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Therapeutic approaches to
hypopigmentation disorder
Dr. Oussama Al Haj-Hussein, Syria
Hipopigmentation is a lake
of pigment in the skin
It can be Definitive
Albinism
or Temporary
After Kriotherapy
Hypopigmentation could be acquired
Vitiligo
Or congenetal
Piebaldism
Hipopigmentation can be generalized
Albinism
Or localized
Vitiligo
The colour of skin
Normal skin colour is dependent
on hemoglobin, carotenoids and
melanin pigment. the major colour
determinant is melanin.
Most of these disorders are related to the
function of Melanocyte, the cell responsible of
producing melanin, the major colour
determinant.
Melanocyte is very sensitive
towards a lot of effects
Medicaments (phenobarbital)
Detergent (Phenol)
Chemicals (Monobenzyl)
Physical effects (Temperature)
Hypomelanotic areas occur following the
resolution of (T cell Lymphoma)
Pityriasis Lichenoide
It may occur in the superficial
fungal infection (mistaken for Vitiligo)
Pityriasis versicolor
In inflammatory disorders of the skin there
are areas of Hypomelanosis
Scleroderma
Hypopigmentation is seen in
Sarcoidosis
Hypopigmentation is seen in
Leprosy
Hypopigmentation is seen in
Syphilis
Amelanosis is when there is a total lack of
melanin in the skin
Albinism
Leukoderma is a white skin and can be
due to a variety of etiological factors
Keratoderma
Both allergic and irritant dermatitis
can produce secondary Leucoderma
Atopic Dermatitis
Treatment
Treatment depends first on removing the
effective agent when possible.
(Medicaments, Detergent, Chemicals..)
Treatment of Albinism
No treatment is possible other than
prescribing photoprotective creams
Treatment of Vitiligo
The treatment of vitiligo is unsatisfactory
and in most cases the patient is advised to
Seek effective cosmetic camouflage for the
lesions on exposed skin.
Sunscreens
In sunny climates, the prescription of
sunscreens is often necessary
Photoprotection
by Sunscreens
Benzylidine campher
Dibenzoyl methan
Benzophenones
Benzimidazoles
Cinnamates
PABA
PUVA Therapy
Treatment with Systemic Psoralens
combined with exposure to sunlight or
to UVA light is effective in some cases
Therapy is continued for at least 6
months, and in some for several years.
Narrow band UVB
It is more effective than PUVA Therapy
Topical Psoralens
The use of topical applications of
Psoralens is hazardous and may
result in untoward blistering of the skin
Topical corticosteroid
In some patient, the more potent topical
corticosteroid preparations are effective
but often at the price of some atrophy.
Skin-bleaching creams
In those patients with extensive
Vitiligo and Only a few areas of
hyperpigmentation skin–bleaching
creams, such as hydroquinone are
of use, under the risk of skin cancer !
Grafting
The use of grafting techniques
minigrafts
and
autologous
cultured melanocytes is interesting
New therapy (Vitix)
Vitix is a new, innovative topical treatment
for Vitiligo with results ranging among the
most effective, and without any reported
side-effects, It is a combination of Catalase
and Superoxide Dismutase.
The Syrian Society of Vitiligo
Arabic English Reviews
Syria
Ugarit (The first alphabet in the world)
Thank
you