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Kena Roots
Chronic skin disease Other name = Leukoderma White spots occur when the
skin no longer forms melanin (pigment that determines the color of your skin, hair, and eyes)
The white patches of irregular shapes begin to appear on your skin
White patches of skin Whitening or graying of the hair on
your scalp, eyelashes, eyebrows or beard
Loss of color in the tissues that line the inside of your mouth
Loss or change in color of the inner layer of your eye
Chalk white color
Convex margins 5mm to 5cm or
more in diameter
Round, oval, or elongated in shape
AVRF
Focal pattern—the depigmentation is limited to one or only a few areas
Segmental pattern—depigmented patches develop on only one side of the body
Generalized pattern—(most common) depigmentation occurs symmetrically on both sides of the body
Focal and segmental patterns do not spread. The generalized pattern is hard to predict and can randomly stop
Can appear at any age, usually first appears between the ages of 20 and 30
White patches may begin on your face above your eyes or on your neck, armpits, elbows, genitals, hands or knees
1-100 of the world population develops Affects both genders and all races
equally
When no melanin is produced, the involved patch of skin becomes white
When a white patch grows or spreads the cause may be Vitiligo
Exact cause is unknown May be due to an immune
disorder, heredity, or environmental causes like sunburn or emotional distress that trigger the condition
A family history of vitiligo
Look to see if there is a rash, sunburn, or other skin trauma that has occurred within 2 or 3 months after pigmentation was discovered
Premature graying of the hair (before age 35)
Stress or physical illness
Also they may ask for an eye examination (inflammation of your eye) and/or blood test (autoimmune disease)
Vitiligo is difficult to treatEarly treatment options include:
Exposure to intense ultraviolet light, such as narrow-band UVB therapy
Medicines taken by mouth such as trimethylpsoralen (Trisoralen)
Medicines: Corticosteroid creams Immunosuppressants such as pimecrolimus (
Elidel) and tacrolimus (Protopic) Repigmenting agents such as methoxsalen (
Oxsoralen)
The use of steroid creams may be helpful in returning the color to the white patches
Doctors often prescribe a mild topical corticosteroid cream for children under 10 years old and a stronger one for adults
Cream must be applied to the white patches on the skin for at least 3 months before seeing any results
Corticosteriod creams are the simplest and safest treatment for vitiligo, but are not as effective as psoralen photochemotherapy
SIDE EFFECTS occur in areas where the skin is thin, such as on the face and armpits, or in the genital region› They can be minimized by using weaker formulations
of steroid creams in these areas.
Most effective treatment available in the United States.
PUVA therapy is to repigment the white patches
time-consuming, and care must be taken to avoid side effects
Psoralen is a drug that contains chemicals that react with ultraviolet light to cause darkening of the skin.
Psoralen is injected orally or is applied to the skin
Then skin is carefully timed exposure to sunlight or to ultraviolet A (UVA) light that comes from a special lamp.
WWHT Dermatology
Used for children 2 years old and older who have small number white spots in a few areas
Treatments are done under an artificial UVA light once or twice a week. Psoralen is applied to your depigmented patches about 30 minutes before
exposing you to enough UVA light to turn the affected area pink. The doctor usually increases the dose of UVA light slowly over many weeks. Eventually, the pink areas fade and a more normal skin color appears. SIDE EFFECTS:
› (1) severe sunburn and blistering › (2) too much repigmentation or darkening (hyperpigmentation) of the
treated patches or the normal skin surrounding the vitiligo.
For people with extensive vitiligo (affecting more than 20 percent of the body) or for people who do not respond to topical PUVA therapy
Not recommended for children under 10 years of age because it increases the risk of damage to the eyes caused by conditions such as cataracts.
You take a prescribed dose of psoralen by mouth about 2 hours before exposure to artificial UVA light or sunlight.
Treatments are usually given 2 or 3 times a week, but never 2 days in a row.
For patients who cannot go to a facility to receive PUVA therapy, the doctor may prescribe psoralen that can be used with natural sunlight exposure.
SIDE EFFECTS include: Sunburn, nausea and vomiting, itching, abnormal hair growth, and
hyperpigmentation. May also increase the risk of skin cancer,
Used for people with small patches of vitiligo The doctor removes sections of the normal,
pigmented skin and places them on the depigmented areas
Infections may occur at the donor or recipient sites The recipient and donor sites may develop scarring, a
cobblestone appearance, or a spotty pigmentation, or may fail to cure the white spot area
Takes time and is very costly
Doctor creates blisters on your pigmented skin by using heat, suction, or freezing cold
The tops of the blisters are then cut out and transplanted to a depigmented skin area
SIDE EFFECTS: scarring and lack of repigmentation
Less risk of scarring with this procedure than with other types of grafting.
Implanting pigment into the skin with a special surgical instrument
Works best for the lip area, particularly in people with dark skin
Difficult to match perfectly the color of the skin of the surrounding area
The tattooed area will not change in color when exposed to sun, while the surrounding normal skin will.
Tattooing tends to fade over time Also tattooing of the lips may lead to episodes of blister
outbreaks caused by the herpes simplex virus
Takes a sample of your normal pigmented skin and places it in a laboratory dish containing a special cell-culture solution to grow melanocytes.
When the melanocytes in the culture solution have multiplied, the doctor transplants them to your depigmented skin patches
Currently experimental and is impractical for the routine care of people with vitiligo
Very expensive and its side effects are not known.
Sunscreen
Helps protect the skin from sunburn and long-term damage
Minimizes tanning, which makes the contrast between normal and depigmented skin less noticeable
Blue Lizard Baby& Sensitive Sunscreen
AVRF
Some vitiligo patients cover depigmented patches with stains, makeup, or self-tanning lotions.
Dermablend, Lydia O’Leary, Clinique, Fashion Flair, Vitadye, and Chromelin offer makeup or dyes that you may find helpful for covering up depigmented patches
Self tanning lotions have an advantage over makeup in that the color will last for several days and will not come off with washing.
AVRF
AVRF
April
1)National Vitiligo Foundation
2)Vitiligo Support International
3)American Vitiligo Research Foundation Inc.
SUPPORT organizations
Nation Library of Medicine (Medicine Plus) American Vitiligo Research Foundation National Institutes of Health, Department of Hea
lth and Human Services : National Institute of Arthritis and Musculoskeletal and Skin Diseases
Drugs.com (Treatments) youtube.com (Lee Thomas- Turning White 20/20
Interview) National Vitiligo Foundation (video gallery-
Elizabeth Vargas Interview)
1) National Vitiligo Foundation2) American Vitiligo Research Foundation In
c.3) Visualdxhealth4) Revolution Health5) WWHT Dermatology 6) Elidel7) National Vitiligo Foundation 8) Vitiligo Support International
Lee Thomas
Kids coping with Vitiligo
Elizabeth Vargas Interview
Ingredient Main active substance
Action
Cocos nucifera oil
Coconut oil contains essential saturated and unsaturated fatty acids, High concentration of Vitamin E and K, high concentration of Zinc and Iron.
Coconut oil is the only type of oil that one should use on one’s skin for it is absorbed easily and keeps the skin soft. Coconut oil contains Vitamin E Alpha Tocopherol. This kind of Vitamin is a well-known potent antioxidant and is beneficial to the skin.
Ingredient Main active substance
Action
Psoralea corylifolia extract
Psoralea corylifolia contains flavons, isoflavons, furanocoumarins, chalcones and coumesterol group of compounds which includes psoralen, isopsoralen and bavichinin2.
Psoralea corylifolia appears to have a purely local action with a specific effect on the arterioles of the subcapillary plexuses, which are dilated so that the plasma is increased in this area. The skin becomes red and the melanoblasts (pigment-forming cells) are stimulated. In leukoderma, melanoblasts do not function properly and their stimulation by the drug leads them to form and exudate pigments, which gradually diffuse into the white leukodermic patches.[ Also, the phytochemically induced covalent binding of the drug to pyrimidine bases is responsible for its therapeutic effect. The photoconjunction involves thymine dimer adducts on the opposite strands of DNA. Psoralen has been found to intercalate into DNA, where they form mono- and di-adducts in the presence of long wavelength UV light and thus are used for the treatment of hypo-pigmented lesions of the skin, such as leukoderma.
Ingredient Main active substance
Action
Berberis vulgaris root extract
Barberry includes such alkaloids as berbamine, berberine, oxyacanthine, resin and tannins, and chelidonic acid. Barberry Root also constituents the B-vitamin thiamine, vitamin C, lutein, zeaxanthin, the carotenoids beta-carotene, chromium, zinc, and cobalt .
Barberry root has antioxidant and cytoprotective properties.
Ingredient Main active substance
Action
Picrorhiza kurroa root extract
Picrorhiza kurroa root extract contains Kutkin, D-Mannitol and Vanillic acid
Picrorhiza kurroa was found to be a potent immunostimulant of both cell-mediated and humoral immunity. picrorhiza was reported to stimulate cell mediated and humoral components of the immune system including stimulation of phagocytosis.
Ingredient Main active substance
Action
Melaleuca Alternifolia (TeaTree) Leaf Oil
Terpineol, Cineol, Pinene, Terpinenes
Powerful and broad spectrum anti-microbial agent (Anti-bacterial, anti-fungal and anti-mycotic agent), and it has an immune system stimulant effect
Ingredient Main active substance
Action
Emu oil Linolinic acis and Oleic acid
Used by the Aboriginal people of Australia for the treatment of muscle and joint pain, contains a variety of fatty acids. Modern research into the properties of emu oil has found that this is the greatest skin emollient in the world, with deep skin penetration properties better than any other natural oil .
Ingredient Main active substance
Action
Vitamin E (Tocopherol)
Alpha-tocopherol Powerful anti-oxidant agent
Natural pathway for PUVA therapy. Rich source of natural powerful anti-
oxidants. Rich source of essential minerals and
vitamins for vitiligo patients. Safe with minor side effects. Cost effective.
Great thanks for your listening
Kena Roots for therapeutic cosmetics
Dr. Hani Malkawi