Vitiligo or white patch or leucoderma

vitiligo is the chronic skin disease . people get confusion about leprosy and vitiligo so in this slide describe about both the disease through the picture

1. Vitiligo Management Prevention And

2. Prepared BY : Riya yadav Roll no : 13 B.sc. Nursing 3 rd year ,9 th batch Sinha Health foundation , pvt. Ltd

3. Introduction : Vitiligo Vitiligo is a skin disorder in which white patches occurs on the skin may be in the form of lesions or on the whole body. Vitiligo can be triggered by stress to the melanin pigment – producing cells of the skin, the melanocytes.

4. Definition Vitiligo is a long lasting skin disease that causes the losing of color from the skin. It occurs when the melanocytes , cells that gives skin their color, die or do not work. Leukoderma is the term applied only to depigmented patches of known causes e.g following burns , chemicals , inflammatory disorder.

5. Incidence : 1 % of population of world is suffering. Race : affects all races No sex predisposition Age – peak – 10 -30 years

6. cause Exact mechanism not known ; 1 . Genetic – Genetic factors definitely important , since 20 % of patients have a positive family history . Inheritance may be polygenic 2 . Autoimmune hypothesis – evidence pointing to autoimmune etiology includes ;

7. frequent association with other autoimmune disorders like alopecia and thyroid disorders . presence of antibodies to melanocytes . presence of lymphocytes in early lesions.

8. Clinical features of vitiligo initially the disease is limited ,but the lesions tend to become more extensive over the years. Physical examination Hypopigmented and depigmented lesions favor sun exposed regions , intertriginous areas ,genitalia and sites over bony prominences ( type A Vitiligo ) Areas around body orifices are also commonly involved 9

9. The lesions tend to be symmetric . occasionally , the lesions are linear pseudodermatomal ( type B vitiligo ) vitiligo lesions may occur at trauma sites ( koebner `s phenomenon ). The hairs in affected areas may be white . The term marginal inflammatory vitiligo is used to describe lesions with raised borders .

10. Diagnostic tests physical examination wood`s light examination may enhance lesions in light – skinned individuals . Dermatopathology – skin biopsy – show normal skin except for absent melanocyte Electron microscopy – absence of melanocytes and melaosome in keratinocytes Lab studies – TSH ,fasting blood glucose , CBC with indices ( pernicious anemia ) .

11. Management . Age of patient . Extent of disease . pattern of disease . cosmetic disability. Effect on quality of life

12. Physical modalities of treatment Photochemotherapy photo – chemotherapy is use of psoralens in combination with UVA exposure ( PUVA ) . It forms the mainstay of therapy in vitiligo . Repigmetation is slow . Most frequently used psoralens is 8 – methoxypsoralen ( 8 – MOP ) . Depending on the extent of disease , either topical ( for localized disease ) or systemic ( for localized disease ) or systemic ( for extensive disease ) therapy is used.

13. 2. Phototherapy 1. Broadband UVB : Is no longer used . 2. Narrow band UVB ( 311 nm ) : Indication : in extensive disease ( > 10 % ). Regimen : in gradually increasing doses of UVB , given from specialized chambers. side effects : generally safe .

14. Medical treatment 1. steroids Topical steroids : Are used for : single lesions , ( sometimes a few localized lesions ) especially of recent origin . As adjuvant to other forms of therapy .

15. Systemic steroids : Are used : when the patient can not be given photo therapy \ photochemotherapy . In vitiligo , unresponsive to psoralens . side effects to steroids limit their use , thought the recently devised weekly schedule ( oral mini pulse6 ) probably causes fewer side effect than daily doses.

16. Surgical measures Indications : At sites poorly responsive to conventional therapy ,in a patient with stable disease ( for at least 6 months.

17. Techniques : Melanocyte transfer . Blister grafting . Punch grafting . Split thickness skin grafting .

18. Vitiligo prevention Despite any evidence , some people prevented vitiligo by following some tips. Drinking a lot of water can boost body immune system that can prevent vitiligo . Having green leafy vegetables, fruits like banana , apple can prevent vitiligo To prevent the formation of white patches avoid consuming alcohol , coffee , fish , red meat .

19. Consuming food which contains vitamin B , C, Amino acids and folic acids can prevent these white patches . Adding minerals like copper, zinc , iron to your food will also help . The skin pigment cells are destroyed when the skin is affected by wounds , burns , sunburns . That can cause vitiligo . Avoiding deep skin woods and burns will prevent vitiligo.s