Therapeutic approaches to

hypopigmentation disorder

Dr. Oussama Al Haj-Hussein, Syria

Hipopigmentation is a lake of pigment in the skin

It can be DefinitiveAlbinism

or TemporaryAfter 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)..

No treatment is possible other than prescribing photoprotective creams

Treatment of Albinism

Treatment of Vitiligo

The treatment of vitiligo is unsatisfactoryand in most cases the patient is advised toSeek effective cosmetic camouflage for the lesions on exposed skin.

Sunscreens

In sunny climates, the prescription of sunscreens is often necessary

Photoprotection by Sunscreens

Benzylidine campherDibenzoyl methanBenzophenonesBenzimidazoles

CinnamatesPABA

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 mayresult 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 extensiveVitiligo and Only a few areas of hyperpigmentation skin–bleachingcreams, 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

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