Vitiligo / Leucoderma / Phulverri (in Hindi)
Vitiligo is an accquired skin disorder with loss of melanocytes (Colour forming cells) affecting around 1 to 2 % world population without prediliction for sex or race. It is generally presumed to be an auto-immune disease in the which the melanocytes are killed by an auto-immune (Self Destructive) Phenomenon.
In India, Vitiligo is considered a social stigma and the afflicted patient and his family are generally under a lot of psycho- social stress because of impending marriage, job etc ultimately leading to lack of self-confidence and hence an impaired quality of life.
The options of management include (a) Medical (b) Photo Therapy and Lasers (c) Surgery (d) Cosmetic Camouflage.
Medical Options especially if used for long term for e.g. Steriods, Psoralens, Ayurvedic Medicine Containing Bawachi (Psoralens) can have significant side effects and can also not be considered in certain age groups or periods of life such as pregnancy and lactation.
Often, one comes across patients who have stopped responding to all possible medical therapies or are developing side effects; hence the role of Photo- therapy in the form of PUVA, NB-UVB, MONOCHROMATIC IPL, Excimer Laser is extremely important in the management of vitiligo. These devices are based on a particular wave length of light (311nm), are generally very safe especially , the NB-UVB which is safe even in small kids and pregnant ladies. These act as immune- modulators thereby causing not only repigmentation (bring back the lost pigment) but also prevent the spread of vitiligo.
Surgical options needs to be considered in patient with refractory but stable vitiligo. These options not only include various forms of tissue grafting such as Split thickness, Suction blister etc but also a newer method of grafting known as the ‘Autologous Melanocyte Cell Suspension’ which is gaining popularity because of its excellent cosmetic result and the need for a very small graft to cover a much larger recipient area unlike the conventional methods in which a large donor skin is required and not such a perfect skin colour match is possible.
Issued in Public Interest (Patient Education).