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Treat leukoderma
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Treat leukoderma

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www.komalclinic.co.in

www.komalclinic.co.in

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    Treat leukoderma Treat leukoderma Presentation Transcript

    • Dr. V. J. Tannu Consultant Dermatologist & Cosmetologist M.D., D. D. V., F. R .S. H. (London) Contact: +91 98231 30197 Email: [email_address] Website: www.komalclinic.co.in
    •  
    • WHITE SPOTS WHITE SPOTS
    • WHITE SPOTS
    • PITYRIASIS ALBA
    • LOSS OF MELANIN melanocyte
    • LEUKODERMA SEEN CLEARLY IN UV LIGHT
    • u v shows progress of the spots
    • Hair dye rubber Ammoniated mercury CHEMICAL LEUKODERMA
    • intrinsic
      • Lack of M S H
      • Increase in melatonin
      • Auto immune against enzyme moiety
      • Allergy
      • Atopy
      • Free radicals
      • Apoptosis (defined death)
      extrinsic
      • Contact with rubber,nylon,mbeh,
      • Tight clothings
      • Antibiotics:strepto, tetra, cipro
      • Photography developers
      • Radiations from t .v and other c r t
      predisposing
      • Family history
      • Septic foci
      • Git and liver problems
      • Trauma
      • Diet deficient in zinc
      • Less of acid in stomach
      • Blood group: B AB
    •  
    • Is it curable ? curable challenging
    • TREAT WHITE SPOTS DEPENDS ON SITE ,AGE , EXTENT
      • NONINVASIVE
      • APPLY PSORALIN LOTIONS
      • ORAL PSORALENS
      • EXPO TO U V L A & NB UVB
      • APPLY / INJECT STEROIDS
      • APPLY TACROLIMUS
      • INVASIVE
      • TATTOO
      • SPLIT SKIN GRAFT
      • PUNCH GRAFT
      • BLISTER GRAFT
      • MELANOCYTE CULTUREAND TRANSFER
    • PUVA THERAPY
      • P : PSORALENS e.g. TAB MELANOCYL, NEOPSORA
      • U V : ULTRA VIOLET
      • A : AROUND 367 NM
      • PATIENT CONSUMES .6 MG/KG PSO
      • 2 HRS LATER EXPOSES TO U V FOR 10 MINUTES (M E D )
      • EVERY WK ONCE
      • EFEECT ENHANCED BY TOPICAL STEROIDS AND ORAL STEROIDS
      • PT GETS PERIFOLLICULAR PIGMENTATION IN 10 EXPOSURES
      • LIMITATIONS ARE : NOT USEFUL ON LIPS ,PALMS
      • CAN CAUSE SEVERE ITCH ,PHOTODERMATITIS
    • P U V A THERAPY : VITILIGO
      • PT CONSUMES 8 MOP .6 MG/KG
      • APLLIES DILUTE PSORALEN LOTION
      • EXPOSES TO UV A TILL MAXIMUM ERYTHEMA DOSE
      • REPEATS RX EACH WK FOR 20 TO 30 EXP
    • PUVA THERAPY
    • PUVA THERAPY
    • U V THERAPY CHANGES
    • Effect of uva therapy
    • PROGRESSIVE BENEFIT P U V A
    • INTRALSIONAL STEROIDS
    • Which therapy for me ?
      • Age:
        • Young adults: P U V A and tachrolimus
        • Adults with slow growth: P U V A
        • Adults with fast growth: Immunosuppressants
        • Old : P U V A ,mtx, psoralens
        • children :oral medication and tachrolimus, steroids for stopping march
        • STABILITY
      • few patches : i.l. inj, surgery,tattooing
        • Unstable few patches: tachrolimus
    • Benefits of aggressive therapy
      • Quick results
      • Can prolong the visits
      • Economical
      • Useful in difficult cases
    •  
    • PUNCH GRFTING ON VITILIGO AREA
      • BIOPSY PUNCH USED TO HARVEST NUMEROUS GRAFTS OF FULL THICKNESS SKIN
      • GENERALLY THE AREA IS FROM GLUTEAL REGION
      • GRATS ARE TEMPORARILY STORES IN SALINE
    • PUNCH GRAFT TECHNIQUE
      • THE HARVESTED GRAFTS ARE IMPLANTED IN SIMMILAR TROUGHS MADE IN THE VITILIGINOUS SKIN AT UNIFORM DISTANCE
      • AFTER IMPLANTING GRAFTS,AREA DRESSED FOR TWO DAYS USING PROPYLELENE GLYCOL
    • PUNCH GRAFT 2
    • PUNCH GRAFT 3
    • SKIN GRAFT PREOPERATIVE SPLIT SKIN GRAFT
    • Dr. V. J. Tannu Consultant Dermatologist & Cosmetologist M.D., D. D. V., F. R .S. H. (London) Contact: +91 98231 30197 Email: [email_address] Website: www.komalclinic.co.in
    • wish you success !!