Hand vitiligo
Vitiligo is a skin disorder shaped spots (macula) of white (hypopigmentation) and looks firm. Vitiligo is sometimes only one spot, could also be some spots in the same area, such as facial area and a member of the body. Sometimes found several spots in different areas and there is someone who is suffering from vitiligo patches almost the whole body. The main problem of vitiligo is cosmetic problem, especially in women. The incidence of vitiligo ranges from 1-8%. Can spread of all races, all ages, and can attack both men and women with the same frequency. Highest incidence (50%) occurred at around 20 years old.
Cause
The cause of vitiligo has not yet clearly known. Allegedly about 20-40% related to hereditary factors (familial). This means that 20-40% of patients have a history of vitiligo in the family. Though the cause is still unclear, experts explain the occurrence of vitiligo through several theories:
- Neurogenic theory. This conjecture is based on observations where vitiligo arises on one side of the body (unilateral), does not pass through the median line of the body and only exist at one or more dermatomes.
- Self destruction theory. This theory is based on the allegation of melanocytes (pigment cells) destruction due to metabolism (metabolites) in the formation of melanin (pigment), especially metabolites of hydroquinone drug class commonly used in the treatment of hyperpigmentation.
- Autoimmune Theory. Hypothesized that disruption of immune system can cause damage to the melanocytes causing hypopigmentation of the skin in specific areas. This is based on the relation of some autoimmune diseases in patients with vitiligo.
Symptoms
Vitiligo is easily recognizable with viewing and checking the signs as follows:
- Found a white spot with clear boundaries, asymptomatic (without complaint), measuring a few millimeters to several centimeters.
- Frequently exposed body areas of vitiligo include fingers, wrists, around the eyes, around mouth, nose, skin shinbone (tibia). Sometimes vitiligo can be found in the genital organs.
- White spots on both sides (bilateral) and can also be symmetrical or asymmetrical.
Factors that allegedly triggered vitiligo are stress, sun exposure, exposure to chemicals. Vitiligo diagnosis is established by recognizing the vitiligo disease history, family history and clinical examination by a doctor. Checks needed to support diagnostic of histopathology examination and biochemical examination. In everyday practice the two examinations are very rarely done because vitiligo is easily recognizable by physical examination by a doctor, by looking at the characteristics of vitiligo.
Treatment
Face treatment
There is no satisfying treatment to cope with vitiligo. Therefore, doctor recommends camouflage to disguise vitiligo, especially in women. Even so, it is recommended to run a treatment according to the examination of skin specialists. Medications commonly used in vitiligo.
- Heliotherapy. This treatment is a combination Trisoralen with sunlight. After treatment, patients are encouraged to avoid sun exposure directly, or using sunscreen.
- Psoralen. Phototherapy with psoralen can be done in two ways, topically psoralen (topical), especially at ages below 18 years. The combination of oral psoralen and topical psoralen (external drug). This method is usually performed on an extensive vitiligo. Use of oral psoralen (methoxsalen) to drink as much as 2 methoxsalen 20 mg capsules (40 mg), two hours before sunbath, three times a week, for six months. The drug will be stopped if there is no progression after six months.
- Orticosteroids. Drugs commonly used including betamethasone valerat 0.1%, applied to one times a day for 3-4 months. Need control from a doctor once a week to evaluate and assess the response of treatment outcomes. The steroid treatment is stopped, if there is no progression after six months.
- MBEH (Mono Benzyl Ether of Hydroquinon) 20%, usually used on an extensive vitiligo (more than 50% skin body surface). These drugs are used if the psoralen did not show satisfactory results. Depigmentation expected to begin occurs after 2-3 months and is expected to be a perfect depigmentation after one year.
- Surgery. This is the last choice if the drug treatment did not work.
