Vitiligo

Vitiligo (Vitiligo) is an acquired, localized or generalized skin depigmentation disorder, is a common skin disease affect beauty. Easy diagnosis and treatment difficult. Chinese medicine called "vitiligo" or "white split the wind."
1 enhance physical mental relaxation: chronic anxiety, tension, unpleasant mood, etc. can stimulate the disease, so patients should be cheerful, open-minded optimism

Note 2 Setting: accommodation wet, rain, cold, sunlight, friction etc. may induce vitiligo.

3 prevent infection: frostbite, burns and other trauma are likely to cause vitiligo.

4 consolidation therapy: after clinical cure vitiligo patients, their immunity and microcirculation has yet to return to normal, so after clinical recovery, ie after the complete disappearance of white, should be to consolidate a course of treatment.
More difficult treatment of this disease, drugs and methods are numerous, but the effects are poor, treatment is long, may relapse after healing.
1. psoralen (psoralen) and its derivatives in the early 13th century, Egypt was in a big Ami called vitiligo treatment plants. Made from three kinds of crystalline substance 1947: ①δ- methoxypsoralen (δ-methoxypsoralen, δ-MOP, ammoidin); ②δ- isopentenyl group psoralen (δ-isoamylenoxypsoralen, ammidin); ③5- methoxypsoralen (5-methoxypsoralen, majudin). Among δ-MOP to produce the best effect pigment. The uniform photosensitive compound, to be combined with sunlight or ultraviolet light. Its role in the treatment of vitiligo mechanism may be damaged cells in the epidermis and has not been completely destroyed or near normal melanocytes and stimulate its function, so tyrosinase melanin synthesis, and promote cell division and movement melanocytes, skin color makes recovery normal.
(1) δ-MOP method is suitable for oral leukoplakia, a wide range of patients. Daily 10 ~ 20mg, 2 times after meals, taking 2 hours after exposure to sunlight and ultraviolet A (UVA), termed photochemotherapy (PUVA). Usually no more than five minutes of sunlight is appropriate. General treatment 16 to 24 times before pigment appears more than 10 times the treatment can achieve the best results, such as continuous treatment for 6 to 12 months still valid, can be considered invalid. Drug side effects are loss of appetite, anemia, white blood cells and reduce toxic hepatitis. Therefore, diabetes, SLE, porphyria and liver dysfunction were hanged. Outdoor activities for a long time when, before the activities of the 3rd stop orally. Treatment time eat limes, celery, mustard, carrots and so on.
(2) δ-MOP external usage of 0.2% to 0.5% of δ-MOP solution coated surface, 1 to 2 hours after phototherapy. It can also be 0.1% δ-MOP lotion or tincture coated surface, sunlight or ultraviolet light for 1 to 2 hours.
(3) trimethyl psoralen (δ-trimethylpsoralen, trisoralen, TMP), is a synthetic, toxic effects than δ-MOP lower its oral daily dose of 10 ~ 50mg, day 1, after serving 2 ~ 4 hours exposure to sunlight or ultraviolet, children as appropriate reductions. No significant side effects, but the effect is not reliable, durable and renewable pigment not need long-term treatment.
Photosensitizer should be used to protect eyes from UV damage, after taking to this end in sunglasses with UV protection within 24 hours and in the evening medication.
(4) for the treatment of vitiligo psoralen conventional medicine. Containing psoralen, after finely containing crude drug 30g per 100mL immersed in 95% alcohol, 5 to 6 days, whichever filtrate coating the affected area, after the sunlight or ultraviolet.
2. corticosteroids corticosteroids may inhibit melanocyte antibodies role in making melanocytes from destruction.
(1) systemic drug prednisone, for example, 5mg three times a day orally, 1.5 to 2 months, decreasing markedly after 2 to 4 weeks 1 to 1 every other day, for 3 to 6 months. Medication for three months as an invalid, termination of treatment. The Act on the exposed parts and generalized damage, especially for the development of skin lesions quickly and under stress associated with autoimmune diseases better effect. Psoralen sometimes ineffective expected effective after the addition of hormones.
(2) ① available containing topical corticosteroids cream or solution is applied to white at the commonly used drugs such as triamcinolone cream, chlorofluorocarbons triamcinolone cream, skin cream, etc. Well, indeed suitable for applications in recent years have frost eligible better effect. Such drugs can cause telangiectasia, skin atrophy, therefore, face white should be used with caution; ② facial injections, injection use within white triamcinolone suspension (10mg / mL), generally once a week, each no more than 10mg, to prevent skin atrophy, medication is not more than 6 times.
3. The lack of copper and zinc preparation was determined in vivo in some patients certain trace elements, after such as copper, zinc, as supplemented by the lack of elements, her condition improved and even cured. Common 0.5% copper sulfate solution 10mL, diluted with water or milk after taking 3 times a day, children reduce. Also available in copper sulphate solution into the affected area to make electric ion trap once a day. Zinc deficiency may serve Licorzince 0.25g, 2 to 3 times a day; or zinc gluconate 0.14g, 2 to 3 times a day.
4. Application of immunomodulators drugs levamisole, transfer factor, thymosin and so on. Levamisole 50mg, 3 times a day, even for 3 days every two weeks. Transfer Factor each hypodermic 1 ~ 2U, 2 times a week. Thymosin, each 5 ~ 10mg, 2 times a week.
Recently it was reported six cases with cyclosporine A treatment patients receive better results. Also useful isoprinosine report.
5. decolorization treatment when the lesion area greater than 50% when there is no response to treatment and drugs; generalized skin lesions, especially in exposed parts of only a small piece of normal skin pigment regeneration in patients unwilling to accept treatment, decolorization feasible for the beauty therapy. Commonly used drugs hydroquinone monophenyl ether (MBEH), irreversible damage can occur melanocytes. To avoid irritating their initial concentration of 10%, 2 times a day topical, if no stimulus response may be in the 2 to 3 months, the 20% mentioned concentration. All decolorization takes 6 to 24 months. The side effects are dermatitis, itching, and might dry skin, alopecia areata, hair as early as white. At least 2 to 3 hours to avoid close contact with other people's skin after treatment.
6. occlusion therapy affect the beauty spot when artificial colorings made available masking agents, applied to the affected area, so close to normal skin. Commercially available as reigning concealers. We have used 0.2% to 5% dihydroxyacetone alcohol solution is applied to the affected area, to achieve better results.
7. The surgical therapy to drug therapy may be considered invalid surgical treatment. Its contraindications as hypertrophic scars and keloids constitution. ① suction blister autologous epidermal grafting with (26.66kPa ~ 39.99kPa 200 ~ 300mmHg) suction, blisters, cut the blister roof epidermis containing melanocytes, transplanted with liquid nitrogen or topical PUVA-induced blisters, skin removed It lesions section. The success of the therapy depends on the type of vitiligo, location and method of forming blisters. Autologous suction blister epidermal grafting does not leave scars, but complicated to operate, require special equipment. ② micro autologous transplantation, also called drilling skin graft from the normal skin of the upper arm or thigh drilling inside to take skin graft; the affected area with the same method of drilling peeled, the normal skin peeled skin graft at the affected part , hole diameter 1.5 ~ 2mm, skin grafts spacing 4 ~ 5mm, topical antibiotics a little, and then a microporous adhesive tape, the dressing was removed after 7 days. Pigment regeneration need 3 to 4 weeks after surgery. ③ autologous melanocyte transplantation, melanocyte cultures isolated from the patients with normal epidermis, the skin is white, after a suction blister using a 25-gauge needle aspiration blister fluid, and then cultured melanocytes suspension into the blister cavity can be after four weeks pigment regeneration.
8. Other surgical methods ①5-FU / dermabrasion, Tsuji et grinding had vitiligo skin cream topical 5-FU treatment in 28 cases, 2 times a day for 7 to 10 days, 64% achieved complete pigment regeneration, mechanism of action is unclear. Infection and the same type reaction to their side effects. ② micro coloring (tattooing method), Halder and other microsurgical techniques at the Division of iron oxide pigment implanted in the dermis, good curative effect, soon appeared obvious pigment loss. Side effects above. ③ active pigment (vitadye) can be used for dyeing, and may cover significant damage. Finish (covermark) is a cosmetic can produce a variety of colors, but also with a good covering effect.