KenaRoots Chronic skin disease Other name = Leukoderma White spots occur when the skin no longer forms melanin (pigment that determines the color of your skin, hair, and eyes) The white patches of irregular shapes begin to appear on your skin White patches of skin Whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard Loss of color in the tissues that line the inside of your mouth Loss or change in color of the inner layer of your eye oval.Chalk white color Convex margins 5mm to 5cm or more in diameter Round. or elongated in shape AVRF . Focal pattern—the depigmentation is limited to one or only a few areas Segmental pattern—depigmented patches develop on only one side of the body Generalized pattern—(most common) depigmentation occurs symmetrically on both sides of the body Focal and segmental patterns do not spread. The generalized pattern is hard to predict and can randomly stop . Can appear at any age. genitals. hands or knees 1-100 of the world population develops Affects both genders and all races equally . usually first appears between the ages of 20 and 30 White patches may begin on your face above your eyes or on your neck. elbows. armpits. heredity. the involved patch of skin becomes white When a white patch grows or spreads the cause may be Vitiligo Exact cause is unknown May be due to an immune disorder. When no melanin is produced. or environmental causes like sunburn or emotional distress that trigger the condition . A family history of vitiligo Look to see if there is a rash. or other skin trauma that has occurred within 2 or 3 months after pigmentation was discovered Premature graying of the hair (before age 35) Stress or physical illness Also they may ask for an eye examination (inflammation of your eye) and/or blood test (autoimmune disease) . sunburn. such as narrow-band UVB therapy Medicines taken by mouth such as trimethylpsoralen (Trisoralen) Medicines: Corticosteroid creams Immunosuppressants such as pimecrolimus (Elidel) and tacrolimus (Protopic) Repigmenting agents such as methoxsalen ( Oxsoralen) .Vitiligo is difficult to treat Early treatment options include: Exposure to intense ultraviolet light. such as on the face and armpits. The use of steroid creams may be helpful in returning the color to the white patches Doctors often prescribe a mild topical corticosteroid cream for children under 10 years old and a stronger one for adults Cream must be applied to the white patches on the skin for at least 3 months before seeing any results Corticosteriod creams are the simplest and safest treatment for vitiligo. . but are not as effective as psoralen photochemotherapy SIDE EFFECTS occur in areas where the skin is thin. or in the genital region › They can be minimized by using weaker formulations of steroid creams in these areas. Topical Calcineurin Inhibitors RDNL . AVRF . WWHT Dermatology . PUVA therapy is to repigment the white patches time-consuming. Psoralen is injected orally or is applied to the skin Then skin is carefully timed exposure to sunlight or to ultraviolet A (UVA) light that comes from a special lamp. Most effective treatment available in the United States. and care must be taken to avoid side effects Psoralen is a drug that contains chemicals that react with ultraviolet light to cause darkening of the skin. Eventually. and hyperpigmentation. May also increase the risk of skin cancer. Treatments are usually given 2 or 3 times a week. You take a prescribed dose of psoralen by mouth about 2 hours before exposure to artificial UVA light or sunlight. SIDE EFFECTS include: Sunburn. The doctor usually increases the dose of UVA light slowly over many weeks. For patients who cannot go to a facility to receive PUVA therapy. SIDE EFFECTS: › (1) severe sunburn and blistering › (2) too much repigmentation or darkening (hyperpigmentation) of the treated patches or the normal skin surrounding the vitiligo. . For people with extensive vitiligo (affecting more than 20 percent of the body) or for people who do not respond to topical PUVA therapy Not recommended for children under 10 years of age because it increases the risk of damage to the eyes caused by conditions such as cataracts.Used for children 2 years old and older who have small number white spots in a few areas Treatments are done under an artificial UVA light once or twice a week. Psoralen is applied to your depigmented patches about 30 minutes before exposing you to enough UVA light to turn the affected area pink. abnormal hair growth. but never 2 days in a row. the pink areas fade and a more normal skin color appears. nausea and vomiting. the doctor may prescribe psoralen that can be used with natural sunlight exposure. itching. Used for people with small patches of vitiligo The doctor removes sections of the normal. suction. . a cobblestone appearance. pigmented skin and places them on the depigmented areas Infections may occur at the donor or recipient sites The recipient and donor sites may develop scarring. or may fail to cure the white spot area Takes time and is very costly Doctor creates blisters on your pigmented skin by using heat. or freezing cold The tops of the blisters are then cut out and transplanted to a depigmented skin area SIDE EFFECTS: scarring and lack of repigmentation Less risk of scarring with this procedure than with other types of grafting. or a spotty pigmentation. When the melanocytes in the culture solution have multiplied. Implanting pigment into the skin with a special surgical instrument Works best for the lip area. the doctor transplants them to your depigmented skin patches Currently experimental and is impractical for the routine care of people with vitiligo Very expensive and its side effects are not known. particularly in people with dark skin Difficult to match perfectly the color of the skin of the surrounding area The tattooed area will not change in color when exposed to sun. while the surrounding normal skin will. . Tattooing tends to fade over time Also tattooing of the lips may lead to episodes of blister outbreaks caused by the herpes simplex virus Takes a sample of your normal pigmented skin and places it in a laboratory dish containing a special cell-culture solution to grow melanocytes. which makes the contrast between normal and depigmented skin less noticeable AVRF .Sunscree n Blue Lizard Baby& Sensitive Sunscreen Helps protect the skin from sunburn and longterm damage Minimizes tanning. Clinique. or self-tanning lotions. Some vitiligo patients cover depigmented patches with stains. Vitadye. and Chromelin offer makeup or dyes that you may find helpful for covering up depigmented patches Self tanning lotions have an advantage over makeup in that the color will last for several days and will not come off with washing. Fashion Flair. Dermablend. Lydia O’Leary. makeup. AVRF . April AVRF . SUPPORT organizations 1)National Vitiligo Foundation 2)Vitiligo Support International 3)American Vitiligo Research Fo undation Inc. . com (Lee Thomas. Department of Health an d Human Services : National Institute of Arthritis and Musculoskeletal and Skin Diseases Drugs.Turning White 20/20 Interview) National Vitiligo Foundation (video gallery-Elizabeth Vargas Interview) . Nation Library of Medicine (Medicine Plus) American Vitiligo Research Foundation National Institutes of Health.com (Treatments) youtube. 3) Visualdxhealth 4) Revolution Health 5) WWHT Dermatology 6) Elidel 7) National Vitiligo Foundation 8) Vitiligo Support International 1) .National Vitiligo Foundation 2) American Vitiligo Research Foundation Inc. Kids coping with Vitiligo Lee Thomas Elizabeth Vargas Interview . . high concentration . This kind of Vitamin is a wellknown potent antioxidant and is beneficial to the .Ingredient Cocos nucifera oil Main active substance Coconut oil contains essential saturated and unsaturated fatty acids.skin . High concentration of Vitamin E and K.of Zinc and Iron Action Coconut oil is the only type of oil that one should use on one’s skin for it is absorbed easily and keeps the skin soft. Coconut oil contains Vitamin E Alpha Tocopherol. the phytochemically induced covalent binding of the drug to pyrimidine bases is responsible for its therapeutic effect. which are dilated so that the plasma is increased in this area. . isoflavons. Psoralen has been found to intercalate into DNA. isopsoralen and .[ Also. In leukoderma. melanoblasts do not function properly and their stimulation by the drug leads them to form and exudate pigments. The skin becomes red and the melanoblasts (pigment-forming cells) are stimulated. where they form mono. chalcones and coumesterol group of compounds which includes psoralen.Ingredient Psoralea corylifolia extract Main active substance Psoralea corylifolia contains flavons. furanocoumarins. which gradually diffuse into the white leukodermic patches. The photoconjunction involves thymine dimer adducts on the opposite strands of DNA.bavichinin2 Action Psoralea corylifolia appears to have a purely local action with a specific effect on the arterioles of the subcapillary plexuses.such as leukoderma .and diadducts in the presence of long wavelength UV light and thus are used for the treatment of hypopigmented lesions of the skin. lutein. oxyacanthine. berberine.Ingredient Berberis vulgaris root extract Main active substance Barberry includes such alkaloids as berbamine. vitamin C.properties . and cobalt Action Barberry root has antioxidant and cytoprotective . zeaxanthin. and chelidonic acid. zinc. resin and tannins. Barberry Root also constituents the Bvitamin thiamine. chromium. . the carotenoids betacarotene. Ingredient Picrorhiza kurroa root extract Main active substance Picrorhiza kurroa root extract contains Kutkin. D-Mannitol and Vanillic acid Action Picrorhiza kurroa was found to be a potent immunostimulant of both cell-mediated and humoral immunity.phagocytosis . picrorhiza was reported to stimulate cell mediated and humoral components of the immune system including stimulation of . Terpinenes Action Powerful and broad spectrum antimicrobial agent (Anti-bacterial. and it has an immune system stimulant effect . Pinene.Ingredient Melaleuca Alternifolia (TeaTree) Leaf Oil Main active substance Terpineol. anti-fungal and anti-mycotic agent). Cineol. any other natural oil . Modern research into the properties of emu oil has found that this is the greatest skin emollient in the world. with deep skin penetration properties better than .Ingredient Emu oil Main active substance Linolinic acis and Oleic acid Action Used by the Aboriginal people of Australia for the treatment of muscle and joint pain. contains a variety of fatty acids. Ingredient Vitamin E (Tocopherol) Main active substance Alpha-tocopherol Action Powerful antioxidant agent . Natural pathway for PUVA therapy. . Cost effective. Safe with minor side effects. Rich source of essential minerals and vitamins for vitiligo patients. Rich source of natural powerful antioxidants. Great thanks for your listening Kena Roots for therapeutic cosmetics Dr. Hani Malkawi .