Leucoderma / Vitiligo

Leucoderma means Leuco – White and Derma – Skin also known as Vitiligo in medical terminology. It is a skin disorder where the skin loses its normal color. Also known as Phulveri in layman’s language. As such it is hardly a disease of medical significance but more of a social stigma attached to it because of cosmetic reasons. As patients usually do not have any complaints like pain or itching etc. with less Melanin formation there is a loss of pigment on the skin.

Causes

Though the exact cause of Leucoderma is not known to the medical world still Stress, and General Low Immunity level and Hormonal connection are considered certain precipitating factors for this ailment. Other precipitating factors have been identified as due to pressure of tight clothes or certain occupational hazards such as wearing certain rubber hand gloves Use of Bindi etc. The Occurance of leucoderma about 42 %, is Stress related , 28% Heriditory and 30%. Is Worms infested.

Symptoms

Leucoderma patch may start as a small white colored almost milky patch which keeps on increasing in varying size and shapes. Patches are usually uniform in colour with well demarcated edges because of peripheral hyperchromia. It may occur anywhere on the body or all over the body but still the commonest sites are around lips, on cheeks, bilaterally distributed on legs, hands, fingers, chest or back around the eyes and even on the head. A single white strand of hair could be the first sign of vitiligo on the scalp. Few patients have these patches around or over the joints like elbow, knee etc. Most of the times people get scared of any white patch on the body and fear it to be leucoderma, but any and every white patch is not of leucoderma they can be because of Liver disorders, Worms ,Taenia infection, Calcium deficiency Injury or burns spots or even Leprosy. As such patient of leucoderma does not have any problem or symptoms like Itching, Pain, Discharge etc. whatsoever but still the patient seek treatment for cosmetic reasons. Though the aetilogy of vitiligo is obscure, various hypothesis are suggestive of its genesis . Among these the important ones are:-

Immune Hypothesis – Melanocyte destruction and dysfunction or both may result into Hypopigmentation of vitiligo.
Neural Hypothesis – Neurochemical inhibitors are released at nerve endings that destroy the melanocytes or inhibit their functioning.
Melanocyte Self-Destruction Hypothesis – Proposes that an intermediate inmelanin synthesis causes melenocyte destruction.
Dietary deficiency of Proeins and Cupro minerals is a major factorfor causing vitiligo. Serum skin and cerebro-spinal fluid copper levels are low in theses cases.
A gastro-intestinal disorder like Chronic amoeboisis,chronic Dyspepsia and Intestinal Worms may be additional factors.
Use of Broad spectrum Antibiotics ,especially Chlormphenicol and Streptomycinleads to appearanceof vitiligo.
Trauma or Local irritation caused by wearing the sari or Trousers too tightly do produce vitiligo in individuals predisposed to it.
Acute Stress may be followed by fast spreading typeof vitiligo proving the theory of Troponeurosis. Emotional crisis may be an additional factor.
An Endocrinal disorder may be operative,Diabetes, Pernicious anaemia, Thyrotoxicosis, Myxoedema, and Addison’sdisease may be associated with vitiligo.
Composite Hypothesis – None of the theories alone is entirely satisfactory. Actual mechanism of inhibition or destruction of melancytes is much more complex than any of these mechanisms suggested.

Precipitating Factors:-

Emotional Crisis – Death in family, Loss of job , Sudden shock etc.
Gastro intestinal tract disorders like Worms, Jaundice, amoeboisis etc.
Prolonged use of Drugs ,antibiotics,Oral anovulating agents etc.
Local causes like trauma,burns exposureto chemicals etc.

Pathologically :- A defect in enzyme Tyrosinase is held responsible for vitiligo. Acording to some Dermatologists, it is a Trophoneurosis and Melatonin, a substance secreted at nerve endings inhibits Tyrisinase, thus interfering in pigment formation. Clinical Presentation of Vitiligo. Localised Type:-

Focal – One or more maculesin two single areas but not segmented.
Segmental – One or more macules in a dermatomal pattern.
Mucosal – Involvement of mucous membrane alone.

Generalized Type :-

Acrofacial – Involvement of face and distal extremities.
Vulgaris – Scattered macules in symmetrical or asymmetrical distribution.
Universalis- Total or nearly whole body involvement.

Manage

There are certain precautions which can dealy or stop the onset of the disease.

Maintain good general health and immunity.
It is a non communicable disease.
Any patch should be thoroughly examined first.
Application of any unconfirmed tropical medication on skin should be avoided.
Use of synthetic clothes should be restricted.
Avoid excess intake of Sour things.
Avoid Steroids.

It is a myth that leucoderma occurs by drinking milk over the fish. There is no relevance in avoiding anything to eat or drink which is white in colour as assumed by some people similarly in cases of Jaundice for Yellow coloured things.

Approaches

Allopathy - Commonest drug used is Psoralen , Melanocyl etc to be use locally followed by sun exposure. In few cases oral Antioxidants are also being used. The latest application of Placentex is also used.UltraViolet Rays exposure or PUVA. Ayurveda - Local application of Babchi Oil over the depigmented areas, Use of Coper utensils. Others - Applying Coloured Dyes, Silver Nitrate etc . Latest being permanent Colouring. Surgical measures- Grafting etc. Homoeopathy - Though Vitiligo has always puzzled physicians of all systems of medicine. However, Homoeopathy system offers reasonably positive treatment if not cure in all the cases. Since it offers a comprehensive treatment as it goes to the root of the problem by helping build up immunity and eventually restores the pigmented patches back to the normal skin colour. I have observed in my clinic that there are some definite connection in the patients who are being treated for Hypothyroidism then getting Hyperthyroidism show patches of leucoderma as drugs induced leucoderma. As a rule, homoeopathy never looks at Vitiligo as a local disease. Vitiligo has been considered as a local expression of a system disturbance hence a constitutional remedy has to be evolved, which calls for individual case study in every case of vitiligo. There is no single specific remedy for all the cases of vitiligo. The exact treatment is determined only on in-depth evaluation of individual case. Miasmatically Syphlytic ( destruction of melanocytes) predominance Psoric - Though in Aphorism 195, Dr.Hahnemann states that “In chronic local maladies that are not obviously veneral, the internal antipsoric treatment alone requisite’ suggests that it is Psoric in nature. Sycotic - As sycosis is the miasm which disturbs the pigment metabolism and produces hyperpigmentation and depigmentation in patches or diffuse in different parts. Is Vitiligo curable with homoeopathy ? The answers is Yes and No both as seen in my clinical study at our center, it can be said that it depends on the following criteria :

Duration of vitiligo
Extent of spread

Duration of vitiligo: Those cases of recent origin respond much better than ones which are more than 10 years old duration. Children and young people have shown better results. Extent of spread: Single or some spots ( 2 to 9) respond better than those which are very large ( more than 5 inches in size). Those individuals having a only a single spot have excellent cure rate. The cases with generalised spread and affection of finger- tips, toes, corners of the mouth and eyes have shown partial results . What is the duration of treatment ? Vitiligo being a chronic and long-standing disorder, it takes time to show results. Larger and older spots take longer time. Exact time can not be predicted. However, improvement begins within 2 to 3 months in most cases. The cases which are to improve show the difference and the cases which do not show any response in this period seldom show improvement later on . Can homoeopathy treatment be taken with other therapy ? Yes , homoeopathic treatment can be taken simultaneously with other therapies e.g intake of Antioxidants PUVA exposure or the application of Placentex etc. these can enhance the progress of treatment.

Investigation

Complete haemogram
Serum Clcium
ECG, Echocardiogram
Stool Analysis

Testimonials

Leucoderma / Vitiligo

Leucoderma cured with Homoeopathy It was a matter of tremendous concern to notice white patches in April ’2003 on the body of my 5 months old son till I contacted ayurvedic dermatologist at Guna (MP) and when he told that the white patch is of Vitiligo, commonly known as Leukoderma. Then I frantically looked for took appointments from dermatologists at Sir Gangaram Hospital New Delhi and Leelavati Hospital Mumbai and they also endorsed the view of the doctor at Guna. It was confirmed that this was vitiligo. It was also told to me that it is not a coincidence but since my brother has vitiligo, it’s hereditary. And of course there were so difficult and unproven treatments available in allopathy, I was completely confused and confounded. I started the allopathic treatment as I never wanted my kid to have such disease. One day I came across the website of OVIHAMS where I read about Dr Gupta. I called him up from Guna (MP) and took his appointment somewhere around in June 2003. I came to Delhi especially to consult him and Dr Gupta after a long discussion and review of previous prescriptions diagnosed the ailment as vitiligo and said that “I will correct it”. The treatment started and within 6 months i.e. by Dec’2003 the patches at armpits, around neck folds, groins, back of knee were recoloured upto around 40%. I sent the photographs to him and the treatment continued. Meanwhile I also got transferred to Mumbai but the treatment continued. Today the coloring of the area is almost 90% complete (treatment still continues) and only when you see very minutely you can ascertain some very dim patches. Now my son has completed 2 years and I have no hesitation in saying that Dr Gupta has really done a commendable job by treating Vitiligo of my son. I am really thankful to him and wish him all the very best in his service to the patients suffering from skin diseases. God Bless All. (Girija Shankar) Mumbai 14-Feb-2005 GIRIJA SHANKAR Mumbai

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