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Abstract: The patient presented with unprovoked white patches on the skin of the neck and was not accompanied by uncomfortable symptoms such as itching and pain, and was seen in the hospital after a recent exacerbation. After the examination results diagnosed as vitiligo, which may be related to sunburn, the patient’s skin whitening symptoms were significantly improved after systematic treatment, and the treatment effect was relatively satisfactory.
[Basic Information] Male, 15 years old
Disease Type】 Vitiligo
Hospital】Xiang Ya Second Hospital of Central South University
Time】March 2022
Treatment plan】Oral medication (prednisone acetate tablets), topical medication (halometasone cream, tacrolimus ointment), intramuscular medication (bone marrow injection), physical therapy (ultraviolet radiation)
[Treatment period] After 8 weeks of outpatient treatment, regular review
Effectiveness】After treatment, the white spots of the patient’s skin were reduced in size and pigmented islands appeared inside.
I. Initial interview
When we first saw the patient, the patient was physically healthy, with a normal mental state and a painless facial appearance. The patient reported the appearance of unprovoked white spots on the skin of her neck one year ago, but she did not care because there were no uncomfortable symptoms such as itching and pain. In the past 3 months, she found that the area of the white spots seemed to be larger than before, so she was afraid and came to the hospital. The patient was found to have a patch of white spots behind the ear and the back of the neck with clear boundaries, and then the Wood lamp examination was carried out and the patient was diagnosed with vitiligo.
Second, the treatment process
The patient’s skin white spot area by Wood lamp examination, the results suggest a gray-white fluorescence, the boundary is unclear, indicating a positive. After the diagnosis I explained to the patient that medication can be carried out and the patient agreed, so the patient was prescribed prednisone acetate tablets to be taken orally, which can help control the development of vitiligo, along with external application of halometasone cream to stop the further spread of the white spots; application of tacrolimus ointment and bone marrow injection to promote skin tone recovery. In addition, also pay attention to adhere to the application of ultraviolet radiation, promote melanin synthesis, help skin tone recovery.
III. Treatment effect
After systematic treatment, patients can get significant relief of skin white spot symptoms. At the 4th week of drug combined with physical therapy, the patient’s skin white spots on the neck became lighter in color and slightly pink. After 8 weeks of treatment, the patient’s skin white spots were relatively smaller in size and pigmented islands appeared inside, and the treatment effect was more satisfactory. On review, the pigment islands within the patient’s skin white spots increased and no other parts of the skin white spots were found, indicating that there was no recurrence of the condition.
IV. Precautions
I am also very happy for the patient to see that after systematic treatment, the symptoms gradually improved and the smile reappeared on the patient’s face, but the following points should be noted in daily life.
1, the patient should pay attention to maintain a positive and optimistic attitude during the disease, and establish confidence in overcoming the disease, try to avoid staying up late, anxiety, tension, etc. In addition, the patient’s family should also be tolerant of the patient, give enough care and comfort.
2. Patients should also pay attention to cleaning the white spot area before medication and massage to promote drug absorption, and avoid tearing if blisters appear after medication to avoid secondary infection.
3, patients should also pay attention to appropriate outdoor activities in life, but need to avoid exposure to the sun, when you go out, you can apply sunscreen or play umbrella, in order to avoid sun stimulation lesions aggravated.
Five, personal insight
Vitiligo belongs to a melanocyte destruction leading to disease, usually due to genetic factors, neurochemicals, but also may be related to exertion, anxiety, sunburn and other factors, like the 15-year-old boy in this case is because there was a sunburn, which induced vitiligo. However, after discovering the aggravation of the symptoms, they were treated in time and the symptoms were improved significantly and the treatment effect was more satisfactory. Therefore, call for people suffering from vitiligo symptoms, should seek medical attention as early as possible, early detection, early diagnosis, early treatment, will be very helpful to the recovery of the disease.