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A Puneet Group Presentation

A Puneet Group Presentation

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A Puneet Group Presentation. Vitiligo - A social stigma. Light! Did you say Light! The patch looks lovely bright Soon the white patch Grows and spreads The sun makes it A little red, how can Vitiligo Harmless, not even skin deep Can cause a trauma so deep?. VITILIGO. - PowerPoint PPT Presentation

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Page 1: A  Puneet  Group Presentation

A Puneet Group Presentation

Page 2: A  Puneet  Group Presentation

LIGHT! DID YOU SAY LIGHT!THE PATCH LOOKS LOVELY BRIGHT

SOON THE WHITE PATCHGROWS AND SPREADSTHE SUN MAKES ITA LITTLE RED,HOW CAN VITILIGOHARMLESS, NOT EVEN SKIN DEEPCAN CAUSE A TRAUMA SO DEEP?

Vitiligo - A social stigma

Page 3: A  Puneet  Group Presentation

VITILIGO

Chronic skin disease occurring worldwide in about 1% of the population, mostly between the age of 10-30

White spots occur when the skin no longer forms melanin (pigment that determines the color of your skin, hair, and eyes)

White patches of irregular shapes begin to appear on skin

Total absence of melanocytes microscopically

Page 4: A  Puneet  Group Presentation

CLINICAL FEATURES Totally amelanotic macule (patch) surrounded by

normal skin Vitiligo macules characteristically have fairly

discrete margins and they are round, oval or linear in shape

Lesions enlarge centrifugally over time, but the rate may be slow or rapid

Vitiligo macule patches ranges from millimeter to centimeter in size

Page 5: A  Puneet  Group Presentation

DISTRIBUTION PATTERN OF VITILIGO

Focal

•a few isolated lesions

Segmental

•unilateral distribution

Vulgaris

• fingers and around mouth

Universal

• total depigmentation

Page 6: A  Puneet  Group Presentation

SUB TYPES OF VITILIGO Differ by anatomical location, and size of lesions

Focal• A few isolated lesions, most common in children

Segmental• Unilateral distribution

Acrofacial • Fingers and periorificial areas

Universal• Almost total depigmentation

Mucosal• Depigmentation of only the mucous membrane

GENERALIZED• Most common, symmetrical distribution, occurs

symmetrically on both sides of the body

Page 7: A  Puneet  Group Presentation

VITILIGO CAUSE- MELANOCYTE DESTRUCTION

1. Stress to the skin in form of wound, burn, excessive sun exposure or contact with bleaching phenol

2. Differential gene expression among melanocytes

3. Inflammatory infiltrate of T cells & macrophages

4. Further induce melanocyte apoptosis

Page 8: A  Puneet  Group Presentation

WHY IS THE TREATMENT IMPORTANT??? Vitiligo - not harmful medically, but

emotional and psychological effects can be devastating.

Affects self-esteem. Women, are sometimes discriminated against

in marriage. Developing vitiligo after marriage can be

grounds for divorce. People suffering from vitiligo feel

embarrassed, depressed, or worried about other people’s reaction.

Page 9: A  Puneet  Group Presentation

THE PRIMARY GOAL OF VITILIGO THERAPY IS TO REPIGMENT THE AFFECTED SKIN. HOWEVER, IT IS NOT ALWAYS POSSIBLE.

In such cases , depigmentation is the only available option

Page 10: A  Puneet  Group Presentation

WHERE DE-PIGMENTATION THERAPY REQUIRED

Patients with widespread and extensive vitiligo with body surface area(BSA)>50%, who desire permanent matching of skin colour, and where the probability of achieving cosmetically significant repigmentation is low. Generally it can be considered if vitiligo involves more than 60% to 80% of BSA.

Patients with less extensive disease (30-50% BSA) who have progressive disease or have shown resistance to standard therapies for repigmentation.

Vitiligo extensively involving cosmetically sensitive areas of face and hands where covering cosmetics are ineffective, although it is unusual to treat only the exposed sites.

Vitiligo involving areas known to be resistant to treatment, e.g. hands, malar areas.

Page 11: A  Puneet  Group Presentation

LIST OF DEPIGMENTING AGENTS

• MONOBENZONE• 88% phenol,• Laser,• cryotherapy

First line agents

• Imatinib• Imiquimod• diphencyprone

Second line agents

• Hydroquinone, 4-Ethoxyphenol,4-methylcatechol,

• Catechol, • IFN-gamma,• Busulfan,• Vaccines using melanoma associated antigens etc

Experimental agents

Page 12: A  Puneet  Group Presentation

COMPOSITION:-MONOBENZONE USP…..20% W/W CREAM BASE…………..Q.S.

Page 13: A  Puneet  Group Presentation

MONOBENZONE

Monobenzyl ether of hydroquinone (MBEH) Chemical Name: P- (Benzyloxy) - Phenol Acts as a skin sensitizer Topical application decreases the excretion of

melanin from melanocytes in animal Depigmentation spreads to distant sites

unexposed to Monobenzone Progressive systemic reaction against

melanocytes

Page 14: A  Puneet  Group Presentation

MECHANISM OF ACTION

INHIBITS

TYROSINE

MELANOCHROME

MELANIN

Tyrosinase

Page 15: A  Puneet  Group Presentation

MONOBENZONE IS THE MOST WIDELY USED DEPIGMENTING AGENT

Page 16: A  Puneet  Group Presentation

LIMITATIONS OF OTHER DEPIGMENTING AGENTS

• Requires longer time prior to the onset of visible depigmentation4-Methoxy Phenol

• large areas applications proved to be toxic to Liver and Kidney.

• Cardiovascular shock, cardiac arrythmias, bradycardia as well as metabolic acidosis

88% Phenol

• Painful & expensive technique• Available only at hospitals.Different type of lasers

• Hospital based treatment.• It gives edema, pain and bulla formation as

side effects.• Not suitable for extensive vitiligo

Cyro therapy

• Require further investigationTopical Imatinib, Imiquimod and Diphencyprone

Page 17: A  Puneet  Group Presentation

EFFICACY OF MONOBENZONE THERAPY

Residual patches of vitiligo affecting more than 70% of her skin surface

Depigmentation after topical application of 20% Monobenzone daily after 8 months

Pigment Cell Melanoma Res. 22; 42-65. REVIEW ARTICLE Update on skin pigmentation therapies in vitiligo. Rafael Falabella and Maria I. Barona. Page No. 11

Page 18: A  Puneet  Group Presentation

ADMINISTRATION: Apply a thin layer of to the normal

coloured skin area which requires depigmentation usually two to three times daily or as directed by physician. There is no recommended dose for children under 12 years of age except under the advice and supervision of a physician.

It may take up to 4 months before the full benefit of this drug takes effect. Once the desired skin colour is achieved, this medication is applied only as needed to maintain the new skin colour (usually 2 times a week).Use cream regularly to get the most benefit from it. Inform the doctor if your condition persists or worsens after 4 months.

Page 19: A  Puneet  Group Presentation

SIDE EFFECTS OF MONOBENZONE Mild burning, Irritation, Redness, Cracking, or Peeling of the treated skin may occur. If any of these effects persist or worsen,

doctor needs to be informed.

Page 20: A  Puneet  Group Presentation

PRECAUTIONS This medication is for use on the skin only.

cream should be applied with a patch test for 48 h to detect hypersensitivity.

Avoid application of to the eyelids and areas close to the eye.

Avoid getting this product in your eyes or on the inside of your nose or mouth. If the cream is accidentally applied in these areas, flush with plenty of water.

After using this medication, the skin will be permanently affected and sensitive to sunlight. Avoid prolonged exposure to sunlight. Always use a sunscreen of SPF 15 or greater, and wear protective clothing when outdoors.

Page 21: A  Puneet  Group Presentation

ALBAQUIN TREATMENT EFFECTS As a depigmenting agent, Monobenzone

lightens up the pigmented areas and matches them with the white patches arisen out of Vitiligo skin disorder and can provide following effects to the patients :

  Permanently depigmented skin Produce an even tone Match the skin around the vitiligo patches to a

uniform light colour Create a feeling of normalcy for the patient

Page 22: A  Puneet  Group Presentation

BRINGS ABOUT PERMANENT DE PIGMENTATION

Only drug used worldwide as a depigmentation therapy for vitiligo

Safe and well tolerated No toxicity to liver or kidney Permanently lightens skin

 

IDEAL THERAPY FOR UNIFYING SKIN COLOUR  

Page 23: A  Puneet  Group Presentation

FOR FURTHER DETAILS CONTACT

PUNEET LABORATORIES PVT.LTD.605 Raheja Plaza , B wing,

LBS Road, Ghatkopar (West), Mumbai 400086, India.TEL. 91-22-61367000

Division Head : Mrs. Rashmi Jain

Customer Care : 18002096261E-MAIL : [email protected]

VISIT US AT: www.albaquin.com