Dr. Sandeep Bhasin

+91 - 9818704499
+91 - 9311444806

Vitiligo Treatment

Vitiligo is a condition that causes depigmentation of sections of skin. It occurs when melanocytes, the cells responsible for skin pigmentation, die or are unable to function.

The cause of vitiligo is unknown, but research suggests that it may arise from autoimmune, genetic, oxidative stress, neural, or viral causes.

Incidence 1-2% worldwide. No different in india
Sexes Equal in both males & females
Family History Positive in 30 – 40 %
Inheritance Polygenic, variable penetrance and expression

Aetiopathogenesis

There are two types of Allergens:-
  • Exact cause not known
  • Auto Immune hypothesis
  • Neurogenic hypothesis (neuropeptide Y)
  • Destructive theory
    • Chemical
    • Contact
    • Defective Keratinocytes metabolism
    • Low catalase level in Epidermis in vitiligo
  • Lack of dopa positive melanocytes in vitiligo

Clinical Presentation

  • Skin
  • Mucous Membrane
  • Hair

Disorders

  • Thyroid disease
  • Pernicious anaemia
  • Addisons Disease
  • Diabetes mellitus
  • Hypoparathyroid
  • Myasthenia gravis
  • Alopecia areata
  • Morphea / lichen sclero
  • Halo neavus
  • Malignant elanoma
  • Vogt Koyanagi Syndrome
  • Vitiligo
  • Uveitis
  • CNS Involvement
  • Premature Canitis

Investigations

  • Haemogram
  • Thyroid Blood Screening
  • ANA)
  • IgE
  • Blood sugra
  • LFT
  • Urea & Electrolytes
  • Skin Biopsy ( Rarely
  • Scleroderma

Treatment - Medical Management :

Immunosuppressive therapy :
  • Systemic
    • Corticosteriods
    • MTX
    • Azathioprine
  • Topical
    • Steroids
    • Tacrolimus
    • Pimecrolimus
    • Methotrexate
Other Topical Preparation :
  • Calcipotriol (Vitamin D Analogue)
  • Placenta Extract
  • Monobenzyl ether of Hydroquinone
  • BFGF derived peptide

Other Systemic Medications

Commonly used :
  • Injection B12
  • Folates
  • Copper
  • Antoxids
    • Salenium
    • Methionine
    • Tocopherol

Phototherapy (Photochemotherapy)

Chemical Used :
  • Psolalen/ Baghchi
  • Khellin
  • Phenylallanine
  • Calcipotriol
  • Tacroliums
Rays Used :
  • UVA
  • UVB
  • NBUVB
  • Targeted NBUVB(311 nm)
  • Xenon Chloride Excimer Laser (308 nm)
Delivery System :
  • Bath
  • Oral
  • Topical