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WHAT IS IT?
Vitiligo is also known as 'leucoderma'. In India, it is called 'safed kod' or 'safed dag' and is considered as a social stigma. Vitiligo is appearance of single or multiple depigmented patches on any part of the body.These patches gradually increase in size & cause lot of psychological stress in the patient. It is an auto-immune condition and may have a genetic predisposition. Treatment of vitiligo usually takes a long time.
Medical treatment helps arrest the spread of depigmentation and in some cases, may bring back the pigmentation. In majority of the cases, medical therapy only achieves stabilization of the vitiligo patch but fails to cause repigmentation. However, repigmentation in cases of 'stable vitiligo' can be achieved by various dermatosurgical techniques.
ROLE OF PUVA IN VITILIGO:
PUVA therapy enhances skin re-pigmentation. An oral psoralen compound is given to the patient. Two hours later , the de-pigmented patch on his body is exposed to ultraviolet-A (UVA) rays, for a fixed time duration. This should be supervised by a medical personnel. If UVA is not available then the patch is exposed to sun rays. The latter is known as PUVA SOL therapy.Treatment with UVB rays is another option. The most recent modality is treatment with Excimer laser.
WHEN IS THE PATIENT FIT FOR SURGERY?
When the de-pigmented patch does not increase in size for a period of two years, it is said to be stable. This is the right time to perform vitiligo surgery. If the patch is growing or is in an active phase, it needs treatment with medicines and / or PUVA till it stops growing.
Method to be used depends on the the type and site of lesion. Hence, selection of the appropriate surgical technique is important for good cosmetic results.
1) Miniature punch grafting.
2) Ultra thin skin grafting.
3) Suction blister grafting.
4) Therapeutic spot or regional dermabrasion.
5) Melanocyte culture and transplantation.
For more information, consult our dermatologist