Vitiligo & Allopecia

8/13/2019 Vitiligo & Allopecia

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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 darkerskin.


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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 melaninformation.


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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 immunecells 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/inflammatoryfunctions & 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 - diffuse loss of hair.Alopecia barbae - 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 hairfollicle.

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 ofhair.

Intralesional steroid injection.

Regrowth occurs only in the area that has been

injected. There is no way of preventing newareas of hair loss.

Medicines which are often tried include topical

steroids& minoxidil, irritants such as dithranol.
http://dermnetnz.org/treatments/topical-steroids.htmlhttp://dermnetnz.org/treatments/topical-steroids.htmlhttp://dermnetnz.org/treatments/minoxidil.htmlhttp://dermnetnz.org/treatments/dithranol.htmlhttp://dermnetnz.org/treatments/dithranol.htmlhttp://dermnetnz.org/treatments/minoxidil.htmlhttp://dermnetnz.org/treatments/topical-steroids.htmlhttp://dermnetnz.org/treatments/topical-steroids.html


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Alopecia Areata

One of the mainstays of treatment is intralesional

& topical corticosteroids. Typically, intralesional

triamcinolone acetonide is injected into thereticular 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 thealopecia improves.

Although systemic corticosteroids can lead to hair

regrowth in many cases, hair loss usually recurs

once therapy is discontinued. Therefore, systemiccorticosteroid 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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Immunosuppressive properties.

Decrease response to delayed & immediatehypersensitivity reactions.

Inhibition of toxic effect from antigen & antibody

complexes.


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Immunosuppressive properties.

Inhibiting action of lymphokines, target cells &

macrophages.

Access of sensitized T lymphocytes &

macrophages to target cells are also prevented.

Vitiligo & Allopecia

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