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Vitiligo |
A clinical count of the vitiligo is varied. It is represented by round or oval, irregular, sharply demarcated white spots. They can be symetrically spaced on the body, mainly around mouth, eyes, genitalia, above joints, v místech zapářky (e. g. inguinae). The course of the vitiligo is unforeseeable, a spontaneous recovery is described at 10 – 20 % of patients. The other way round, new centres can appear after a skin lesion, that´s why it is strongly unrecommended to carry out chemical peeling, lifting, surgical cosmetic operations etc. on patients who suffer from the vitiligo.
A cure for the vitiligo has still been a problem because there is no absolutely effective method. Because the vitiligo is a frequent disease and it can cause psychical disorders and lack of self-confidence, it is necessary to explain the essential of the disease to a patient, to examine him in general and to recomend a cure according to the extent of the vitiligo. The cure includes 1) a cosmetic camouflage, 2) a re-pigmentation, 3) a depigmentation.
1. A cosmetic camouflage is suitable for all those who will hide the white spots for a short time. It is made either by sun-tan creams or by a clinical make-up.
2. A re-pigmentation (renovation of pigmentation) is carried out by means of phototherapy (light-cure) by a UV-light. The phototherapy makes use of a wide or a narrow radiation-spectre, it can be combined with other methods (aplication of those medicaments that make the skin more sensible to the radiation, corticosteroides, etc.). A cure by narow-spectered radiation (308-311 nm) is seen as the most effective one and nowadays, a so-called microphototherapy ( i. e. a radiation confined to the affected centres, by EXCILITE) is preferred. The microphototherapy is suitable for those patients at whom the vitiligo extent is not more than 20 % of body surface. An advantage of this curative method is the fact that the contrast between white and normally coloured skin is not emphasized, total radiation dose is very low thanks to a selective radiation of affected centres, it allows to radiate different body parts with different radiation-intensity and, last but not least, the healthy skin doesn´t get unnecessarily exposed to the UV-radiation effects, so the risk of skin tumour rise is smaller. The radiation is performed once a week.
3. A depigmentation (skin decoloration) is recommended when the vitigo extent is more than 80 % of body surface. However, this curative method causes a permanently higher sensitivity to sun radiation, that´s why it is often used when other re-pigmentation efforts have failed. The depigmentation is performed by means of a high hydrochinone concentration, experimentally by means of lasers.
Certain medicaments (L-phenylalanine, Heline, melagenine, pseudocathalase), a permanent make-up and surgical methods rank also among alternative curative methods.
Thus the vitiligo, a disease that is difficult to accept from a cosmetic view, can be cured or at least its effects can be tempered.
| Monday | 08:30 - 17:00 |
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| Tuesday | 11:30 - 20:00 |
| Wednesday | 08:30 - 17:00 |
| Thursday | 11:30 - 20:00 |
| Friday | 08:30 - 16:00 |
Prague Dermatological Centre, copyright 2007