Vitiligo

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Vitiligo
Vitilgo affects nearly 2% of the population. Strikes people between 10 & 30 years old more often. More evident in people with darker skin.
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Vitiligo
All ethnic groups & both sexes are affected Loss of pigment most commonly noted first on the hands, feet, arms, face or lips Disease is progressive.

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Vitiligo
Manifested by acquired progressive loss of pigment resulting from structural & functional metabolic defect of melanocyte system of the skin, resulting in defective melanin formation.
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Vitiligo
Clinical Features
Localised or wide spread.
Scattered or confluent. Small sized macules, oval round & irregular in shape & sometimes in streaks & sheets. Lesions may be unilateral, mostly bilateral & not always symmetrical. Colour of lesions may be milk white.
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Vitiligo
Disfiguring medical disease Cause is unknown Destruction of melanocytes in the skin, mucous membranes, eyes, inner ear & occasionally in hair bulbs. Melanocytes provide the pigment that gives skin its color. Loss of melanocytes alters both structure & function of these organs & results in absence of pigment.
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Vitiligo

Autoimmune disease, where immune cells of body start attacking Melanocytes of selfs body.

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Vitiligo

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Vitiligo
Therapy
Primary goal of therapy is to restore skin's color by restoring melanocytes to the skin. Repigmentation of the skin with melanocytes allows the skin to regain its normal immune/inflammatory functions & improves appearance.
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Vitiligo
Corticosteriods PUVA.

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Alopecia Means loss of scalp hair,

or baldness.

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Alopecia
Related forms of alopecia, based on location & distribution are as follows: Alopecia totalis - loss of all facial & scalp hair. Alopecia universalis - loss of all body hair. Alopecia postpartum - loss of significant hair following pregnancy & is usually temporary. Alopecia diffusa Alopecia barbae - diffuse loss of hair. - affects a man's beard area.

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Alopecia Hair growth cycle

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Alopecia Areata

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Alopecia Areata

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Alopecia Areata
Is an autoimmune disorder characterized by hair loss.
T-cell mediated autoimmune disease of hair follicle. Found equally in men & women. It is the partial loss of hair on the scalp which may result in round bald patches.

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Alopecia Areata
These individuals have no obvious skin disorders or systemic diseases.

Disease can occur at any age, even during childhood & old age, although most cases have their first expression in teen years or early 20s.

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Alopecia Areata
Unfortunately there is not yet any reliable cure for alopecia areata. Luckily the hair usually grows back slowly by itself. Injecting a cortisone medicine into the area of hair loss may speed up the natural regrowth of hair. Intralesional steroid injection. Regrowth occurs only in the area that has been injected. There is no way of preventing new areas of hair loss. Medicines which are often tried include topical steroids & minoxidil, irritants such as dithranol.
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Alopecia Areata
One of the mainstays of treatment is intralesional & topical corticosteroids. Typically, intralesional triamcinolone acetonide is injected into the reticular dermis in very small amounts. Low concentrations are typically injected into eyebrows or facial skin, & the highest concentration is used on the scalp. Proportionately lower doses are used for children.

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Alopecia Areata
A lower mid-potency topical steroid cream may be applied twice daily to affected facial areas. Corticosteroid therapy is slowly tapered as the alopecia improves. Although systemic corticosteroids can lead to hair regrowth in many cases, hair loss usually recurs once therapy is discontinued. Therefore, systemic corticosteroid therapy is seldom used.

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Steroids : Place in therapy in Vitiligo & Alopecia Areata

Anti-inflammatory activity.

Result from decreased formation, release & activity of mediators of inflammation (kinins, histamine, lysosomal enzymes, prostaglandins & leukotrienes).

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Steroids : Place in therapy in Vitiligo & Alopecia Areata

Immunosuppressive properties. Decrease response to delayed & immediate hypersensitivity reactions. Inhibition of toxic effect from antigen & antibody complexes.

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Steroids : Place in therapy in Vitiligo & Alopecia Areata

Immunosuppressive properties. Inhibiting action of lymphokines, target cells & macrophages. Access of sensitized T lymphocytes & macrophages to target cells are also prevented.

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