VITILIGO.
DEFINITION
– Vitiligo is chronic disorder of skin causes depigmentation patches .
– It occurs when melanocytes are not functioning or when it dies.
* Causes : not known
* Symptoms
– Depigmented patches can be seen in sun exposed areas
– Areas rarely shows erythema are : mouth , eyes , navel, nostrils , genitals
– If hair is involved : turns into white colour
* Appearance pattern
√ Focal – limited to 1 or few areas
√ Segmental – only one side of body
√ Generalized – Different parts are involved
* Treatment
– In some cases , best treatment is the no treatment at all
– Areas are easily sun burned so avoid tanning
– Use sunscreens ( SPF 30)
– Skin should be covered to avoid sun exposure
– Aim of treatment is returning normal pigment or destruction of remaining pigment.
• In children’s
– Aggressive treatment is generally avoided
– Sun screen can be used
– Use Topical corticosteroid
– PUVA is not used until age of 12 years
• Repigmentaion therapy
– Topical corticosteroids can be used for small areas of vitiligo
– It can be used along with some other treatment
– But it can cause thinning of skin kr Cause stretch mark
• PUVA
– It is an special form of Repigmentaion therapy where psoralen is used for the treatment
– This will make the skin sensitive to light
– Skin is treated with UV light called UVA
– If only smaller area is involved , psoralen can be applied over vitiligo area befor UVA treatment
– Treatment with PUVA has 50 -70 % chances of returning colour to face , trunk, upper arm and legs
– Parts which poorly responds to PUVA are hands and feet
– Treatment is given twice weekly atleast for a year
– It should be given under supervision of dermatologist
– Side effects : sun burn, Freckles or skin cancer
– Eye glasses must be used to prevent risk of cataract
– PUVA is not used for childrens , pregnant women and feeding women
• Narrow band UVB
– It is a form of phototherapy
– Skin is treated atleast 3 times for few months
– Used in children.
• Grafting : transfer of skin is done
• Depigmentation therapy
– In case of execessive involvement , treatment is to remove remaining pigment of normal skin and depigmenting the full body
– It is done with chemical called hydroquinine.
– It takes about an year and pigment removal is permanent.
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