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Vitiligo Surgery

What is Vitiligo?

Vitiligo is a chronic skin disease that causes loss of pigment, resulting in irregular pale or white patches of skin. Common areas of the skin losing pigment are the face, lips, hands, arms, legs, and genital areas. Vitiligo occurs when the melanocytes die or are unable to function. However, the precise cause of vitiligo is complex and not fully understood. Today, about 0.5 to 1 percent of the world’s population has Vitiligo. Most of the people who have vitiligo develop it before age 40; half the people develop it before their 20th birthday. Vitiligo affects individuals of all ethnic origins and both sexes; however, it is much more easily noticed on darker skin.

There are at least three theories about the underlying mechanism of vitiligo:

Nerve endings in the skin release a chemical that is toxic to the melanocytes
Melanocytes simply self-destruct
It is type of autoimmune disease in which the immune system targets the body's own cells and tissues.

Vitiligo patches often occur symmetrically across both sides on the body. Occasionally small areas of the body may repigment as they are recolonised by melanocytes. Vitiligo may also be caused by stress that affects the immune system. The disturbed immune system may lead the body to react and start losing skin pigment. Vitiligo on the scalp may affect the color of the hair, leaving white patches or streaks and so affect facial and body hair.

Therapy:

The primary goal of therapy is to restore the skin's color by restoring melanocytes in the skin. Repigmentation of the skin with melanocytes allows the skin to regain its normal immune/inflammatory functions and improves the appearance of those suffering from this disease.

Medical:

Several methods of treatment with varying success rates are currently in use. Some doctors prescribe topical medications and/or ointments with or without corticosteriods. A treatment frequently used is the application or ingestion of a drug (psoralens) followed by exposure to ultra-violet light (sun light). This combined treatment is known as PUVA or PUVB. It is reported that these treatments result in limited success (only 61% of patients achieve more than 25% repigmentation). Even in patients who have a good response to medical treatment methods, the hands, fingers, feet, and ankles and penis frequently do not repigment.

Surgical:

You should consider the surgical treatment of vitiligo only if:

  • Your vitiligo has not changed in the last year.
  • You are not responding to PUVA or PUVB treatment.
  • Your skin has never permanently lost its color (pigment) when you have suffered a small cut or scrape.
  • You do not have Hepatitis C or AIDS.

Surgical treatment is ideal for those that have Segmental Vitiligo (this form involves an area only on one side of the body and tends not to repigment with other forms of treatment).

 
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