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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