VITILIGO  CAUSES AND TREATMENT

Right knowledge of vitiligo causes and treatment can allay the unnecessary fear . And also help one make right decision about the treatment.

WHAT IS VITILIGO

 Vitiligo is a disease where Skin suddenly devolves white patches. White patches can be of any shape and size. They can either be limited to one part of body or they may be widespread. Even the hair over the affected region looses color. Disease may b e static or may be progressive that is keep spreading to involve a very large area of body. It not communicable i.e. doesn’t spread by touch. It’s asymptomatic. But has profound effect on person psyche.  

WHAT CAUSES VITILIGO

 It’s an autoimmune disease i.e. person immune system starts attacking the colour producing skin cells called melanocytes. Stress acts as triggering factor. Genetic predisposition is increases the chance of vitiligo in children. There is just increase chances of getting vitiligo in children born to parents having vitilig . It’s not that they will get it.

WHAT IS THE TREATMENT FOR VITILIGO

AIM OF VITILIGO TREATMENT:

 

To stop the progression of the disease.

To get the skin colour back

To stop the progression of the disease

An oral course of steroids and immunosuppressant  are given.  Immusupressants can be azathioprine, cyclosporine etc. This prevents or suppresses the immune system from attacking black pigment of skin. Regular monitoring of blood count, liver function test, and kidney function test are done to keep a check on side effects.

Various modalities can be adopted to get the colour back

Phototherapy :  Photoptherapy is basically concentrating UV rays towards white patches on skin. This stimulates pigments producing cells to produce more pigment. Phototherapy can be done in multiple ways.

Oral PUVA:  A medicine is given for oral consumption. After two hours patient is advised to stand in sun for 5 minutes. It’s advised when disease is wide spread and its not possible for person to visit the clinic frequently.

Bath PUVA:   A medicine is poured into bath tub. Patient is advised to be in tub for 20 minutes, so that skin absorbs the medicine. After that person can stands in UV chamber. This is advised when disease is wide spread and its convenient for patient to visit clinic on thrice a week basis.

ORAL PUVA: Two hours after taking and oral medicine person stands in UV chamber.

UV CHAMBER FOR VITILIGO

Topical PUVA: A medicine is applied on white patches and then after half n hour exposed to sun for 10 minutes. This is advised when limited number of patches are there.

Hand held UV lamps are also available for use at home. They are practical only for smaller patches.

HAND HELD UV LAMPS

Excimer laser: It releases wavelength of 308 nm . Repeated sittings are required. It’s an expensive technology. But very effective for small patches. much more effective than UV chambers

EXCIMER LASER FOR VITILIGO

Oral medicine prescribed is 8 methoxypsoralen. It’s available in tablet and lotion form.

 

In case phototherapy fails to bring the colour back then alternate methods are chosen to get the colour.

Surgery: There are various surgical modalities:

Punch grafting: Mini circular punch shaped skin is taken out from non effected area (back of ears or thighs ). Mini punches are digged out at white patches. Then punches from non effected are are put into white patches. Colour from non effected are slowly spreads to white patches, finally the complete are gets colour.

PUNCH GRAFTING FOR VITILIGO

Split skin graft: A very thin section of Skin from non affected area is taken out . The white patches abraded . i.e. top most most layer is reoved with a machine creating a raw area. The thin section of skin is applied to the affected area. Dresing don for a week . Final result is colour t the whit patches. Practical only for small white patches.

SPLIT SKIN GRAFT

Non cultured autologous melanocyte transfer:  when a wide spread area are involved then above two surgical modalities are no feasabl. In NCMCT, a small are of non effected skin is taken out . It’s processed in lab to separate the melanocytes (colour producing skin cells).

MELONOCYTE CELL TRANSFER FOR       VITILIGO

Camouflage techniques:

Artificial colour is filled into white patches. It too can be achieved either ways;

Micro pigmentation: With the help of a machine colour is filled into the superficial skin layer. Colour matching the person’s original skin colour is chosen. With the help of a machine colour is filled into the superficial skin layer. Once done, a touch up may be required after a month’s time. Colour remains for around 2 years. Henceforth once a year touch up is required.

Camouflage make up:  Special make up is available which matches one’s skin tone .It cover up the white patches. Its water resistant i.e. doesn’t come out with sweat. It needs to be applied every day.

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