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Vitiligo: Oral, laser, surgical treatment for leukoderma or white leprosy

Vitiligo, sometimes known as ‘leucoderma’ or or white leprosy, is an autoimmune disorder in which the body’s immune system targets healthy cells which produce pigment causing damage to the body. Melanocytes are the cells that produce the skin pigment melanin, which gives your skin its colour and when the melanocytes die, these white patches develop.

While the spread of white spots can be slow in some cases, it can be rapid in other cases and white patches can be found on the face, wrists, hands and other parts of the body. Health experts have debunked myths including that vitiligo is caused by eating the incorrect foods at the wrong times, such as drinking milk right after eating fish or that persons with vitiligo are mentally impaired or vitiligo is contagious and incurable.

In an interview with HT Lifestyle, Dr Sanjeev Gupta, Professor and Head, Deptt of Dermatology at MM Institute Of Medical Sciences And Research Mullana Ambala India, shared “There are several myths associated with vitiligo that contribute to the social stigma which has restricted and hindered an individual’s usual style of living as well as his or her involvement into society. Individuals with vitiligo suffer from low self-esteem, lack of confidence, and social anxiety, especially if their vitiligo affects parts of the skin that are difficult to conceal with clothes or with cosmetics/ makeup. Therefore, anxiety or depression symptoms should be recognised as soon as possible, and experienced dermatologists should be consulted. Also, counselling sessions should be held frequently in order to increase the patient’s confidence level.”

There are various topical, surgical, laser and other alternative methods available to treat vitiligo in recent years as with medical advancement, vitiligo treatment options have recently expanded, making the disease more manageable. However, rather than depending on home cures, it is critical that a patient consults a board certified dermatologist at the appropriate time as this will aid in the proper diagnosis of vitiligo and the arrest of further progression of disease.

The treatment approach of an individual is determined by several aspects such as the kind of vitiligo and the extent of involvement of the body surface area. According to Dr Rohit Batra, Dermatologist and Vitiligo Expert at New Delhi’s Sir Ganga Ram Hospital, listed that medical treatments for vitiligo includes:

• Oral and Topical Steroids

• Topical Calcineurin Inhibitors

• Oral JAK inhibitors

• Oral Immunosuppressive agents

• Narrow Band UVB

• Excimer Laser

• Topical and Oral PUVA

Dr Batra pointed out that the above options may not work well in all patients. So, in few cases the surgical options may be required like –

1. Suction Blister Epidermal Grafting: The method is used to treat a small area of a person’s body affected by vitiligo. The skin is separated by vacuum pressure and is transplanted on vitiligo patch. The colour-pigmented skin is applied to the white spots.

2. Melanocytes Cell Suspensions: The white areas are covered without being cut in this method. The skin pigment from a normal portion of the body is extracted and transformed as a liquid, which is then injected into the white patched area of the skin.

3. Melanocyte Culture: Following a skin biopsy, a small section of the skin is cultivated in a specialized laboratory before being grafted into the afflicted area”.

Dr Sanjeev Gupta suggested, “If you notice white patches on your skin, don’t ignore it. Visit a skilled dermatologist for an examination. Treatment is more effective when only a small area of skin is affected. Increasing awareness about vitiligo with correct flow of information is also very important. So, don’t have a negative opinion of your friend or co-worker because it could affect the lives of a lot of people. The difference will be made by a modest amount of care, concern and sensitivity.”

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