Vitiligo is a disease that causes the loss of skin in blotches. The extent and rate of color loss from vitiligo are unpredictable. It can affect the skin on any part of your body. It may also affect the hair and the inside of the mouth.


Vitiligo is a skin disorder in which the cells that make melanin pigments are destroyed. The destruction results in the appearance of white patches o the skin. Vitiligo can occur at any age, but usually before the age of 20 in about 50 % of patients.


Normally, the color of hair and skin is determined by melanin. Vitiligo occurs when the cells that produce melanin die or stop functioning. Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin. The condition is not life-threatening or contagious. It can be stressful or make you feel bad about yourself.


There are five main types of vitiligo, which are based upon the location of the white patches and the pattern of involvement, focal, generalized, acrofacial, segmental and universal.


Focal vitiligo: minimal involvement with only one or a very few white patches scattered on the skin.


Generalized Vitiligo: The most common type with symmetrical patches on any location on the skin including the trunk and or extremities.


Acrofacial Vitiligo: White patches limited to the fingers and around the mouth and eyes.


Segmental Vitiligo: White patches on one side of the body and in a linear or line like distribution.


Universal Vitiligo: Widespread patches involving the entire body.


The cause of vitiligo is not well understood. It is believed to be an autoimmune, disorder which means that certain blood cells in your body, lymphocytes, turn against and attack the melanocytes. Another theory is that vitiligo is caused by an interaction between the body nerve cells and melanocytes.


Vitiligo may be associated with other immune disorders. They include Addison disease, alopecia areata, diabetes mellitus, thyroid disease, melanoma, chronic mucocutaneous candidiasis, pernicious anemia, and uveitis.


Skin is made up of many layers, the skin is the largest organ of the body. It protects, maintains the temperature balance, releases out the toxins out of the body in the form of sweat and maintains the equilibrium. It reflects the internal and general health of the person. Unhealthy, dry, discolored and pigmented skin depicts indication for certain medical diseases.


Skin cell contains melanin, a dark pigments that give the color to the skin and protects it from the strong rays of the sun that are particularly harmful. If the melanin is destroyed at a certain part of the body or not produced then the skin looses, its color and turns leave white spots known as Leukoderma or Phulveri in laymen's language. Leukoderma means Leuco- white and derma, the skin is also known as vitiligo in medical terminology. It is also true that all white spots are not of leukoderma.


Children born with congenital absence of melanin have complete white skin of the whole body called Albinism that is a congenital and incurable condition.


Symptoms:


The main sign of vitiligo is patchy loss of skin color. Usually, the discoloration first shows on sun-exposed areas, such as the hands, feet, arms, face, and lips.


Vitiligo signs include:


. Patchy loss of skin color

. Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard.

. Loss of color in the tissues that line the inside of your mouth and nose

. Loss of or change in color of the inner layer of the eyeball



Vitiligo can start at any age, but often appears before age 20


Depending on the type of vitiligo you have, the discolored patches may cover;


Many parts of your body. with the most common type, called generalized vitiligo, the discolored patches often progress similarly on corresponding body parts


Only one side or part of your body. This type, called segmental vitiligo, tends to occur at a younger age, progress for a year or two, then stop.


One of only a few areas of your body. This type is called localized vitiligo.


It's difficult to predict how your disease will progress. Sometimes the patches stop forming without treatment. In most cases, pigment loss spreads and eventually involves most of your skin. Rarely, the skin gets its color back.


Aetiology:



Vitiligo is obscure, the various hypothesis is suggestive of its genesis. Among these the important ones are


. Immune Hypothesis:

Melanocyte destruction and dysfunction or both may result in 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 in melanin synthesis causes melanocyte destruction.


.Dietary deficiency of proteins and cupro minerals is a major factor for causing vitiligo. Serum skin and cerebrospinal fluid copper levels are low in these cases.


. A gastrointestinal disorder like chronic amoebiasis, chronic dyspepsia, and intestinal worms may be additional factors.


. Use of broad-spectrum antibiotics, especially chloramphenicol and streptomycin leads to the appearance of 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 a fast-spreading type of vitiligo proving the theory of Troponeurosis. The emotional crisis may be an additional factor.


. An Endocrinal disorder may be operative, Diabetes, Pernicious anemia, Thyrotoxicosis, Myxoedema, and Addison's disease may be associated with vitiligo.


. Composite Hypothesis- None of the theories alone is entirely satisfactory. The actual mechanism of inhibition or destruction of melanocytes is much more complex than any of these mechanisms suggested.


Precipitating Factors:


. Emotional crisis- Death in the family, loss of a job, sudden shock

. Gastrointestinal tract disorders like worms, Jaundice, amoebiasis.

. Prolonged use of drugs, antibiotics, oral ovulating agents

. Local causes like trauma burns exposure to chemicals etc.

. pathologically: A defect in enzyme Tyrosinase is held responsible for vitiligo. According to some dermatologists, it is a Trophoneurosis and melatonin, a substance secreted at nerve endings inhibits Tyrosinase, thus interfering in pigment formation.


Clinical Presentation of Vitiligo:


Localized type:


Focal- one or more macules in two single areas but not segmented.

Segmental- One or more macules in a dematomal pattern.

Mucosal- Involvement of mucous membranes 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


Precautions:


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


- Maintain good general disease

- It is a non- communicable disease

- Any patch should be thoroughly examined first

- Application of any unconfirmed tropical medication on the skin should be avoided

- Use of synthetic clothes should be restricted

- Avoid excess intake of sour things

- Avoid steroids

- It is a myth that leukoderma occurs by drinking milk over the fish. Thre is no relevance in avoiding anything to eat or drink which is white in color as assumed by some people similarly in cases of jaundice for yellow-colored things.


Homeopathy:


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 color. I have observed in the clinic that there is some definite connection in the patents who are being treated for Hypothyroidism then getting Hypertjyroidism show patches of leukoderma as drugs induced leukoderma.


Miasmatically:


- Syphilitic- Destruction of melanocytes- the predominance

- Psoric - Though in Aphorism 195, Dr. Hahnemann states that in chronic local maladies that are not obviously venereal, 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 diffuses in different parts.


How effective is Homeopathy?


Homeopathy is able to give wonderful and miraculous cures in many of vitiligo. This is due to the fact that homeopathy treatment enhances the natural production of pigments. According to Homeopathic philosophy vitiligo not a disease in itself but an expression of an inner disturbed state of the body. Thus, the cure should occur at a level where things have gone wrong. In order to archive this, the patient is analyzed on various aspects of mental and physical and familial attributes and also a complete study is done on the psychological environment that the patent has gone through in his life.