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Common skin problem

A patient with vitiligo before treatment...	...after treatment.

Vitiligo patients most often try out different systems of medicine, but homoeopathy can cure this disorder, says DR. GNANA SAMBANDAM.

VITILIGO is the most common skin disorder in the world. This non- infectious ailment appears as white patches all over the body, symmetrically or asymmetrically. Leucoderma is localised to a part of the skin whereas vitiligo affects the entire body.

The person affected has often to face stigma.

"Melanin" is what gives our skin its natural colour. Thus whenever Melanocyte ceases to function, the skin becomes white. The Melanocyte Stimulating Hormone (MSH) is secreted from the pituitary gland which controls pigment cell function. Vitiligo holds three prominent theories - the auto immune, self destruct and neural. Abnormal nerve cells may injure pigment cells; the body might be destroying its own tissue as an auto immune response because it perceives the pigment cells to be foreign; or the pigment cells may leave an auto toxic substance that destroys the new pigment cells.

Heredity plays a major role in the aetiology of cases of vitiligo. Clinically, this disease may be associated with some other ailments such as diabetes mellitus, thyroid or endocrine disorders and anaemia.

Gastrointestinal disorders too play a role. A past history of typhoid, jaundice and amoebic dysentery has been quoted. Physical and chemical agents are responsible for localised lesions. Leucodermal patches may appear as a result of an over indulgence with chemicals and physical stimuli. I have found clinical cases of white skin because of patients wearing rubber chappals, synthetic innerwear and tight clothing. In cases of burns, hypopigmentation occurs. The inflammatory process of psoriasis and eczema can interfere with the melanin synthesis in a few patients who report white discoloration of the skin.

Prolonged indication is also found to produce pigmentary disorders. Emotional and physical stress may precipitate the ailment. In many cases we often have no clues why one develops vitiligo.

Diagnosis of vitiligo does not need special investigation. It is visible to the naked eye. Normally white patches appear in two ways. In some cases the discoloration may appear symmetrically on the lips, fingertips, toes, around the eyes, the armpits, the areola of the nipple and private parts. Progression is very slow.

In the other type, the hypopigmentation starts asymmetrically as a single or multiple lesion.

The face, limbs, abdomen and the back are affected. In some patients the depigmented part remains the same size for years together. Sometimes it spreads rapidly. Hypopigmentation starts as a small brown spot and is trichromic. Fungal infections such as Taenia alba and Taenia versicolar which look like vitiligo patches require differential diagnosis.

There is no sensory and motor dysfunction. Whatever the cause, the disease is never life threatening. Normally sunlight promotes the pigmentation. Vitiligo patients are unable to withstand sunlight as it could produce blisters on over exposure.

Ascorbic acid tends to reduce melanin pigmentation. Clinically, dietary regulations are necessary. Latest clinical research shows that non-vegetarian food has to be avoided too as it acts as a foreign body to pigment cells.

In treatment, vitiligo patients move from one system to another. Clinical studies have shown that homoeopathy can cure this disease. If we browse internet websites on vitiligo many are on homoeopathy.

We cannot treat vitiligo as a local malady as other systems of medicines do. External applications with creams and ointments, exposure to sunlight and ultraviolet rays will not help restore normal body chemistry. Pigmentation appears with external treatment, but soon vanishes. These white patches are the local expression of internal derangement.

The next point is the duration of treatment. Normally the small patches respond very quickly rather than the generalised spread. Dark complexioned patients develop pigmentation very quickly. I have seen an improvement within four months in most cases. The length of treatment should be considered for over six months to one year or more.

The writer is a homoeopathic consultant and is based in Chennai.

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