VITILIGO. Made by: Basma Noor, Maryam Mahjoub, Irin Chankao and Sara Samadi.

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1 VITILIGO Made by: Basma Noor, Maryam Mahjoub, Irin Chankao and Sara Samadi.

2 What is Vitiligo? Vitiligo is a chronic skin disease (a long-lasting condition that can be controlled but not cured) characterized by portions of the skin losing their pigment. It occurs when skin pigment cells die or are unable to function. Aside from cases of contact with certain chemicals, [1] the cause of vitiligo is unknown. Research suggests vitiligo may arise from autoimmune (Immune system attacking the healthy body cells), genetic, oxidative stress, neural, or viral causes. [2] There is no cure for vitiligo but many treatment options are available including topical steroids, calcineurin inhibitors, and phototherapy.

3 Classification: Non-Segmental Nonsegmental vitiligo, or NSV, is the most common type of this disorder. It is characterized by white skin patches that do not have a specific area of occurrence that is, they can be seen anywhere on the body, and they are often symmetrical. This means that if the patches appear on, say, behind the right knee, then nearly the samesize patch can also be seen behind the left knee. Similarly, if they appear around the right corner of your mouth, then they are also likely to appear on your mouth s left side. Classes of non-segmental vitiligo include the following: Generalized Vitiligo: the most common pattern, wide and randomly distributed areas of depigmentation [8] Universal Vitiligo: depigmentation encompasses most of the body [8] Focal Vitiligo: one or a few scattered macules in one area, most common in children [8] Acrofacial Vitiligo: fingers and periorificial areas [8] Mucosal Vitiligo: depigmentation of only the mucous membranes [8]

4 Non-Segmental Generalized Vitiligo Focal Vitiligo

5 Non-Segmental Acrofacial Vitiligo Mucosal Vitiligo

6 Classification: Segmental Segmental vitiligo (SV) patches are small at their initial stages but can grow huge eventually, and it spreads more quickly than nonsegmental vitiligo. Segmental vitiligo has to be cured at the right time before it progresses and spreads all over the body. The upside is that even if it spreads more quickly, it is also more treatable during the early stages, and topical treatments have been effective in its treatment. SV tends to affect skin areas that have something to do with the dorsal roots from the spine and as mentioned, they are often unilateral. A large white patch may appear on the back of your right hand, while there is no sign of any patch on the back of the left hand.

7 Segmental Vitiligo Segmental Vitiligo on the face. White hairs of the eyebrow in segmental vitiligo can be seen.

8 Treatment Herbal treatment: Herbal treatment is complicated and it takes experts in the field to recommend the herbs for treating this disorder. The chances are likewise high that the level of damage while getting treatment is increased. Only the right herbs that are proven to be effective in increasing melanin production by triggering melanocytes are to be administered. There are also some herbs that increase the efficiency of the nerves and the immune system. Using such herbs can be effective if the condition is severe. Surgical treatment: Doctors would often remark that there is no proper cure for vitiligo. There are many surgical methods, however, that could minimize vitiligo s social effects. One such method apart from natural methods is surgery. The available surgical methods for treating vitiligo are medical tattooing, blister grafting, and autologous skin grafting. Each method is unique and is performed depending on the location of the white patches and severity of the disorder.

9 Treatment Medical tattooing is performed mostly on the areas close to the lips. There is no guarantee that the tattoo to be made would match the patient s skin. For the other methods, a healthy pigmented region is taken and transferred to the affected areas. The surgical methods are not very dependable as there is no guarantee for treatment of the condition but they can actually reduce the awkward appearance of the white spots. Medications for vitiligo: Medications for vitiligo are available in many types. There are some common light therapies and photochemotherapy that can act directly on the affected layer of the skin. Most of the treatments for skin disorders are based on a definite light source. Corticosteroids, immunomodulators, and narrowband UVB are other treatments available for its treatment. Each treatment method is selected based on the degree of the disorder. Depigmentation is a unique method in which the other areas that are unaffected are treated to make them lighter, to match the affected areas. This method somehow reduces the contrasting skin tones and improves the appearance of the skin.

10 Medical tattooing

11 Treatment Dr. Richard Spritz has spent several years researching the genetics of vitiligo. His work began with families that have more than one member with vitiligo in hopes of isolating a gene. Through this work came his discovery of the NALP1 gene that seems linked to vitiligo and closely related autoimmune diseases. He is currently working on a genome association study that will take all of the genes within the human genome and examine them for the possibility of being associated with vitiligo. He has recruited teams of researchers in countries all over the world to join in this effort and collect saliva samples of both vitiligo patients and healthy controls in order to identify suspect genes. Study enrollment is ongoing and continually needed; all that is required is a questionnaire and a saliva sample. The more samples he has, both patient and control, the more likely it is that his team will have results that are meaningful.

12 Symptoms of Vitiligo The most obvious sign or symptom of vitiligo is loss of pigment on the skin, resulting in milky-white, irregularly-shaped patches on the skin. Typically occurs first on sun-exposed areas (face, hands, feet, arms, legs). Less common signs include pigment loss or graying of hair on scalp, eyebrows, eyelashes or other affected areas. May also experience loss of pigment on the tissues that line the inside of the mouth (mucous membranes) and the retina of the eye. Will it spread? There is no way to predict if vitiligo will spread. For some people, it will not spread for years or will only spread very slowly, for others it will spread rapidly. Vitiligo is usually progressive, however, and over time will usually spread to other areas of the body. Some people report pigment loss following periods of physical or emotional stress.

13 Coping with Vitiligo The change in appearance caused by vitiligo can affect a person's emotional and psychological well-being and may cause them to alter their lifestyle becoming less active in social activities. Many people experience emotional stress as vitiligo develops on visible areas of the body, such as the face, hands, arms, feet, or on the genitals. Adolescents, who are already concerned about their appearance, can be devastated. It is not uncommon for those with vitiligo to feel embarrassed, ashamed, depressed, or worried about how others will react. One of the first steps in coping is finding a doctor who is knowledgeable about vitiligo and current treatments and capable of providing emotional support. If depression is a problem, you should let your doctor know, as mental health professionals can help stabilize the emotions. For two reasons it is very important to educate yourself on vitiligo and treatments.

นพ.วาสนภ วช รมน หน วยโรคผ วหน ง คณะแพทยศาสตร โรงพยาบาลรามาธ บด

Vitiligo Vitiligo Update Acquired pigmentary disorder Depigmented macules and patches นพ.วาสนภ วช รมน หน วยโรคผ วหน ง คณะแพทยศาสตร โรงพยาบาลรามาธ บด Prevalence The prevalence of vitiligo is often said