Vitiligo poster

VITILIGO poster

1. INTRODUCTION
VITILIGO - A HOMEOPATHIC PERSPECTIVE
BACKGROUND
Based  on dermatological  outpatient 
records, the incidence of vitiligo is found to
 be 0.25-2.5% in India.Vitiligo occurs world
wide  with  an  overall  prevalence  of  
1% The highest  incidence  of  the  
condition  
has  been  recorded in Indians from the
 Indian subcontinent, followed by Mexicans
 and Japanese.There is a stigma attached 
to vitiligo and  affected  persons  
and family.This  disorder does  not  result  
in restriction   of  capacity  to  work   or   
expectancy of  life,  but   it   
causes cosmetic   disfigurement  leading  
to psychological  trauma  to the 
patients.The spread of the disease
 can be arrested and substantial amount of 
repigmentation can be achieved in majority 
of patients who undergo appropriate 
treatment. 
This paper unearthes homeopathic
treatment as a most viable treatment
modality in vitiligo .

Vitiligo is an acquired autoimmune
depigmentary condition characterized by
appearance of chalky or milky white
macules with well defined margins of
varying sizes and shapes.It has familial
predisposition. It is the only skin disease
which does not itch, pain or give any kind
of physical discomfort.
AIMS AND OBJECTIVE
Study design and settings
80 self reporting vitiligo patients attending out patient 
department of a  hospital were selected for the study.
It  was  a  observational, descriptive  study  done  in  OPD of 
SHMC.for a period of three yrs (April 2010 to march 2013.)
INCLUSIVE CRITERIA
Well diagnosed cases of vitiligo were taken for study. The 
patients reported in three different stages:
V1 – Active stage, lesion size increasing and borders ill-defined 
         and hypo pigmented.
V2 - No new lesion, lesions stationary in size. Static stage.
V3- Lesions decreasing in size, no new lesion, re-pigmentation 
of margins which become well defined. It is a recovery stage.
EXCLUSIVE CRITERIA 
Albinism
Nevus achromicus
Tenia versicolor
Leprosy
Pityriasis alba
Lichen scelerosis 
Piebaldism
Data collection The demographic and clinical data of the 
patients were collected using a data collection form and also
from  the  medical  records  of  patients.
MATERIALS AND METHODS
1)To highlight the efficacy of homeopathic medicines in 
achieving and maintaining the remission state in natural 
course of vitiligo.
2)      The objective of the present study was to assess the
          prevalence, precipitating factors clinical features   
          and concomitant disease in vitiligo patients.
 
CASES
Sulphur 200
Natrum mur 200
Lachesis 200
Natrum mur 200

2. The earliest onset was at 2 years of age, 
whereas the latest was at 60 years of age. 
Majority of the patients (45%) were in the
 age  group of  21-40yrs  followed by 
2-20yrs (37%)  at time of onset of vitiligo.
Duration   of  the   disease  at  the  time  
of presentation  varied  from  
2 months to15 years. 
Most  cases  (56.2%)  were  less  than    
5 years  duration, regardless  of  
sex.Around8.8%  patients  had  family  
history  of 
vitiligo
First  degree  relatives  (parents/  brother/ 
sister/  children) were  affected  in  6%  of 
the  study  population  and  second  
degree relatives (grand parents/ maternal 
and / or paternal uncle/aunt) in 2.8% of 
 patients. Positive  family  history  
is considered to be a poor prognostic facto
r for vitiligo
  
Negative family history  91.2%. 
Major  precipitating  factor  of  vitiligo  
was found to be  physicaltrauma/ injury  
(18.8%).followedby   emotional  
trauma (16.2%),chemicals  /  drugs  
(3.8%),  footwear  
(1.3%),  pregnancy  (1.3%)  etc.
 A record  was  made   of  the precise 
distribution of lesions, and the clinical staging was 
done as V1,V2 and V3.
Study approval
The  study  protocol was  approved by Delhi 
Homeopathic Anusandhan paris 
RESULTS & DISCUSSION
Of  the 80 patients   Females  (52.5%)
were affected more than males (47.5%)
 giving a male female ratio of 1.1:1.  The incidence 
of 1.3% obtained in the present study of vitiligo 
corresponds to the observations made by different 
authors 
Though vitiligo affects both sexes equally,] most of 
the studies. show a female preponderance. The 
cause of female preponderance in most of the 
studies is probably because of a greater cosmetic 
awareness among females.
Of the 80 patients, 32.5% of the study
population was within the age group  of 21-40   
years  while 31.3%  were  within     the age  group   
of   2  – 20yrs and 12.4% in 41- 60  years  age  
group  .
The youngest patient  was   4  years      old  and  
the oldest  was  65  years.  .
MATERIALS AND
METHODS
Lycopodium 30
Lachesis 200
Tuberculinum
CASES
VITILIGO - A HOMEOPATHIC PERSPECTIVE
Flouric acid 30Lyco 200

3. Associated systemic(autoimmune) and cutaneous diseases
were observed in 38.8% of the patients.Thyroid disease being
the most common(17.3%) followed by diabetes mellitus (15.8%).
Association of Koebner phenomenon was observed in 20%
of the patients which is a common feature of active stage
(progressive) .
The associated cutaneous diseases noted in this study were
Alopeciaareata (12.5%), leukotrichia (6.3%). Leukotrichia is
considered to be a poor prognostic,factor.,atopic dermatitis (3.8
%),pruritis in (2.3%).
The distribution pattern of lesions which denotes the clinical
types of vitiligo were.
Vitiligo vulgaris / generalized vitiligo(53.7%) the most
common morphological pattern. Other patterns seen were
 focal vitiligo (18.8%)
 acrofacial vitiligo (13.8%),
 segmental   vitiligo  (8.8%), 
 mucosal  vitiligo  (3.8%)
The most common site of onset of vitiligo lesion was
lower limbs (42.5%), followed by face (27.5%), upper limbs
(13.8%), finger
tips (7.5%), trunk (3.8%), scalp (2.5%), and genital mucosa (2.5
%) in the descending order of frequency
Drug analysis:
Medicines found to be most effective
Nat Mur=42% cases Pulsatilla=28%
Lycopodium=8 % arsenic album=6%
Sulphur=17% Tuberculinum-6%
Sepia=4 Medorrhinum=4%
Lachesis=3% Natrum silicate=2%
Nux Vom=2% Baryta sulph=2%
23%of patients shifted fromV1 to V2, 42%from V2 to V3 and 
12% remained static in V2stage.92%patients completed the 
study.52%of patients went into remission and there was no 
appearance of new lesion and spread of old lesion for a 
minimum period of 6 months.8% of patients had remission 
of as long as period of 2 yrs.
CONCLUSION
This study shows the efficacy of 
Homoeopathic medicines in 
achieving remission, preventing 
recurrence and checking its 
further progression.
Prospectus for future: To study the
role of homeopathic medicines as
immunomodulators in the natural
course of vitiligo.
Key words: depigmentation,
autoimmunity, leucotrichia, koebners
phenomenon, constitutional
treatment, repigmentation,
remission,concomitant disease
ACKNOWLEDGEMENT
I express my gratitute to Dr V.K
Chauhan,principal,SHMC for his
constant support and encouragement
throughout the project.
I am thankful to Dr S.N.Jana,(co
guide) ,Drs pavneet,arushi
,kalpna,meenakshi parvez,neha
richa,himanshuand manu interns
who have helped me in the OPD.
Dr Neena Mehan
Asst.professor
Department of medicine,SHMC
Project guide
Sepia 200
Natrum mur 200
Calcarea silicata
Staph 200