1, what is the cause of vitiligo?
The incidence of vitiligo is about 1% to 4%, no gender differences, can occur in any part of the body surface, its exact cause is not clear, but with genetics, autoimmune defects, neuroendocrine disorders, melanocyte self-destruction and biochemical abnormalities have a close relationship.
2.What kind of performance does vitiligo have?
A: Vitiligo is a complete loss of pigment, porcelain white spots, white spots of different sizes and shapes, clear boundaries, increased pigmentation at the edges, no self-perceived symptoms, can occur in any part.
3, how to confirm the diagnosis of vitiligo?
The majority of vitiligo can be diagnosed through the clinical experience of dermatologists, and for some vitiligo with atypical performance can be diagnosed through Wooden lamp, dermoscopy, skin pathology and other ways to assist.
4, vitiligo patients have what misconceptions?
1) Vitiligo patients will definitely inherit this disease to the next generation? —– is not right!
2) Vitiligo will be infectious to family members? —– is not right!
3) Vitiligo cannot be cured? —- is not right
4) Vitiligo has a quick cure treatment? —Not true
5) What is the best treatment for vitiligo?
Vitiligo currently does not have a special eradication method for all different types of vitiligo, but with the development of modern medicine, many advanced vitiligo treatment methods are constantly appearing, currently commonly used vitiligo treatment methods include topical immunomodulator tacrolimus ointment, hormone cream, PUVA therapy, narrow wave UVB therapy, 308 nm excimer laser, 304 nm high energy ultraviolet therapy, the autologous epidermal transplantation, melanocyte culture transplantation, dermabrasion + 5-fluorouracil cream therapy, herbal therapy, tattoo color method, depigmentation method, etc. for vitiligo. At present, dermatologists mostly use combined therapy to treat vitiligo, so that many vitiligo patients embark on the road to recovery and face the colorful world with a joyful mood. The best choice for both doctors and patients is to formulate individualized treatment plans according to the different conditions of the patients.
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The actual fact is that you will be able to get a lot more than just a few of the most popular and most popular items. It is suggested that vitiligo development and genetics have a close relationship, although vitiligo and genetic related, but should be recognized that vitiligo and other diseases compared to a very low hereditary rate of genetic disease. The heritability of primary hypertension is 62%, peptic ulcer is 37%, coronary heart disease is 65%, diabetes is 75%, bronchial asthma is 80%, compared to the heritability of vitiligo is not only very low, and in the clinical family history of vitiligo patients only account for a very small percentage.
7, how to treat the progressive vitiligo?
The localized or segmental vitiligo can be treated with topical glucocorticoids or other immunomodulators, immunomodulators (transfer factor, thymidine, etc.), local phototherapy: narrow frequency medium wave ultraviolet light, excimer laser, excimer light, etc., Chinese herbal medicine. And scattered type, generalized type and extremity type vitiligo can be treated with Chinese herbal medicine, immunomodulators (transfer factor, thymidine, etc.), system with glucocorticoids, phototherapy: narrow frequency medium wave ultraviolet, excimer laser, excimer light, etc., local topical medicine with the same limited type.
8, how to treat stable vitiligo?
The limited type or segmental type can be treated with topical psoralen drugs, glucocorticoids, nitrogen mustard, etc., autologous epidermal transplantation, local phototherapy or photochemotherapy: narrow-frequency medium-wave ultraviolet light, excimer laser, excimer light, etc., traditional Chinese medicine. Scattered type, pancytopenia and extremity type can be treated with TCM, phototherapy or photochemotherapy: narrow-frequency medium-wave UV, excimer laser, excimer light, PUVA, etc., autologous epidermal transplantation (exposed parts or parts requested by the patient), and its topical topical treatment is the same as that of limited type.
9.What are the precautions in vitiligo treatment?
1) Long-term treatment and regular follow-up should be adhered to, and the duration of one therapy is usually not less than 3 months.
2) Trauma or exposure to the sun should be avoided, especially in the progressive stage.
3) Topical glucocorticosteroid treatment should be less than 10% of the body surface area of the white spots; patients with white spot area greater than 90% of the body surface area and no efficacy, decolorization therapy can be recommended as appropriate.
4) Supplementation of vitamin B, vitamin E, folic acid, zinc, etc. may be helpful.
10.What is the relationship between the efficacy of vitiligo and the time of onset?
A: Generally speaking, the shorter the onset time, the better the treatment effect, the longer the time, the more difficult the treatment. Therefore early diagnosis, early treatment is very important thing.
11.What is the relationship between the efficacy of vitiligo and the size of the white spot?
A: The efficacy of small area is high, the efficacy of large area is poor, the cure time of coin-sized white spot or palm-sized white spot is about 3 months to 15 months; the white spot with larger area and multiple patchy distribution around the body usually takes 2-4 years to cure.
12.What is the relationship between the efficacy of vitiligo and the location of the white spots?
A: The efficacy of vitiligo is in order of face, head, neck, back, forehead, both iliac, waist, abdomen, hands and feet and mucous membrane parts. The white spots on the face are easy to cure in other parts. The cure rate of the white spots on the hands and feet and mucous membrane areas is lower.
13.What is the relationship between the efficacy of vitiligo and the type of rash?
A: The cure rate of limited small area and ganglion type vitiligo can be as high as 95% or more, the area of large disease or sporadic lesions with large area or unstable disease healing time is longer or easy to repeat, while the cure rate of generalized is less than 5%.
14.What is the relationship between the efficacy of vitiligo and the age of the patient?
A: The efficacy of adolescent children is better than that of middle-aged and elderly people. The best efficacy of vitiligo for children with limited duration of disease.
15.What is the relationship between the efficacy of vitiligo and individual life?
A: The clinical treatment effect of vitiligo, individual differences, even the same body, in different periods, different parts of the efficacy of the significant differences, regular life, good physical quality, balanced nutrition, cheerful personality, can follow the medical advice of patients with good efficacy, and vice versa, poor efficacy, in addition, partial diet, addicted to tobacco and alcohol, children addicted to snacks and desserts slow efficacy, long course of treatment.
16, the face is not very clear with flakes of white spots is vitiligo?
This situation is mostly seen in white pity, namely commonly known as “worm spot”, “peach fungus”, performance is round or oval superficial dry scaly hypopigmentation spot, not as vitiligo color white, edge is also unclear. It occurs mostly in children and teenagers.
17.Is a halo nevus vitiligo?
A: Halo nevus also known as centrifugal acquired leukoplakia may be a type of vitiligo, its occurrence is related to autoimmunity, mostly seen in young people, its skin lesions are characterized by single or multiple pigmented nevi surrounded by round or oval white spots in the shape of a halo, with clear edges. And there are some patients with other parts of the skin complicating vitiligo.
18.Are the white spots on the elderly vitiligo?
A: The elderly white spots, also known as idiopathic dotted white spots, are mostly found in the middle-aged and elderly people over 50 years old, trunk, limbs most common, many scholars believe that this disease is one of the elderly skin degeneration performance. The majority of the pitting white spots are round and oval, the diameter is generally not more than the diameter of the soybean cross-section, the maximum diameter of not more than 1.0cm, the color is gradually changed from light white to porcelain white, the border is clear, does not expand or fuse, but the number of increasing trend with age.
19.What are the manifestations of the white spots of pemphigus vulgaris?
A: Mottled lesions, also known as patterned leukoderma or restricted albinism, are autosomal dominant, and are born with white spots of varying size, irregular shape and irregular distribution, but occur more in the near center of the body, such as: chest, abdomen, limbs, etc. The normal skin color spots are interspersed in the white spots, or in the white spots or in the normal skin with deepened pigmentation. Hair on the affected area may turn white. Very few patients have only a small strand of white hair and no white spots of skin.
20.How long does vitiligo treatment take?
A: Vitiligo is not an incurable disease, now there are many treatment methods to choose from, but the treatment process is longer, so sufferers must have patience to adhere to treatment, do not treat 1 week to a month to see the effect of discouragement. Because many of the effects of treatment is often about 3 months to 6 months to clearly show. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
21.What is vitiligo phototherapy?
A: Vitiligo phototherapy includes ultraviolet therapy and helium-neon laser therapy, because the latter is not used much, so the general speaking of phototherapy basically refers to ultraviolet light therapy, ultraviolet therapy and includes PUVA therapy, NBUVB, 304nm high energy ultraviolet light, 308nm excimer laser, 308nm excimer light, etc.
22, what is vitiligo photochemotherapy (or PUVA therapy)?
A: Photochemotherapy is called PUVA therapy, which refers to the treatment of vitiligo with long-wave ultraviolet radiation after topical or oral photosensitizer, which is more practical and effective for patients with limited or segmental type. The commonly used photosensitizer now is 8methoxypsoralen (8MOP). This therapy has a long course and generally requires 100 to 300 treatments to achieve the desired effect, but if there is still no significant pigmentation after 30 treatments, the therapy should be abandoned. Oral treatment generally involves oral administration of 8MOP at 0.3-0.6 mg/kg 1 to 2 hours before irradiation, followed by long-wave ultraviolet irradiation 2 to 3 times a week. About 50% of patients respond well to this therapy, and the response to treatment is better for the face and trunk than for the extremities. Oral 8MOP treatment should be treated with attention to its side effects and avoidance of light. Topical PUVA therapy can also be used for small areas of the rash.
23.What is NBUVB therapy?
A: NBUVB therapy is the abbreviation of narrow spectrum medium wave UVB therapy, narrow band UVB method does not need to be combined with oral 8MOP, its treatment wavelength is 311nm medium wave UVB, the treatment instruments used are full cabin type, half cabin type, folding type, half body, hand and foot special type, table lamp type, handheld type and other models suitable for different parts, due to its relatively low cost of treatment, more widely used in China. Westerhof et al. compared narrow-band UVB with conventional PUVA and found that the former was 67% effective after 4 months, while the latter was only 46%. This may be due to the ability of UVB to modulate tyrosinase activity and stimulate melanocyte proliferation and melanin synthesis. The treatment method is 2 to 3 times a week, and the number of treatments ranges from a dozen to hundreds of times.
24.What is 308nm excimer laser light therapy?
A: 308 nm excimer laser is a UV laser with a wavelength of 308 nm produced by using xenon chloride (chemical formula: XeCl) as the laser excited gas. Novak et al. found that 308 nm excimer laser can promote the apoptosis of activated T cells in vitiligo lesions. The 308 nm excimer laser targeted treatment of vitiligo has the characteristics of high energy, high efficacy, convenience and safety and rapid onset of action, and the course of treatment is significantly shorter than NBUVB therapy, but because of its expensive instruments, the treatment cost is high, so only a few hospitals have carried out this therapy. In addition, there is 308nm excimer light (a word difference) treatment equipment, equipment costs and treatment costs are also lower than the former.
25.What is 304nm high-energy ultraviolet light therapy?
A: 304nm high-energy UVB is a special type of UVB, it is through the device emits high-density UV beam, with the help of liquid light guide fiber so that the effective light to the lesion site, the effect of high intensity, the spot area is small, can maximize the protection of normal skin, to achieve “target site treatment”. The actual treatment period is significantly shortened, the number of treatments is significantly reduced, the efficacy is comparable to 308nm, the treatment cost is between 308nm excimer laser and NBUVB therapy, and the tolerance of patients is increased.
26.What is the principle of phototherapy for vitiligo?
A: Phototherapy has a definite efficacy on vitiligo and is one of the preferred treatments for vitiligo in China. In addition, it produces thermal effect and biostimulation on the affected area of the skin, which effectively improves the local circulation and promotes its metabolism, which is conducive to the recovery of pigmentation and the integration of melanin island with normal skin color as soon as possible.
27.What are the side effects of phototherapy?
A: PUVA requires oral photosensitizer, so it is necessary to avoid light after treatment. In addition to local reactions such as erythema and itching, there may be eye and gastrointestinal discomfort, etc. NBUVB, 308nm, 304nm phototherapy does not require oral photosensitizer, so there is no systemic discomfort, mainly local erythema, blistering, slight pain and other tolerable discomfort. The treatment of vitiligo can be effectively controlled by adjusting the dose.
28.What are the advantages of Chinese medicine in treating vitiligo?
A: The traditional medicine of our country is profound and profound, and the balance of yin and yang (i.e. Western medicine called immune balance theory) is its essence. If you’re looking for a good deal more than just a few of the most popular and most popular products in the world, you’ll be able to find the right one.
29.Do vitiligo patients need to avoid eating foods containing vitamin C?
A: Vitamin C is a vitamin needed by the human body, when vitamin C deficiency, easily cause scurvy, collagen synthesis disorder, cause capillary permeability increase, bleeding phenomenon and impede the ossification process, so that osteoblasts can not form normal bone tissue, cartilage ossification disorder. The epiphysis is prone to dislocation or separation, while bone resorption continues, resulting in generalized osteoporosis and atrophy. In addition, the formation of dental bone matrix is impaired, and the teeth are dysplastic and prone to loosen and fall off. The actual fact is that you will be able to get a lot more than just a few of the most popular and also the most popular.