Leukoderma
Treatment
Vitiligo (Leukoderma)
Vitiligo means a patch on the skin where melanin or dark pigment is absent. So the patch appears white. The patch can be of small in size or slowly it may involve multiple parts of the body.
Vitiligo is an autoimmune condition having genetic predisposition. No exact cause is known.
The vitiligo or whitish patches on the skin is considered as a social stigma. So, this condition causes lot of stress in patients.
Unstable vitiligo: Unstable vitiligo increases in size, shows appearance of new lesion and has ill-defined margins.
Types of vitiligo: There are various types of ways of presentation of vitiligo. Focal vitiligo is small & is limited in particular part of the body so it has good prognosis. Vitiligo vulgaris has several patches. It has fair prognosis. Segmental vitiligo has no satisfactory prognosis. Acrofacial and universal vitiligo has poor prognosis. Indicators of poor prognosis are lesion on prominent and bony part, lesion on palm and sole, nipple and areola.
Treatment of Active & Unstable Vitiligo:- Active vitiligo is first treated with PUVA is therapy of enhancing skin repigmentation. Orally psoralen tablet is given two hours later the patch is exposed to ultraviolet (PUVA) rays for a fixed duration. When UVA is not available patch is exposed to sun rays (PUVA SUL). Treatment with narrow band UVB can also be done. Excimer laser and excimer light may also be used. Such medical treatment is done to stabilize growing white patch.
Stable Vitiligo:- When patch stops growing it is called as stable vitiligo. After 1 to 2 year such stable vitiligo can be treated by surgery.
Any stable patch of vitiligo means it remains of the same size & shape at least for 2 year. Plastic or cosmetic surgery on the stable patch of vitiligo: If patch of vitiligo is stable for 1 to 2 year then cosmetic plastic surgery can be done. There are various ways of skin grafting to eradicate white patch. These are as follow:
Excision of Patch: If vitiligo patch is small and if patient want dramatic improvement or disappearance of patch then patch can be excised and results are dramatic or cent percent.
Laser Treatment for Leukoderma
| Focus Area | Procedure Description | Expected Outcomes |
|---|---|---|
| Targeted Repigmentation | Utilizes focused laser technology, such as the Excimer laser, to stimulate melanocyte cells in white patches of skin, promoting repigmentation. | Partial to full restoration of the natural skin color over multiple sessions, depending on individual response to treatment. |
| Uniform Skin Tone | The laser targets the borders of leukoderma patches, blending them into the surrounding skin to reduce contrast and improve overall skin appearance. | Increased uniformity of skin color and texture, leading to a more natural, cohesive look. |
| Minimize Visibility | Strategic application of laser treatment to make white patches less noticeable, focusing on areas most visible and impactful to the patient's appearance. | Decreased visibility of leukoderma patches, enhancing the patient's confidence and quality of life. |
- Skin grafting:This is good method of eradicating white patch on the skin. Skin from thigh area is taken and it is grafted on that prepared area of the vitiligo patch.
- Punch skin grafting:This is less skillful procedure. It takes some time to achieve results. Small circular patches (punched pieces) of skin are removed & grafted on the white patch. Slowly the pigment of the graft spreads in surrounding area. They need additional PUVA therapy.
- Blister method of skin grafting: It is similar to skin grafting. Skin for grafting is removed by producing blister with the help of vacuum.
- Non cultured melanocyte transfer: To cover big sized area, epidermis of skin graft is separated. The melanocytes from such processed graft tissue are transplanted on the vitiligo patch. It is costlier procedure.
- Cultured melanocyte transfer: When vitiligo patches are extensive. The melanocyte patches of the cells from normal skin grafts are removed & cultured. These cultured cells are transferred on ablated white patch. This method covers larger area. So it is costlier procedure.
- Tattooing:
- In this method of treatment artificial pigment is injected into depigmented areas, so patch disappear. This method is good for small size patches or areas on body where response to above treatment is not seen. Matching pigment shade is selected. With the help of manually or electrically driven needles pigment granules are implanted into leukoderma patch. After 1-2 year bluish hue ad develop at this site which may be unacceptable by beneficiary. So, this procedure is reserved in cases where patch is in an inoperable site.
Treatment on dark spots and normal skin patches on the area of vitiligo
Those who have complete vitiligo on the body or on the face are likely to have dark areas or normal skin areas which look ugly. To treat this pigmented area Q Switch laser treatment can be done so that area appear uniform in color. For this treatment one needs 6-10 session of Q switch Nd:YAG laser.
About Specialist
Dr. Pramod Hari Mahajan
Dr. Pramod Hari Mahajan is a highly esteemed Laser and Cosmetic Surgeon in North Maharashtra. With certification from the Australian Board and over 40 years of experience.
He is a skilled practitioner of advanced cosmetic and laser procedures. As a former Professor of Surgery at M. H. Medical College, Nashik. Dr. Mahajan brings a wealth of knowledge and expertise to his practice, ensuring the highest quality of care for his patients.
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