IFN-gamma was in some ways superior to anti-TNF-alpha, which was ineffective in MS. Anti-IFN-gamma therapy holds great promise for treating many Th-1 ADs, especially skin diseases.

 Vitiligo is virtually unknown in hunter-gatherer populations but is quite prominent in populations with recent transition to Neolithic and worse, modern refined foods. The dual insult of gut irritation from incompatible plant lectins combined with increased systemic inflammation from chronically elevated insulin results in quite an array of pathologies.