The Vitiligo is a skin disorder, which destroys the melanocytes unknown to the skin, mucous membranes, eyes, hair and pears. The key 1% to 2% of the world and at least 1-2 million people in the U.S. alone. No sexual preference, and although all races are affected, is of particular importance in patients with darker skin. The highlight of the occurrence of the disease is 10 to 30 years old, and in half the cases, the disease manifests itself in the first two decades of life. The disorder begins Progressive, in white with Macul for an initial period of rapid growth followed by periods of latency. Repigmentation spontaneous seen from time to time. There is an element of the inheritance of the disease, since 30% of patients with vitiligo have a family. Stress, illness and personal crises have been associated with the occurrence of the disease. The Vitiligo is a deep psychological effect on patients, with two thirds of patients a deficit because of the possibility of the psychosocial effects of the disease.
Clinically, the patients with a circumscribed depigmented and hypopigmented Macul. Various Macul these millimeters to centimeters in diameter and are oval-to-tower shape. They have scalloped (concave) edges, which appear as if the affected areas are the invasion of the surrounding normal skin. Convexity of the severity of the injuries was repigmentation. The changes are usually Macul and triple-color model with a third or even fourth interim color, within the lesion. The face, back, wrists, armpits, navel and genitals are places of pain. Depigmented inflammation of the lesions with the borders can be seen at 2% to 5% of patients. The phenomenon is vitiligo injuries Koebner on the website traumatized. This applies to one third of patients, and Macul more or less like the original location of the lesion.
Vitiligo childhood is a subgroup of the disease in children under 12 years, in which it leads to increased incidence of vitiligo segmented. These children have an increased incidence of car-specific serum and in the wrong answers to topical PUVA therapeutic problems. In a study of 82 children with vitiligo, their families and had an increased incidence of car and diseases of the glands compared to the controls.
A variety of theories have been formulated to the cause of this disorder. The theory suggests that the neurons in the vicinity of nerve cells, an Ombudsman, the neurochemical is toxic to the melanocytes. The self, which says the theory is the synthesis of melanin is toxic to the melanocytes. Normally these melanocytes these metabolites can be dangerous, but the imbalances of the system can occur.
Pigmented eye abnormalities (hypopigmented hyperpigmentierten or choroidalen and retinal Pigmentepithels, uveitis) were in 40% of patients with vitiligo. ACUITY was the poor visibility at night, photophobia, and are about 5% of patients. In a study of 35 patients with a result of the control group, 43% (15) had one or more signs of a disease of the thyroid, compared to 20% (7) of controls. Vitiligo patients also have an increased incidence of thyroid cancer car.
The diagnosis is based on a good history and physical examination. It is important to define the development of the disease, to determine the aggressiveness of treatment. Inform yourself about the factors that exposure to chemicals, recreation and exposure to chemicals is very important because a large number of chemicals can Leukoderma.
The goal of treatment is to restore the pigmentation and thus improving the representation of the affected patients. The reserve requirements for the repigmentation melanocytes migrate to the normal skin and hair. Oral and topical psoralens photochemotherapy (PUVA), electrophoresis (trisoralen and the light of the sun), the topical corticosteroids.
Of these, the PUVA the highest efficiency, but a few months last May Debate three times per week, a significant improvement. Dermabrasion inclusion of new therapies and topical 5-fluorouracil, khellin and UVA light, and L-phenylalanine.
If you PUVA, is crucial to a test for the detection of anti-antibodies to disseminate lupus erythematosus, a disease in which light therapy is contraindicated. A screen chemistry is generally due to diseases of the liver and kidneys may on the metabolism of the oral psoralens. Autologous transplantation of skin may be useful to injuries isolated. The side effects of these new therapies are the scars, stains repigmentation, paving and the nature of the skin. In vitiligo with little residual normal pigmentation, which is reached, a more selective acceptable cosmetic effect. Vitiligo Treatments
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