1.What is vitiligo/leucoderma? Vitiligo is a pigmentation disorder in which special skin cells (melanocytes) that produce the pigment melanin in the skin as well as the tissues (mucous membranes) that line the inside of the mouth, nose, and genital and rectal areas, and the retina of the eyes are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo may also turn white.
2.Symptoms of vitiligo?The typical appearance of Vitiligo is a milky white de-pigmented spot or spots. It may vary from a single white spot to multiple spots. The shape too is a variable. In some cases generalized de-pigmentation observed all over the body. It has a tendency to start as a single spot and gradually grow in size and number. It may present with a single or several spots on limbs or abdomen or back and then spreading to other parts of the body. Some cases showing affection of the muco-cutaneous junctions such as finger-tips, corners of the mouth, private parts, around eyes. The spread of the disorder is usually slow and progressive. Symmetrical appearance on both the sides of the body (say, on the legs, hands, etc.) is common. In rare cases one finds vitiligo spreading all over the body.
Associated Skin Disorders:At times, you may find Vitiligo associated with one or more of the following conditions:
° Alopecia Areata (Loss of hair)
° Premature graying of the hair
° Lichen Planus
° Lichen sclerosus
° Psoriasis
° Halo Naevus
° Ichthyosis
Associated Systemic Disorders:There are several systemic diseases (affecting the entire body system), which are at times associated with Vitiligo:
° Thyroid Disorders (Hypo and Hyperthyroidism)
° SLE (Systemic Lupus Erythematosus)
° Pernicious Anemia
° Addison’s Disease
° Collagen Diseases
° Grave’s Disease
° Diabetes Mellitus
It may be noted that the sufferers of Vitiligo need not be unduly scared of the above disease conditions, as they should not be regarded as the complications of Vitiligo in every case.
3.Causes of vitiligo?The cause of vitiligo is not fully known, but there are several theories. One theory of some substance is that people with vitiligo develop antibodies that, instead of protecting them, turn upon them and destroy their own melanocytes, the special cells that produce the pigment melanin that colors their skin.
Another theory is that the melanocytes somehow attack and destroy themselves. Finally, some people with vitiligo have reported that a single event such as a severe sunburn or an episode of emotional distress seem to have triggered their vitiligo. Events of this nature, however, have not been scientifically proven to cause vitiligo and may simply be coincidences.
Who is affected by vitiligo? About 1 to 2% of people in the world, or 40 to 50 million people, have vitiligo. In the United States alone, 2 to 5 million people have the disorder.
Ninety-five percent of people who have vitiligo develop it before their 40th birthday. The disorder affects all races and both sexes equally.
3.Is vitiligo inherited? Yes, in some cases it is. Vitiligo may be hereditary and run in families. Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder.
There are a sizable number of inherited disorders associated with vitiligo. To illustrate, they include: albinism of the ocular type, autoimmune polyendocrinopathy syndrome, congenital deafness with vitiligo and achalasia, dyschromatosis symmetrica hereditaria, ermine phenotype, familial histiocyctic reticulosis, kabuki syndrome, Letterer-Siwe disease, progressive hemifacial atrophy, progressive vitiligo with mental retardation and urethral duplication, Schmidt syndrome, and the syndrome of spastic paraparesis, vitiligo, premature graying and characteristic facies.
The abundance of genetic diseases associated with vitiligo clearly reflects the fact that there are a number of genes which normally govern the development and wellbeing of the melanocyte.
4.Do the depigmented patches spread? There is no way to predict if vitiligo will spread. For some people, the depigmented patches do not spread. However, the disorder is usually progressive, and over time the white patches often spread to other areas of the body.
For some people, vitiligo spreads slowly, over many years. For others, the diffusion occurs rapidly. Some people have reported additional depigmentation following periods of physical or emotional stress.
5.How vitiligo diagnosed? Important factors in a patient’s medical history include: vitiligo in the family; a rash, sunburn, or other skin trauma at the site of vitiligo 2 to 3 months before depigmentation started; stress or physical illness; and premature graying of the hair (before age 35). In addition, it is important to know whether the patient or anyone in the patient’s family has had any autoimmune diseases and whether the patient is very sensitive to the sun.
The doctor then examines the patient to rule out other medical problems. The doctor may take a small sample (biopsy) of the affected skin and may also take a blood sample to check the blood-cell count and thyroid function. For some patients, the doctor may recommend an eye examination to check for uveitis (inflammation of the front portion of the eye). A special blood test to look for the presence of antinuclear antibodies (a type of autoantibody) may also be done. These evaluations can help to determine if the patient has an additional autoimmune disease.
6.Treatment of vitiligo & homeopathic approach:As a rule, homoeopathy never looks at Vitiligo as a local disease. Vitiligo has been considered as a local expression of a system disturbance. As per the classical homoeopathy, we believe in constitutional prescribing. This calls for individual case study in every case of Vitiligo. There is no single specific remedy for all the cases of Vitiligo. The exact treatment is determined only on in-depth evaluation of individual case.
Constitutional approach:What we understand by the Constitutional Approach in homeopathy is nothing but analysis and evaluation of various factors affecting the human constitution to determine the disease diagnosis and the exact treatment in turn. Every case of Vitiligo calls for study of the patient’s constitution which includes various aspects of his physical aspects as well as the in-depth study of the mental sphere, such as emotions, psychosocial background, behavior and personality pattern, etc.
The homeopathic remedy selected in every case after such a detail study is called the constitutional medicine, which when administered in the correct dose brings about harmony at the constitutional level, stimulating the normal pigmentation and hence induces normal skin coloration. It will be of interest to note that the homeopathy medicines are essentially oral and not in the form of creams, lotions or any local application on the skin.
Diet & Regimen:There are a few instructions for patients regarding their diet in vitiligo especially with mention of what they should avoid during the treatment of vitiligo. Following are some of our observations based on our clinical experience of treating a large number of patients (clinical observations):
Foods that are excessively sour should be avoided. The ascorbic acid in sour foods tends to reduce melanin pigmentation. So the patients should restrict their intake of citrus foods.
Non vegetarian foods are also to be avoided as they act as a foreign body to pigment cells.
Flavoured drinks are to be avoided.
Artificial colours used in various food preparations should also be avoided.
There may not be enough scientific evidence to prove how these foods worsen vitiligo but our clinical experience has shown that many patients report worsening of their vitiligo from these items and hence they are better avoided.
Usually small amounts of milk, for example in tea or coffee, do not cause any problems. Dairy products such as butter, cheese and yoghurt are also well tolerated. If milk is excluded, it should be replaced with low lactose milk or with Soya milk. This should be discussed with a dietician to ensure that the nutritional balance is maintained.
Ginkgo Extract Effective Treatment for Vitiligo:Healthnotes Newswire (August 21, 2003)—Supplementation with a standardized extract of ginkgo (Ginkgo biloba) may help slow the progression of skin depigmentation and actually increase pigmentation in adults suffering from vitiligo, according to a study in Clinical and Experimental Dematology (2003;28:285–7). This is encouraging news for the millions of adults that have to deal with this often difficult to treat condition.
Bahasa Melayu:
Walaupun agak sukar untuk merawat kes-kes vitiligo atau 'balau', jika bintik-bintik puteh dikulit jadi membesar, mungkin istilah Melayu dinamakan 'sopak', namun kita dalam homeopati tetap berusaha untuk merawatnya.
Diantara remedi utama dalam merawat kes-kes in ialah:
Graphite, Mezerium, Rhust Tox., Sulphur., Hydrocytle, Hepar Su;lph., Thuja dan lain-lain.
Perlu diingatkan bahawa rawatan untuk penyakit ini akan makan masa yang agak panjang, Mungkin satu atau dua tahun. Namun sekurang-kurang masih ada harapan untuk merawat !
