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Therapeutic approaches to hypopigmentation disorder Dr. Oussama Al Haj-Hussein, Syria
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Hipopigmentation is a lake of pigment in the skin It can be Definitive Albinism or Temporary After Kriotherapy
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Hypopigmentation could be acquired Vitiligo
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Or congenetal Piebaldism
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Hipopigmentation can be generalized Albinism
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Or localized Vitiligo
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The colour of skin Normal skin colour is dependent on hemoglobin, carotenoids and melanin pigment. the major colour determinant is melanin.
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M ost of these disorders are related to the function of Melanocyte, the cell responsible of producing melanin, the major colour determinant.
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Melanocyte is very sensitive towards a lot of effects Medicaments (phenobarbital) Detergent (Phenol) Chemicals (Monobenzyl) Physical effects (Temperature)
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Hypomelanotic areas occur following the resolution of (T cell Lymphoma) Pityriasis Lichenoide
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It may occur in the superficial fungal infection (mistaken for Vitiligo) Pityriasis versicolor
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In inflammatory disorders of the skin there are areas of Hypomelanosis Scleroderma
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Hypopigmentation is seen in Sarcoidosis
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Hypopigmentation is seen in Leprosy
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Hypopigmentation is seen in Syphilis
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Amelanosis is when there is a total lack of melanin in the skin Albinism
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Leukoderma is a white skin and can be due to a variety of etiological factors Keratoderma
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Both allergic and irritant dermatitis can produce secondary Leucoderma Atopic Dermatitis
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Treatment Treatment depends first on removing the effective agent when possible. ( Medicaments, Detergent, Chemicals..)
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No treatment is possible other than prescribing photoprotective creams Treatment of Albinism
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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.
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Sunscreens In sunny climates, the prescription of sunscreens is often necessary
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Photoprotection by Sunscreens Benzylidine campher Dibenzoyl methan Benzophenones Benzimidazoles Cinnamates PABA
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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.
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Narrow band UVB It is more effective than PUVA Therapy
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Topical Psoralens The use of topical applications of Psoralens is hazardous and may result in untoward blistering of the skin
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Topical corticosteroid In some patient, the more potent topical corticosteroid preparations are effective but often at the price of some atrophy.
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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 !
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Grafting The use of grafting techniques minigrafts and autologous cultured melanocytes is interesting
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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.
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The Syrian Society of Vitiligo Arabic English Reviews
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Syria Ugarit (The first alphabet in the world)
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Thank you
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