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Vitiligo
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Vitiligo
Vitilgo affects nearly 2% of the
population.
Strikes people between 10 & 30 years
old more often.
More evident in people with darkerskin.
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Vitiligo
All ethnic groups & both sexes are
affected
Loss of pigment most commonly
noted first on the hands, feet, arms,
face or lips
Disease is progressive.
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Vitiligo
Manifested by acquired progressive
loss of pigment resulting from structural& functional metabolic defect of
melanocyte system of the skin,
resulting in defective melaninformation.
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Vitiligo
Clinical Features
Localised or wide spread.
Scattered or confluent. Small sized macules, oval round & irregular
in shape & sometimes in streaks & sheets.
Lesions may be unilateral, mostly bilateral ¬ always symmetrical.
Colour of lesions may be milk white.
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Vitiligo
Disfiguring medical disease Cause is unknown
Destruction of melanocytes in the skin,
mucous membranes, eyes, inner ear &occasionally in hair bulbs. Melanocytes
provide the pigment that gives skin its
color.
Loss of melanocytes alters both structure
& function of these organs & results in
absence of pigment.
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Vitiligo
Autoimmune disease, where immunecells of body start attacking
Melanocytes of selfs body.
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Vitiligo
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Vitiligo
Therapy Primary goal of therapy is to restore
skin's color by restoring melanocytes
to the skin.
Repigmentation of the skin with
melanocytes allows the skin to regain
its normal immune/inflammatoryfunctions & improves appearance.
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Vitiligo
Corticosteriods
PUVA.
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Alopecia
Means loss of scalp hair,or baldness.
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Alopecia
Related forms of alopecia, based on location &distribution are as follows:
Alopecia totalis - loss of all facial & scalp hair.
Alopecia universalis - loss of all body hair.
Alopecia postpartum - loss of significant hair following
pregnancy & is usually
temporary.
Alopecia diffusa - diffuse loss of hair.Alopecia barbae - affects a man's beard area.
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Alopecia
Hair growth cycle
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Alopecia Areata
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Alopecia Areata
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Alopecia Areata
Is an autoimmune disorder characterized by hair
loss.
T-cell mediated autoimmune disease of hairfollicle.
Found equally in men & women.
It is the partial loss of hair on the scalp which
may result in round bald patches.
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Alopecia Areata
These individuals have no obvious skin disorders
or systemic diseases. Disease can occur at any age, even during
childhood & old age, although most cases have
their first expression in teen years or early 20s.
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Alopecia Areata Unfortunately there is not yet any reliable cure for
alopecia areata. Luckily the hair usually grows
back slowly by itself.
Injecting a cortisone medicine into the area of
hair loss may speed up the natural regrowth ofhair.
Intralesional steroid injection.
Regrowth occurs only in the area that has been
injected. There is no way of preventing newareas of hair loss.
Medicines which are often tried include topical
steroids& minoxidil, irritants such as dithranol.
http://dermnetnz.org/treatments/topical-steroids.htmlhttp://dermnetnz.org/treatments/topical-steroids.htmlhttp://dermnetnz.org/treatments/minoxidil.htmlhttp://dermnetnz.org/treatments/dithranol.htmlhttp://dermnetnz.org/treatments/dithranol.htmlhttp://dermnetnz.org/treatments/minoxidil.htmlhttp://dermnetnz.org/treatments/topical-steroids.htmlhttp://dermnetnz.org/treatments/topical-steroids.html8/13/2019 Vitiligo & Allopecia
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Alopecia Areata
One of the mainstays of treatment is intralesional
& topical corticosteroids. Typically, intralesional
triamcinolone acetonide is injected into thereticular dermis in very small amounts.
Low concentrations are typically injected into
eyebrows or facial skin, & the highest
concentration is used on the scalp.Proportionately lower doses are used for children.
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Alopecia Areata
A lower mid-potency topical steroid cream may be
applied twice daily to affected facial areas.
Corticosteroid therapy is slowly tapered as thealopecia improves.
Although systemic corticosteroids can lead to hair
regrowth in many cases, hair loss usually recurs
once therapy is discontinued. Therefore, systemiccorticosteroid therapy is seldom used.
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Steroids : Place in therapy in
Vitiligo & Alopecia Areata
Anti-inflammatory activity.
Result from decreased formation, release& activity of mediators of inflammation
(kinins, histamine, lysosomal enzymes,
prostaglandins & leukotrienes).
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Steroids : Place in therapy in
Vitiligo & Alopecia Areata
Immunosuppressive properties.
Decrease response to delayed & immediatehypersensitivity reactions.
Inhibition of toxic effect from antigen & antibody
complexes.
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Steroids : Place in therapy in
Vitiligo & Alopecia Areata
Immunosuppressive properties.
Inhibiting action of lymphokines, target cells &
macrophages.
Access of sensitized T lymphocytes &
macrophages to target cells are also prevented.