1. Therapeutic approaches to hypopigmentation disorder Dr. Oussama Al Haj-Hussein, Syria

2. Hipopigmentation is a lake of pigment in the skin It can be Definitive Albinism or Temporary After Kriotherapy

3. Hypopigmentation could be acquired Vitiligo

4. Or congenetal Piebaldism

5. Hipopigmentation can be generalized Albinism

6. Or localized Vitiligo

7. The colour of skin Normal skin colour is dependent on hemoglobin, carotenoids and melanin pigment. the major colour determinant is melanin.

8. M ost of these disorders are related to the function of Melanocyte, the cell responsible of producing melanin, the major colour determinant.

9. Melanocyte is very sensitive towards a lot of effects Medicaments (phenobarbital) Detergent (Phenol) Chemicals (Monobenzyl) Physical effects (Temperature)

10. Hypomelanotic areas occur following the resolution of (T cell Lymphoma) Pityriasis Lichenoide

11. It may occur in the superficial fungal infection (mistaken for Vitiligo) Pityriasis versicolor

12. In inflammatory disorders of the skin there are areas of Hypomelanosis Scleroderma

13. Hypopigmentation is seen in Sarcoidosis

14. Hypopigmentation is seen in Leprosy

15. Hypopigmentation is seen in Syphilis

16. Amelanosis is when there is a total lack of melanin in the skin Albinism

17. Leukoderma is a white skin and can be due to a variety of etiological factors Keratoderma

18. Both allergic and irritant dermatitis can produce secondary Leucoderma Atopic Dermatitis

19. Treatment Treatment depends first on removing the effective agent when possible. ( Medicaments, Detergent, Chemicals..)

20. No treatment is possible other than prescribing photoprotective creams Treatment of Albinism

21. 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.

22. Sunscreens In sunny climates, the prescription of sunscreens is often necessary

23. Photoprotection by Sunscreens Benzylidine campher Dibenzoyl methan Benzophenones Benzimidazoles Cinnamates PABA

24. 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.

25. Narrow band UVB It is more effective than PUVA Therapy

26. Topical Psoralens The use of topical applications of Psoralens is hazardous and may result in untoward blistering of the skin

27. Topical corticosteroid In some patient, the more potent topical corticosteroid preparations are effective but often at the price of some atrophy.

28. 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 !

29. Grafting The use of grafting techniques minigrafts and autologous cultured melanocytes is interesting

30. 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.

31. The Syrian Society of Vitiligo Arabic English Reviews

32. Syria Ugarit (The first alphabet in the world)

33. Thank you