What is vitiligo?
There are pigment producing cells in our skin (melanocytes)
which give color to skin, because of some defects
these cells either become dormant/dead resulting in
producing less or no pigment. So there is formation
of white patches on the skin.
There is only loss of pigment in that area otherwise
skin is healthy.
It can affect any age and sex regardless of race.
It is more noticeable in dark skin color.
What causes vitiligo?
The exact cause of vitiligo is unknown, but it is
often considered to be a combination of genetic,
immunologic and environmental factors. This means
that some people may have a greater tendency to
develop the disease when exposed to the right
trigger.
Is Vitiligo communicable?
Absolutely not. It can not be transmitted from
person to person. However possibility of genetic
transmission can not be ruled out
What treatments are available for vitiligo
patients?
The goal in treating vitiligo is based on two basic
approaches- either we try to restore the normal
pigment in the vitiligo patches by medicines or
surgery or we try to destroy the remaining pigment
cells if the most of body surface area has lost the
pigment called depigmentation therapy.
Treatment choices for vitiligo are based on the
number of white patches you have and how widespread
they are. Each person responds differently to
treatment, and a particular therapy may not work for
you.
Treatment modalities for vitiligo can be divided
into Medical and surgical treatment.
What are medical treatments for Vitiligo?
There are lots of medical treatments which can be
given for oral use or for topical use. Just to name
a few Psoralens, steroids, calcipotriene,
Ultraviolet light therapy etc.
When do patients need surgical treatment?
Surgical treatment is needed when in spite of best
medical treatment the lesions have become
recalcitrant and stable (not responding to
treatment).
So, if lesions are stable i.e. neither increasing in
size nor new lesions are appearing the surgical
treatment is indicated.
What is done in surgical treatment?
In surgical treatment the non pigmented skin is
replaced by pigmented skin from the patient body
itself called skin grafting.
There are different types of skin grafting-
-
Therisch grafting
-
Punch skin grafting
-
Suction blister grafting
There are few drawbacks in above two techniques e.g.
scarring and donor site, mismatch of color and
texture and recipient, cobblestone appearance.
Infection etc.
Suction blister grafting is best among all the
options.
What is done in Suction blister grafting for
Vitiligo?
With the help of specially designed apparatus pieces
of skin is removed from the patient depending on
size of lesion. Patient has to lie down on the table
comfortably for 1-3 hours depending on the time of
blister formation (which varies from person to
person, age and site). After blister is formed, it
is removed and applied on the lesion after removing
the non pigmented skin of lesion.
From which donor site skin is removed for suction
blister grafting in vitiligo?
It can be removed from thighs, buttocks etc.
Is the procedure painful?
No it is least painful. However Local anesthesia is
given at the site. Patient can listen to music
comfortably during the procedure.
Is there any complication if this procedure?
It is a procedure with least complications. Minor
complications are infection on site and graft
rejection. They can be managed easily later on.
When dressings are removed?
Dressing at donor site can be removed after 2-3 days
but of recipient site it is kept 5-7 days.
Can a person do daily activities and go to work.
Absolutely he/she can do everything. He/she has to
avoid wetting the dressing. Some time special
precautions are needed depending on the operative
site. This technique offers Drive in and Drive out
concept.
Is there any color mismatch after procedure?
As for as color match is concerned, it is the best
technique among all where there is absolute color
match after this procedure. After some time no one
is able to recognize that some procedure was done on
site or not.
Is there any scarring on the donor site (site
from where skin is removed)?
This technique does not cause any scarring on
Donor site. We can have repeated grafts from same
site.
Minor skin abrasions on donor site heal within 7-10
days.
Is color permanent with this technique?
Permanency of color cannot be guaranteed with any
technique. May it be medical or surgical. It depends
on the activity/non activity of disease process. Any
surgical treatment is done only after the stability
of disease process is confirmed.
