Dermatology: Vitiligo — Diagnosis and conservative treatment. Treatment
Vitiligo is a chronic disease caused by skin pigmentation disorder. The number of cases in different countries is 0.5 to 2% of the population. Vitiligo affects men and women equally often, but women are more likely to seek medical help. Pathology cannot be cured completely, but a variety of therapeutic techniques can stop its further development in 90% patients.
Upon vitiligo, skin produces a small number of melanocytes, i.e. cells producing the protective pigment, melanin. The reasons for this phenomenon are not fully clear. However, physicians have several theories in this regard. It is believed that the disease can be provoked by:
- autoimmune disorders,
- genetic mutations,
- neuroendocrine diseases,
- mechanical trauma to the skin,
- tyrosinase deficiency (enzyme involved in melanin synthesis)
In typical cases, there are white spots with clearly defined boundaries on the skin. The problem is often found in the warmer months, when healthy skin darkens from the sun, and the affected areas remain discolored. The very spots do not cause discomfort, but rarely may be accompanied by itching.
Most patients suffer because of change in appearance. Studies have shown that in 80% cases vitiligo is associated with psychological disorders:
- increased anxiety,
- sleep disorders.
Diagnosis is based on characteristic symptoms of the disease. For better visualization of spots, the dermatologist can use a special device, Wood lamp, emitting the violet.
If the diagnosis remains unclear, a biopsy of the affected tissues is performed. The microscopic examination of the sample reveals the lack of melanocytes.
To determine the form of vitiligo and identify the comorbidities, a set of laboratory tests (complete blood count, urinalysis for thyroid hormones, and others) is prescribed.
Treatment is usually started with prescription of local steroid ointments and ointments with calcineurin inhibitors. When the course proves to be ineffective, a local phototherapy is indicated. The lesions are irradiated with ultraviolet light. Sometimes the procedure is combined with the use of photosensitizing agents (PUVA therapy). For patients with segmental vitiligo, the laser therapy is practiced.
If conservative methods do not provide a proper result, the patients are offered surgery. There are 2 options of surgery:
- transplantation of skin grafts from healthy parts of the body,
- implantation of melanocytes obtained by biotechnology in the skin.
To overcome the psychological problems, we recommend consulting a therapist.Hide
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