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Dermatology

1. Allergic Contact Dermatitis

Human skin is exposed to various allergens in form of various chemicalswhich are used in day to day activities or occupation. Several plant andanimal products like wool, leaves and grains can trigger allergic contactdermatitis. The following are the common allergens.

  1. Metal allergens: Indian culture, customs and practice since ancienttimes use various metals in form of jewellery. Commonest metalallergen to cause skin allergy is nickel. Ear lobes, nose, ankle arecommonest sites for jewellery that make them vulnerable for theallergy. Foot wear, textile, plastic, cement and rubber can cause allergy.

  2. Dermatitis from topical medicaments: indiscriminate use of varioustopical preparations without consultation of dermatologists or usingprescription given to someone else or self medications can cause skinallergy.

  3. Plant and parthenium dermatitis: commonest occupation in India isagriculture. Indian farmers are exposed to parthenium weed thatbelongs to composite family popularly known as congress grass. Itcauses contact hypersensitivity over face and arms. Patients use crudeextracts of various plant leaves like neem over face and extremitieswhich can cause ACD.

  4. Cosmetic dermatitis: various cosmetics like lipstick, lip salvage, nailpolish, facial creams, toothpaste, and mouth wash can trigger ACD.There will be preservatives and additives that can trigger allergy. InIndia, kumkum (bindi) worn by women causes ACD.

  5. Hair dye dermatitis: In modern era awareness and consciousness forones appearance has resulted in discriminate usage of hair dye to maskgrey hair. Itching and discoloration of hair, forehead, pigmentationover nape of neck, photo sensitivity are the commonest symptoms.Para phenylenediamine (PPD) present in hair dye triggers ACD.Patients give history of using hair dye since several years before thesesymptoms. Usually patients will not be aware of this allergy as it takesa very long time to manifest.

  6. Sun light allergy: Redness, burning sensation over the face onexposure to sunlight and sense of relief when one goes to shade ischaracteristic of sunlight allergy. These patients have to cover theirforearms, wear full sleeved clothing and use umbrellas to avoidsunlight. Sunscreens are very helpful. However, they have to consulttheir nearest dermatologist who would be helpful to advice regardingthe appropriate sunscreens for their skin.
    Preventive measures:
    Consult your nearest dermatologist, who can suggest appropriatesunscreens, moisturizers, cosmetics that can beautify skin without anyadverse reactions.Do not use medicines advised to friends or relatives.
    Patch testing:
    ACD is cured by avoiding the causative allergen.To identify the suspected allergen, dermatologist will advice aprocedure called patch testing. Suspected set of allergens are appliedover the patient’s back. They are removed after 48 hours and reading istaken. 2nd reading is taken after 96hours. If patient is allergic to any ofthe applied allergen there will be a positive reaction. So, allergen isidentified and there by patient can avoid them.

 

Faqs - Allergic Contact Dermatitis

  1. Why I develop Allergic contact Dermatitis?
    A. Frequent exposure to various allergens in day to day life results insensitization of the skin and causes allergic contact dermatitis.

  2. What are the common substances that can trigger ACD?
    A. Hairdyes, kumkum, bindhi, cosmetics, gloves, ornaments, soaps anddetergents, footwear, textiles etc that are used frequently in day to day usagecan cause ACD.

  3. What tests are available to confirm ACD?
    A. Patch testing identifies the allergen responsible for ACD. It is simple andcost effective test.

  4. What preventive measures to be taken for ACD?
     A. Suspected allergens have to be avoided. Contact your nearestdermatologist who can advise you on ACD.

  5. How will I know that I developed ACD?
    A. Itching, burning, oozing are the commonest symptoms of ACD.

 



 

2. Acne Vulgaris

  • It is usually called ‘pimples’ and appears more commonly in adolescence

  • Acne involves the sebaceous glands over the face.

  • Skin coloured solid raised lesions appear on and off over the face.

  • They can get infected resulting in pus filled lesion.

  • Comedones are common and they can be black heads or white heads.

  • Sex hormones (estrogen and progesterone androgens) are the circulating chemical substances, that influence the growth of sebaceous glands and its secretions

  • There is no relation between the onset of acne and consumption of food items and oils.

  • Apart from face, they can present over chest, back and thighs

  • Most common complications following acne is pigmentation and scarring.

  • Various antibiotic creams like Erythromycin, Azithromycin, Clindamycin and comedolytics like Benzyl peroxide, Retinoic acids, Adapelene with various concentrations are available for its treatment.

  • Pigmentation following acne can be managed with various skin lightening creams.

  • Surgical procedures like acne scar revision are done to minimize the post acne scar.

  • The acne should not be manipulated or pricked, and any creams given by friends or chemist or any home remedies should not be applied over the acne. Acne is an age related problem. It should not be considered as a disease and do not worry about the condition as stress increases the problem and good treatment options are available.

  • Please contact your nearest dermatologists who can advice appropriate treatment and adhere to his instructions.

 

Faqs – Acne Vulgaris

  1. Why do I get Acne?
    A. Acne develops commonly over the face. Chest, back and thigh arealso involved. The circulating chemical substances called hormoneswill influence the growth of sebaceous glands and its secretions.Infection and blockage of sebaceous ducts will result in thedevelopment of acne.

  2. What foods do I need to avoid?
    A. There is no definite relationship between acne and diet.However, high glycemic loads, dairy products, and refinedsugar products can flare. One need not be anxious on this issue. 

  3. I get acne frequently, is there a hormone defect in me?
    A. There should not be any anxiety. Acne although more frequent inadolescents it can appear in any age group. A dermatologist canexamine and treat accordingly.

  4. I have acne, pigmentation and scar over the face. Will it be treated?
    A. Acne causes pigmentation and scarring. Topical antiacne and skinlightening agents are available that can effectively treat acne andpigmentation. Surgical procedures to correct acne induced scars areavailable. Well trained dermatologists practice these surgicalprocedures.

  5. I get acne from several years. What I should do?
    A. Acne causes remissions and exacerbations. Your dermatologistshould have advised maintenance anti acne treatment that youneed to take. Please adhere to his advice. Do not stop the treatment.

  6. My neighbour had suggested creams for the management of acne.Shall I follow the advise?
    A. It is one of the commonest mistakes followed by the public thatresults in unscientific and undesirable response. These creamscontain steroids in various strengths. The temptation to use suchcreams is due to the immediate temporary relief observed over the applied areas. Sustained use of these steroid based creams result intopical steroid-dependent face (TSDF). It means there will bereddish discolouration over the face with severe itching andburning. Multiple white patches and wrinkles can appear. Therecan be pus filled lesions and increased unwanted hair growth overthe applied areas of skin. Public are advised to be careful and not toaccept such suggestions from unqualified persons.

 



 

3. Fungal Infection of Skin

Common fungal infection that affects superficial skin layer is called Tinea(popularly known as Ringworm). It is not caused by a worm. It is caused by afungus, which live and spread on the upper layer of the skin and hair.

They grow best in warm, moist areas, such as body folds and contagious. Itspreads when you have skin-to-skin contact with a person or animal that hasit. It can also spread when you share things like towels or clothing. Tineaoccurs in people of all ages.

Tinea of the skin usually causes itchy rash, shape of a ring a small area ofinfected skin tends to spread outwards. It typically develops into a circular,red, inflamed patch of skin. The outer edge is more inflamed with scalingthan the paler centre.

Tinea of the foot looks like athlete's foot. The skin on the palm of the handgets thick, dry, and scaly. Skin between the fingers may be moist and haveopen sores.

If you have a ring-shaped rash, you are likely to have tinea. Yourdermatologist will be able to collect the scrapings from the rash under amicroscope to check for the fungus.

Treatment with topical antifungal cream or oral antifungal tablets respondswell. Your rash may clear up soon after you start treatment, but it’s importantto keep use the cream for up to four weeks. This will prevent the recurrenceof fungal infection. If the cream doesn't work, your doctor can prescribe pillsthat will kill the fungus.

 

Prevention of fungal infection:

  1. Don't share clothing or towels.

  2. Wear slippers or sandals in locker rooms and public bathing areas.

  3. Wear loose-fitting cotton clothing. Change your socks and underwear at least once a day.

  4. Keep your skin clean and dry. Always dry yourself completely after showers or baths.

You do not need to stay off work or school once treatment has started. Toprevent passing on the infection, do not share towels. Also, try not to scratchthe rash, as this may spread the fungus to other areas of your body. If you orsomeone in your family has symptoms, it is important to treat other familymembers.

 

Faqs - Fungal Infection of Skin

  1. What is Ring worm?

    A. It is called Tinea infection caused by fungus. It can occur on any part of skin, hair and nails associated with itching.

  2. Are fungal infections contagious?

    A. Yes, like virus and bacteria, fungal infections are contagious. They can spread from sharing clothing, combs and footwear.

  3. Who are at risk of developing fungal infection?

    A. Unhygienic personal habits, underlying medical conditions such as diabetes and patients on chemotherapy/HIV-AIDS.

  4. Can I use preparations advertised in the market?

    A. No, various preparations are in the market that claims to be effective for fungus. However these preparations can cause irritation therefore consult your nearest dermatologist who will advise suitable antifungal preparations like clotrimazle, ketoconazole, terbinafine etc. that are safer and effective.

  5. How long do I need to apply these antifungal preparations?

    A. Ideally antifungal preparations are to be used for 3–4 weeks. However it has to be used for longer duration when fungus affects the hair and nails. Consult your nearest dermatologist who can advise on appropriate antifungal preparation and its duration of use.

 



 

4. Hair and Nail Care

Common causes of hair loss are nutritional deficiency, certain medications,stress and strain, chronic disorders like thyroid dysfunction, diabetes mellitusand underlying prolonged illness. In India women suffering fromlongstanding illness like prolonged fever, typhoid and malaria are prone tosuffer from hair loss. Iron deficiency anaemia due to improper diet, menstrualloss, pregnancy and lactation can further worsen the hair loss. Hormonalimbalance also leads to hair loss. In children due to nutritional deficienciesand worm infestations have resulted in hair loss and premature greying.

Crash diet and junk food also affects hair. Dandruff -excessive scaling offlakes over the scalp will result in hair loss. Improper hair care practises like(hair strengthening curling, perming, colouring and styling) can result in hairloss.

Hair care

Regular and proper nutritional food, a balanced diet containing adequatecarbohydrate, protein, fat, minerals with appropriate healthy exercise willkeep hairs healthy.

Personal hygiene and hair care practices like regular oil massage for the scalpand shampooing, combing of the hair, daily bath and conditioning.

A proper treatment for any infections like furuncles (boils) and fungalinfection needs to be taken for better hair care.

Avoid using crude extracts of oil, flowers and herbal preparation over thescalp. Please consult your nearest dermatologist for more tips on hair care.

Nail care

Nails are exposed to external environment in day to day activities, prone fortrauma and recurrent viral, bacterial and fungal infections. In children nailbiting is common. Regular manicure and pedicure practice offers protectionagainst the infections. Nails reflect the health and well being of an individual.Nutritional deficiency and prolonged illness can affect the nails. Washing theHair and Nail care hands and personal hygiene, regular nail trimming provides a good care forthe nails. Please consult nearest dermatologist if you notice discoloration ofnails or brittleness since it can be due to fungal infection.

 

Faqs - Hair and Nail Care

  1. What are the common causes for hair loss?

    A. Stress, nutritional deficiencies, underlying chronic medical disorders like –thyroid and diabetes, malignancies, acute fever, worm infestations and acidpeptic ulcers.

  2. Does change in places affect my hair?

    A. Climatic conditions and water do not influence hair loss.

  3. Who are the Persons prone for hair loss?

    A. Crash diet, poor nutrition, alcoholism, smoking, prolonged illness, faulty hair care practices and hereditary factors contribute for hair loss.

  4. Will there be increased hair loss during pregnancy and lactation?

    A. Yes, there will be increased hair loss during that period however it is reversible.

  5. How does a dermatologist treat hair loss?

    A. A dermatologist will evaluate and investigate the cause and treat it specifically. Several topical and systemic preparations are available. Consult your nearest dermatologist for appropriate treatment.

 



 

5. Melasma

Melasma also known as chloasma is a dark or brown discoloration commonlyseen over cheeks, forehead, nose and upper lip. It is also known as mask ofpregnancy.

Melasma can affect anyone, but more common in women especially pregnantwomen. It is related to external sun exposure, hormones like birth controlpills and internal hormonal changes as in pregnancy.

Three types of common facial patterns have been identified Centro facial(center of the face), malar (cheek bones), mandibular (jaw bone). Facialdiscolorations of any cause have significant impact on the quality of life andthe effect is on self-perception and self-presentation.

Melasma of pregnancy usually fades away within a few months of delivery.Sometimes melasma may be preventable by avoiding sun exposure.

Sun screen can be used to prevent sun exposure. Various treatment optionslike sunscreens, topical de-pigmenting agents or skin lightening agents andother procedures like chemical peelings, micro dermabarasion are available.

Although melasma tends to be a chronic disorder with periodic ups anddowns, the prognosis for most cases is good. Just as melasma developsslowly, clearance also tends to be slow.

The gradual disappearance of dark spots is based on establishing right combination of treatment for each individual skin type, which can be done bya dermatologist.

 

Faqs - Melasma

  1. 1. What are the causes for melasma?

    A. Multifactorial – Hormonal, familial and sunlight.

  2. What are the various treatment options available for melasma?

    A. There is a rapid advancement in the treatment options for melasma, it ranges from topical skin lightening agents, chemical peels, surgical modalities. Consult your nearest dermatologist who will assess and advice appropriate treatment.

  3. Are there any fairness creams available?

    A. Avoid self medications, some of the fairness creams may contain chemical preparations that may harm the skin. Ask your dermatologist before using any cream over the face.

  4. Whether Melasma is going to spread all over the face?

    A. Mostly it is confined to initial areas of involvement; however the intensity of color may vary. In some cases it can spread to other areas of face.

  5. Is melasma curable?

    A. There has been recent advances of newer chemicals that are effective in reducing melasma. Maintenance treatment is the most important. A dermatologist will decide regarding the initial and maintenance depending on severity of involvement. Please consult your nearest dermatologist.

 



 

6. Psoriasis

Psoriasis is a chronic skin condition characterized by an unpredictable courseof remissions and relapses and presence of solid elevated patches with loosesilvery scales at typical sites like scalp, elbows, knees, outer aspect of limbs,palms and soles. There is frequent nail and joint involvement.

Exact cause for psoriasis is unknown but many factors have beenincriminated. About 30% of people with psoriasis have a family history of thecondition, and certain genes have been linked to psoriasis. However, thecondition will only appear if it is triggered by an environmental factor.Triggers may include stressful life events, infection with certain viruses andbacteria, skin injury, or reactions to certain medications.

Adaptation to living with a disease is a broad term which encompasses arange of phenomena, including quality of life, emotional well being, goodself-esteem, acceptance of life with a disease, social participation andfulfillment of social roles. In chronic diseases, such as psoriasis, affectedindividuals need to develop psychological mechanisms enabling them toadapt to the disease in the best way possible.

Psoriasis can have a significant impact on the quality of life of those who areafflicted due to chronicity of the disease and frequent remissions and relapses.There are many topical and systemic medicines taken internally to treatpsoriasis and psoriatic arthritis. Phototherapy is another treatment option andthere are practical ways to care for the skin that may help to remove psoriasisscales, improve the skin's ability to move and bend or to make the skin feelbetter. Treating psoriasis is critical to good disease management and overallhealth. Work with dermatologist to find a treatment—or treatments—thatreduce or eliminate your symptoms. What works for one person withpsoriasis might not work for another. So it's important to know the differenttreatment options and keep trying until you find the right regimen for you.

Recent advances in the understanding of the cause of psoriasis have led to thedevelopment of new, genetically engineered, targeted therapies for thiscondition. Still, reassurance and emotional support are invaluable. Physicaland mental rest may enhance the effects of the specific management of acuteepisodes

 

Faqs - Psoriasis

  1. Is psoriasis a rare disease?

    A. Psoriasis is a common and recurring skin condition affecting 2% - 3% of thepopulation.

  2. What causes Psoriasis?

    A. Psoriasis is a multifactorial genetic disease. About 30% of people with psoriasis have a family history of the condition, and certain genes have been linked to psoriasis. However, the condition will only appear if it is triggered by an environmental factor. Triggers may include stressful life events, infection with certain viruses and bacteria, skin injury, or reactions to certain medications.

  3. Is psoriasis contagious?
    A. Psoriasis is not contagious. It cannot be caught from touching someone who has the condition, swimming in the same pool, sharing towels, or eating food prepared by a person with psoriasis.

  4. How about diet?

    A. Diet is thought to play only a small role in psoriasis. In general, a well balanced diet is advisable in people with psoriasis, just as it is in everyone.

  5. Is psoriasis incurable?

    A. The treatment of psoriasis should be individualized and depends on patient and disease factors. Treatment is concerned with control rather than cure. Psoriasis can be managed with sustained judicious use of various treatments.

  6. Any alternative treatments exists that can cure psoriasis?

    A. No conventional and alternative treatments exists that can cure psoriasis.

  7. What is the role of climate and sunlight?

    A. Hot, humid environments tend to make bad cases of psoriasis worse. In contrast, sunlight and dry, sunny climates, as a rule are helpful - particularly in mild cases.

 



 

7. Pyoderma

Pyoderma means any skin disease with pus filled lesions. These includesuperficial bacterial infections such as impetigo, impetigo contagiosa,ecthyma, folliculitis, Bockhart's impetigo, furuncle, carbuncle, tropical ulcer.

Pyoderma is caused by the bacterial infection. It results in a painful swollenarea on the skin caused by an accumulation of pus and dead tissue.

Most human infections are due to staphylococci, notable for the bacteria'sability to produce coagulase, an enzyme that can clot blood. Almost anyorgan system can be infected by S. aureus.

Skin infections tend to be recurrent in many patients and often may spread toother family members. Systemic factors that lower resistance commonly aredetectable, including:-diabetes, obesity, disorders, malnutrition andimmunosuppression.

Sign & symptoms – they present as bumpy, red, pus-filled lumps around ahair follicle that are tender, warm, and very painful. They range from peasizedto golf ball-sized. A yellow or white point at the center of the lump canbe seen when the boil is ready to drain or discharge pus. In a severe infection,an individual may experience fever, swollen lymph nodes, and fatigue.Treatment includes topical and systemic antibiotics. If untreated, it can leadto serious complications.

 

Faqs - Pyoderma

  1. Are these infections contagious?

    A. Yes these infections can be passed among family membersthrough using same towels and touching the wound.

  2. Pyoderma occurs in all age groups?

    A. Yes, it can occur in all age groups. But it is recurrent in Middle age group, in diabetics, poor hygiene and in immunosuppression.

  3. It occurs more in males or females?

    A. Occurs more commonly in males.

  4. Is it easily treatable?

    A. Yes, it can be treated easily with topical antibiotics and systemic antibiotics for 5 days.

  5. When should we visit the doctor?

    A. When red nodules associated with pain, pus and fever occur recurrently every month.

 



 

8. Scabies

Scabies is one of the commonest contagious skin diseases that can affect anyage group and socio economic class. Over crowding, poor environmentalhygiene and poor personal health habits can contribute for the spread of thisinfection. It is caused by a parasite - itch mite that harbours in the humanskin. Hostels, lodges are commonly infested with this disease.

Female itch mite burrows and lays its eggs in the superficial layer of skin(stratum corneum). The average life span of itch mite is about 30 days.Common sites affected are hands, wrists, elbows, feet and ankle. On anaverage there are about 10-12 itch mites are present in an affected individual.

Itching occurs typically in the night and it is the commonest symptom. It canbe associated with bacterial infections (pyoderma) that require earlytreatment and if neglected the infection can affect kidneys.

All family members of the affected individuals are to be treated. The bedlinen, clothes including the inner wear have to be washed with hot water.Hygiene is important. Anti scabicidal creams like permethrin, gama benzenehexachloride (lindane) and Benzyl Benzoate have to be used overnightapplication after a scrub bath. It has to be applied all over the body,excluding face and head, like a paint. The application should be present allover the body and left for the whole night. Then next morning it should bewashed off during bathing.

If you or your family members are having itch during the night, pleasecontact your nearest skin specialist who can advice appropriate treatment.

 

Faqs - Scabies

  1. Is scabies contagious?

    A.One of the commonest contagious skin diseases that can affect any agegroup and it can affect irrespective of socio economic class.

  2. Who gets scabies and what are its predisposing factors?

    A. It is caused by a parasite - itch mite that harbours in the human skin. Over crowding, poor environmental hygiene and poor personal health habits can contribute for the spread of this infection. Poorly maintained hostels, lodges are commonly infested with this disease.

  3. How do I know that I am suffering from scabies?

    A. Common sites affected are hands, elbows, feet and ankle. Itching occurs typically in the night and it is the commonest symptom. It can be associated with bacterial infections (pyoderma) that require early treatment.

  4. What are the Hygienic measures I need to take along with the treatment of scabies?

    Hygiene is important. All family members of the affected individuals are to be treated. The bed linen, clothes including the inner wear have to be washed with hot water.

  5. What happens if Scabies is neglected?

    Early consultation and treatment are important. Neglected cases of scabies can lead to bacterial infections (pyoderma) that if untreated progress to affect and damage the kidneys.

 



 

9. Viral Infections

There are many viral infections ranging from the common to the rare, fromthe mild to the severe and from those causing just skin infection to those withassociated systemic disease.

Nonspecific viral rash

This is a widespread reddish rash sometimes seen in viral infections. It isaccompanied by the common symptoms of a viral infection, such as fever andheadache. The rash develops rapidly and appearance of rash varies.

Local viral infections

 

Herpes Simplex

  • Primary infection occurs through a break in the mucus membranes ofthe mouth or throat, via the eye or genitals or directly via minorabrasions in the skin.

  • Initial infection is usually asymptomatic, although there may be minor local vesicular lesions.

  • Reactivation of latent virus leads to recurrent disease

 

Herpes Zoster

A person should be affected by chicken pox prior to get Herpes zoster. Itappears as unilaterally distributed, grouped and fluid filled lesions. It isassociated with pain and burning sensation.

 

Molluscum Contagiosum

This is a skin infection caused by a DNA pox virus that affects both childrenand adults. Transmission is usually by direct skin contact and has occurred incontact sports and by sharing baths, towels and gymnasium equipment.Outbreaks in schools are well recognized. Autoinoculation produces linearshiny or skin colour lesions.

 

Warts

Warts are caused by human Papillomavirus. Common warts appear as papules andnodules with a keratotic or rough surface. They occur anywhere but are mostcommon on the hands in young people and children.

Other types include: Filiform warts - these are small finger-like wartsconsisting of hyperkeratotic projections.

 

Viral infections that produce rashes

There are a number of viral infections that may cause a rash - most of themtypically in childhood. Examples include:

  • Measles.

  • German measles (rubella).

  • Chickenpox

  • Fifth disease (erythema infectiosum)

  • Roseola

  • Pityriasis rosea

  • Echovirus and adenovirus infections

  • Epstein Barr virus of infectious mononucleosis

  • Primary HIV infection

 

Other viral infections with skin involvement

 

Hand, foot and mouth disease

  • Herpes gladiatorum

  • The name implies association with martial arts. In association with rugby it is called 'scrum pox'.

  • Transmission is primarily by direct skin-to-skin contact and abrasions may facilitate a portal of entry. The majority of lesions occur on the head or face, followed by the trunk and extremities.

  • A prodromal itching or burning sensation is followed by clustered vesicles on an erythematous base which heals with crusts over about 1 to 2 weeks. Less often, headache, malaise, sore throat and fever may be reported.

 

Faqs - Herpes, Varicella and Zoster

  1. Are Herpes, Varicella and Zoster contagious?

    A. Yes, they are contagious – can spread from one person to another.They are communicable diseases.

  2. How do they spread?

    A. They spread by droplet infection from one person to another; close contact, overcrowding, poor hygienic conditions can predispose to spread of these infections. Herpes can spread by sexual contact.

  3. How does these infections present?

    A. Multiple fluid filled lesions associated with burning, itching, and pain.

  4. Does viral infections recur?

    A. Yes, they recur. Frequent episodes are known to occur. Dermatologist has a protocol to manage such recurrences and advice specific antiviral drugs.

  5. Who are at risk of developing the infection?

    A. Children, old age, immunocompromised patients, diabetics, malignancies and patients on chemotherapy are associated with viral infections.



 

10. Vitilig

Vitiligo is an acquired, idiopathic, progressive whitening of the skin and haircharacterized by destruction of pigment producing cells in the skin calledmelanocytes. Vitiligo appears to affect at least 1% to 2% of the population,irrespective of sex, race, or age and 50% begin before age 20. The more darkskinned a person is, the more their vitiligo stands out, because of the contrastbetween affected and unaffected areas of skin.

People from families with an increased prevalence of thyroid disease,diabetes mellitus, and vitiligo appear to be at increased risk for developmentof vitiligo. The two predisposing (genetic) and precipitating (environmental)factors contribute to vitiligo. Many patients attribute the onset of their vitiligoto physical trauma, sun burn, illness, or emotional stress. The typical vitiligomacule is chalk white in color, has convex margins usually present on theextensor surfaces and in priorificial orifices which are typically symmetrical.The disease progresses by gradual enlargement of individual macules and thedevelopment of new white spots on various parts of the body.

Vitiligo can be categorized as one of three types, based on the pattern ofdepigmentation. The most common type is generalized vitiligo, in whichthere is widespread distribution of white macules, often in a remarkablysymmetrical array. The focal type is characterized by one or more macules ona single site; in some cases, this may be an early evolutionary stage of one ofthe other forms of the disease. The segmental type, which is uncommon, ischaracterized by one of several macules on one hand or one side of the body.This type is not usually associated with vitiligo macules in other parts of thebody, and new vitiligo spots do not appear.

The change in appearance caused by vitiligo can affect your emotional andpsychological well-being. You may experience emotional stress, particularly ifvitiligo develops on visible areas of you body, such as your face, hands, armsor feet. You may feel embarrassed, ashamed, depressed or worried about howothers will react. Young people, who are often particularly concerned abouttheir appearance, can be devastated by widespread vitiligo. Find a dermatologist who's knowledgeable about vitiligo. Find out as much as you can about vitiligo and its treatment options so you can participate inmaking important decisions about your health care.

 

Faqs - Vitilig

  1. What is vitiligo?

    A. A depigmenting disease of unknown origin that causes destruction ofmelnocytes.

  2. Can vitiligo be curable?

    A. There is a rapid advancement in the field of treatment for vitiligo. Various treatments, medical and surgical either alone or in combination ranging from topical to systemic medications are available. Appropriate treatment will be planned by the dermatologist depending on your case.

  3. What is the treatment of vitiligo?

    A. Though treatment of vitiligo is not very satisfactory, reasonable improvement can be expected in several patients. Treatment depends on age of patient, extent and pattern of vitiligo, cosmetic disabilty and effect on quality of life. A dermatologist will assess and advice appropriate treatment.

  4. Is treatment of vitiligo impossible?

    A. This is clearly not true and the majority of patients can achieve good results.

  5. Is oral psoralens, which form the basis for some vitiligo treatments are toxic to the liver?

    A. Oral psoralens are not toxic to the liver.

  6. Is psoralen + Ultra Violet -A (PUVA) treatments for vitiligo cause cancer of the skin?

    A. When used to treat vitiligo, PUVA therapy requires only a limited number of treatments-approximately 150 in number that has not been shown to cause skin cancer.

  7. If I have vitiligo, will my children develop it?

    A. There is no definite mode of inheritance however; siblings may or may not develop. One need not be anxious regarding it.

  8. Will the patches reoccur?

    A. Most probably the patches may not reoccur. However in some instances it may reappear. A dermatologist will assess and advice appropriate treatment.

  9. When do a dermatologist advice surgery for vitiligo patches?

    A. A dermatologist is going to assess whether a patient is suitable for the surgery. A patch that remains stable for 6 months, site of transplantation and underlying medical conditions.