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Abstract: Leukodystrophy is an acquired limited or generalized skin pigment loss disease caused by local pigment cell destruction, which mainly manifests as limited pigment loss patches, white in color, and generally with clear borders. In this case, the patient was admitted to the hospital with white spots on the skin behind the ear and neck. According to the patient’s clinical symptoms, the preliminary diagnosis was vitiligo, and the symptoms improved after medication and phototherapy were given.
[Basic Information] Male, 15 years old
Disease Type】 Vitiligo
Hospital】Xiang Ya Second Hospital of Central South University
Time】May 2022
Treatment plan】Medication (prednisone tablets, multivitamin capsules (13), halometasone cream, tacrolimus ointment) + physical therapy (ultraviolet radiation)
【Treatment cycle】 Outpatient treatment for 1 day, prescribed medication to be taken at home, 1 month outpatient follow up
【Treatment effect】 Good re-coloring effect of skin lesions
I. Initial consultation
The patient, male, 15 years old, found white spots on the skin behind the ear and back of the neck one year ago, went to the hospital, diagnosed as “vitiligo”, the doctor gave “bone marrow injection, halometasone cream, tacrolimus ointment” treatment, slightly improved, one month ago the white spots widened and aggravated. He came to our hospital with burning pain and redness in the skin after sun exposure. The physical examination showed that there were patches of white spots behind the ears and on the back of the neck, with clear boundaries, varying sizes and patterns of white spots, increased pigmentation of the surrounding skin, and sparser hair than the surrounding area. The patient was given wood lamp examination to assist in the diagnosis, the results were positive, the diagnosis of “vitiligo”.
The treatment process
The patient’s skin is burning and red after exposure to sunlight, and is in the progressive stage of the disease. Prednisone tablets are given orally. The disease is controlled by the combination of multivitamin capsules (13), halometasone cream and tacrolimus ointment. The patient reported that he had UV irradiation equipment at home, so the patient was advised to have UV irradiation every other day and to follow up after 1 month.
III. Treatment effect
The patient after a month of drug treatment and phototherapy, to the hospital follow-up, the patient’s skin lesions, the naked eye can be seen in the number of white spots reduced, sun exposure to the lesions suitable symptoms disappeared, the edge of the skin lesions, white spot area in the center of the hair follicle as the center, scattered spots of normal skin color patches, clinically known as pigment islands. At the same time, the color of the vitiligo lesions of the patients appeared lighter than the last visit, from the darker white began to turn light white. The wood lamp was rechecked and the area of skin lesions under the lamp was reduced compared to the last visit.
The first thing you need to do is to take a look at the photos.
The patient was depressed and worried at the time of consultation. I guessed that it might be related to the fact that the skin lesions were gradually becoming poorly covered and affecting the aesthetics as summer was approaching. After treatment, I advised the patient to relax and avoid excessive stress, because anxiety, tension, unpleasant life and events can stimulate and trigger the disease. During the treatment period, we should pay attention to the living environment should not be too wet, dirty, clean and tidy living environment can promote the recovery of skin lesions. Pay attention to weather changes and avoid getting wet, which can aggravate the disease. In addition, pay attention to maintain a balanced nutrition, avoid picky eating, and pay attention to exercise to enhance their resistance.
Five, personal insight
The vitiligo lesions affect the appearance of the patient to a certain extent, the doctor should pay attention to the psychological state of the patient in addition to treating the skin lesions. The actual fact is that the actual person is not only the actual person, but also the actual person who is the actual person. In addition to psychological concern for the patient, the family should be encouraged to also maintain a good state of mind and must remain happy and not pessimistic when approaching the child to avoid the state of the family directly affecting the child. Therefore, the family members need to build confidence and patience to encourage the child to do battle with vitiligo.