This is also called as leucoderma this disorder has white colored (milky white) patches which do not have any simtance but has normal sensations (as these patches often mistaken for patches of leprosy). Age is no bar for this disorder. There are several types of this disorder the commonest type is called as vitiligo vulgaris. Face, lips, tips of fingers and toes, genitals, and entire body surfaces can be involved. Overlying hairs may or may not be white. White hairs over white patch indicate a poor prognosis (outcome).
It is a genetic disorder and recurrences are common. There is an absence of epidermal melanocytes (black pigment containing cell).
Treatment range from local (topical) applications of medicinal creams to oral medicines.
Ultraviolet (UVA, UVB) rays are highly effective part of treatment in all age groups. Targeted photo therapy with 308 wave length light is probably most useful treatment in early stages, for localized areas. Narrow – band UVB rays treatments are also currently in vogue.
Surgical techniques are effective and quick method of treatments for stable vitiligo these are
A. Split thickness skin grafting:
This technique is useful for small stable (not increase in size and shape for the last one year) white colored patches on any area of the body. The procedure is performing under local anesthesia. And hence it is a office procedure (require no indoor admission). The affected area (recipient area) is abraded. The donor area (donor site) is selected. Thin sheet of skin (split thickness – epidermis, and not dermis) thin sheet of the skin is removed surgical blade. This skin is spread on an abraded (recipient) area. It is fixed in place with surgical glue. Dressings are placed for 10 days. This insures a quick and permanent method of removal of the whitish (vitilaginous) patches. (VIDEO LINK)
B. Punch grafting:
This is again an office procedure and hence does not require in door admission. It is done under local anesthesia it is done for stable (not increasing in size and shape for last one year) and large patch. Multiple punches by a skin biopsy are taken and thrown away from an affected (recipient) patch. Similar punches of similar diameter from a normal skin are taken and placed in the wells created in the recipient area. Several punches are placed at a gap of 2 to 5 mm. surgical glue is applied dressing are placed and the punched grafts placed are taken up nicely by 10th day there onwards the pigment spreads gradually in the adjoining arrears.
C. Melanocyte cell suspension transfers (non – cultured):
This is latest technique of good outcome for larger but stable (not increase in size and shape for the last one year) patches of vitiligo. This can be done general and local anesthesia and May required admission for one day.
A small sheet of skin (epidermis) is removed with a surgical blade this is subjected through different chemicals viz: trypsin, anti – trypsin, phosphate buffer solution etc… in this process the melanocytes separate from the others cells of the epidermis. This solution is centric fused. The sediment is picked up and speeded over all ready dermabraded vitiligo (receipt) patches. Collagen dressings are placed after 10 days the dressing are removed and the white patches bears a good brownish black hue. After one month these patches must be subjected for UVB therapy.