Vitiligo is a common and frequent pigmented skin disease. The disease is characterized by localized or generalized pigment loss forming white patches, which is an acquired limited or generalized skin pigmentation loss, a common skin disease affecting beauty, easy to diagnose and difficult to treat. Vitiligo is a limited white patch that occurs as a result of skin pigmentation loss, making the local skin appear white like. The medical usually call this lesion as pigment loss.
Although vitiligo disease is not painful, but erode the patient’s healthy skin and mind, serious damage to human appearance, frustration, affect normal life, marriage, work and social, is one of the world’s difficult to treat disease.
Vitiligo has the following four main hazards.
(1) vitiligo on the patient’s normal study, employment, marriage, family, social and so on cause serious impact.
(2) There are many people in the society have some discrimination against vitiligo patients, leading to the majority of patients self-esteem devastating blow, thus producing a series of mental disorders.
(3)As confirmed by Professor Qi Shujun of the Chinese Medicine Research Center, vitiligo patients have weak ultraviolet defenses and have a higher incidence of skin cancer than normal people.
(4) Vitiligo can induce a variety of diseases, such as pernicious anemia, baldness, psoriasis, pernicious tumors, bronchial asthma, rheumatoid arthritis and cataract, as well as complications such as hyperthyroidism.
Classification
Congenital vitiligo: Congenital vitiligo is a primary, limited or generalized skin pigmentation disorder, which is caused by hypofunction and loss of tyrosinase system in the melanocytes of the skin and hair follicles. The lesions are without any pigmentation, varying in size and shape, and can occur in all parts of the body, with clear borders, darker border pigmentation, and whitening of hair follicles within the spots.
It is easy to diagnose and difficult to treat. It is called “vitiligo” or “white bruise” in Chinese medicine. The most important thing is that it is not only a good idea to have a good look.
It is more frequent in adolescents. The lesions are well-defined white spots, round, oval or unshaped. It can occur on any part of the body. It has no conscious symptoms and does not affect physical health, but affects cosmetic appearance and can cause mental pain to the patient. A few small lesions can fade on their own, but psychological factors, sun exposure and trauma can aggravate the symptoms or trigger the disease. The cause is unknown, there are autoimmune theory, neurohumoral theory, melanocyte self-destruction theory and so on. Photochemotherapy, i.e., oral psoralen plus long-wave ultraviolet radiation, can be tried for extensive lesions. The localized corticosteroid preparations are available.
vitiligo treatment consensus
1, progressive vitiligo
(A) common type.
1, confined type: topical glucocorticoids or other immunosuppressants, immunomodulators (transfer factor, thymidine, etc.), local phototherapy: narrow spectrum medium wave ultraviolet light, excimer laser, excimer light, etc., traditional Chinese medicine.
2. Disseminated, panniculitis and extremity type: TCM, immunomodulators (transfer factor, thymidine, etc.), systemic glucocorticoids, phototherapy: narrow-spectrum medium-wave UV, excimer laser, excimer light, etc., topical topical drug therapy (refer to progressive limited type).
(B) Segmental type: refer to the treatment of progressive limited type.
(i) Unusual type.
1. Restricted type.
Topical supplemental osteoporins, glucocorticoids, nitrogen mustard, etc., autologous epidermal transplantation, local phototherapy or photochemotherapy: narrow spectrum medium wave ultraviolet (NBUVB), excimer laser and excimer light, etc., traditional Chinese medicine.
2. Disseminated, pancytopenia and limbic types.
Traditional Chinese medicine, phototherapy or photochemotherapy: narrow-spectrum medium-wave UVB (NBUVB), excimer laser, excimer light, PUVA, etc., autologous epidermal transplantation (exposed site or site requested by the patient), topical topical drug treatment (refer to stable limited type).
(ii) Segmental type.
Autologous epidermal transplantation; other refer to stable stage limited type treatment.
3.Adjunctive treatment
Exposed areas can be covered with different shades of masking agents according to skin color if necessary, but masking agents are not recommended. If necessary, psychological counseling is available to relieve concerns, build confidence, adhere to treatment, and supplementation with vitamin B, vitamin E, folic acid, zinc, calcium, etc. may be of some help.