VITILIGO                      BY:                      Mohammadreza                      Khademi                      Guil...
DEFINITION         EPIDEMIOLOGY                      CLINICALPATHOGENESIS                     MANIFEST    DDx             ...
DEFINITION                  Macule and Patch Melanocytes dysfunction Acquired Progressive                Author: Moha...
Epidemiology                 0.5-2% global population AGE: Average age: 20 years                 Author: Mohammad Reza...
Pathogenesis                 Multifactorial Genetically Environmentally Forms: Absolute and Relative(DOPA+ melanocyte...
genetically                   Familial and twin studies:   Genetics role in development   Heterogeneous and complex dise...
Clinical features                 Amelanotic macule and patch in milky- chulk white  surrounded by normal skin Lesion’s...
Clinical features Cont.              Develop anywhere, interested in hyper pigmented  area such as :  face , dorsal aspe...
vitiligo                         Facial Vitiligo:  typically involve around eyes and mouth Extremity Vitiligo:  elbows,...
vitiligo                        Acrofacial Vitligo:  preriungual involvement of 1 finger or more P.S. : extremities‘ di...
Author: Mohammad Reza Khademi -           GUMS-Iran
vitiligo                       Difficult diagnose of VTligo without  Wood’s lamp in lightly pigmented @:  palm soles, li...
vitiligo                      CLINICAL VARIANTS:   Poctue’   Inflamatory   Blue   Trichrome ,quadri, penta   IKP(Iso...
Clinical Classification                •SEGMENTAL (CHILD>ADULT)      •NON SEGMENTAL       Author: Mohammad Reza Khademi -...
segmental   Author: Mohammad Reza Khademi -           GUMS-Iran
Clinical Classification                    LOCALIZEDGENERALIZED                         UNIVERSAL        Author: Mohammad...
LOCALIZED                Focal:  1 or more macule w/o segmental distribution Unilateral/Segmental :  one or more macule...
Author: Mohammad Reza Khademi -           GUMS-Iran
Generalized                   Vulgaris:  scattered patches that are widely distributed Acrofacial:  distal extremities ...
Vulgaris  Author: Mohammad Reza Khademi -           GUMS-Iran
Acrofacial   Author: Mohammad Reza Khademi -           GUMS-Iran
Universal                   Complete or nearly complete depigmentation.                 Author: Mohammad Reza Khademi - ...
More than 90% R  generalized             Universal                              Generalized                  localized  G...
Course of disease               Insidious Sun exposure & tanning Case-by-case unpredictable Extension by 2 forms  1.d...
DDx                         chemical or drug-induced ( imatinib) leukoderma, Post inflammatory depigmentation, the leu...
Treatment                     The aims :  1.repigmentation  2.stabilization of the depigmentation process. The choice o...
Treatment                          Corticosteroids    topical,injection,class    Topical calcineurin inhibitors    Tacr...
Treatment                           Surgical therapy  resistance /autolog graft Micropigmentation  iron oxide tattoo D...
ANY QUESTION???         Author: Mohammad Reza Khademi -                    GUMS-Iran
Upcoming SlideShare
Loading in …5
×

Vitiligo,by Mohammadreza Khademi,GUMS-IRAN

1,173 views
868 views

Published on

Published in: Health & Medicine
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,173
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
27
Comments
0
Likes
3
Embeds 0
No embeds

No notes for slide

Vitiligo,by Mohammadreza Khademi,GUMS-IRAN

  1. 1. VITILIGO BY: Mohammadreza Khademi Guilan university- IRANAuthor: Mohammad Reza Khademi - GUMS-Iran
  2. 2. DEFINITION EPIDEMIOLOGY CLINICALPATHOGENESIS MANIFEST DDx TREATMENT Author: Mohammad Reza Khademi - GUMS-Iran
  3. 3. DEFINITION  Macule and Patch Melanocytes dysfunction Acquired Progressive Author: Mohammad Reza Khademi - GUMS-Iran
  4. 4. Epidemiology  0.5-2% global population AGE: Average age: 20 years Author: Mohammad Reza Khademi - GUMS-Iran
  5. 5. Pathogenesis  Multifactorial Genetically Environmentally Forms: Absolute and Relative(DOPA+ melanocyte) Author: Mohammad Reza Khademi - GUMS-Iran
  6. 6. genetically  Familial and twin studies: Genetics role in development Heterogeneous and complex disease Wide genome linkage analysis: Lucus and genes involved in A. Immune and immune sys Author: Mohammad Reza Khademi - GUMS-Iran
  7. 7. Clinical features  Amelanotic macule and patch in milky- chulk white surrounded by normal skin Lesion’s shape: oval , round , irregular , linear Convex border , enlargement centrifugally , rapid or slow size : mm to cm Diagnostic aid by 1.Wood’s lamp 2.Tanning Pruritis in some cases Most of time Asymptomatic Author: Mohammad Reza Khademi - GUMS-Iran
  8. 8. Clinical features Cont.  Develop anywhere, interested in hyper pigmented area such as : face , dorsal aspect of hand , nipples , axillary , umbilical , sacral , inguinal and anogenital Friction, frequent trauma, pressure seen in many sites of common vitiligo Author: Mohammad Reza Khademi - GUMS-Iran
  9. 9. vitiligo  Facial Vitiligo: typically involve around eyes and mouth Extremity Vitiligo: elbows, digits, flexor wrist knee,dorsal ankles ,shins Author: Mohammad Reza Khademi - GUMS-Iran
  10. 10. vitiligo  Acrofacial Vitligo: preriungual involvement of 1 finger or more P.S. : extremities‘ distal and face involvement Scalp vitiligo: 1 or more localized patches of white-gray hair which can be scattered Author: Mohammad Reza Khademi - GUMS-Iran
  11. 11. Author: Mohammad Reza Khademi - GUMS-Iran
  12. 12. vitiligo  Difficult diagnose of VTligo without Wood’s lamp in lightly pigmented @: palm soles, lips, oral mucosa. Leukotrichia of body varies from 10 to >60 % Author: Mohammad Reza Khademi - GUMS-Iran
  13. 13. vitiligo CLINICAL VARIANTS: Poctue’ Inflamatory Blue Trichrome ,quadri, penta IKP(Isomorphic Koebner phenomena) Author: Mohammad Reza Khademi - GUMS-Iran
  14. 14. Clinical Classification  •SEGMENTAL (CHILD>ADULT) •NON SEGMENTAL Author: Mohammad Reza Khademi - GUMS-Iran
  15. 15. segmental Author: Mohammad Reza Khademi - GUMS-Iran
  16. 16. Clinical Classification  LOCALIZEDGENERALIZED UNIVERSAL Author: Mohammad Reza Khademi - GUMS-Iran
  17. 17. LOCALIZED  Focal: 1 or more macule w/o segmental distribution Unilateral/Segmental : one or more macules involving a unilateral segment of the body lesions usually stop abruptly at the midline Mucosal: mucous membranes alone Author: Mohammad Reza Khademi - GUMS-Iran
  18. 18. Author: Mohammad Reza Khademi - GUMS-Iran
  19. 19. Generalized  Vulgaris: scattered patches that are widely distributed Acrofacial: distal extremities and face Mixed: various combinations of segmental, acrofacial and/or vulgaris distribution pattern Author: Mohammad Reza Khademi - GUMS-Iran
  20. 20. Vulgaris Author: Mohammad Reza Khademi - GUMS-Iran
  21. 21. Acrofacial Author: Mohammad Reza Khademi - GUMS-Iran
  22. 22. Universal  Complete or nearly complete depigmentation. Author: Mohammad Reza Khademi - GUMS-Iran
  23. 23. More than 90% R generalized  Universal Generalized localized Generalized Localized Universal Author: Mohammad Reza Khademi - GUMS-Iran
  24. 24. Course of disease  Insidious Sun exposure & tanning Case-by-case unpredictable Extension by 2 forms 1.development of existing 2.new depigmented area Natural course;usually slowly but can be rapid Some degree of sun-induced or spontaneous repigmentation not uncommon but complete and stable spontaneous repigmentation is rare. Author: Mohammad Reza Khademi - GUMS-Iran
  25. 25. DDx  chemical or drug-induced ( imatinib) leukoderma, Post inflammatory depigmentation, the leukodermas associated with melanoma and scleroderma late stages of treponematosis & onchocerciasis. stage III halo nevus A nevus depigmentosus post inflammataory hypopigmentation, pityriasis versicolor,other cutaneous infections Author: Mohammad Reza Khademi - GUMS-Iran
  26. 26. Treatment  The aims : 1.repigmentation 2.stabilization of the depigmentation process. The choice of therapy depends on : extention, location, activity of disease , age, skin type and motivation to undergo treatment. The effectivity of A treatment needs to 2-3 month Author: Mohammad Reza Khademi - GUMS-Iran
  27. 27. Treatment  Corticosteroids topical,injection,class Topical calcineurin inhibitors Tacrolimus,Pimecrolimus Photo(chemo) therapy: UVB,PUVA,Sunbath Lasers: Excimer laser and lamp, Helium neon laser, Author: Mohammad Reza Khademi - GUMS-Iran
  28. 28. Treatment  Surgical therapy resistance /autolog graft Micropigmentation iron oxide tattoo Depigmentation Author: Mohammad Reza Khademi - GUMS-Iran
  29. 29. ANY QUESTION??? Author: Mohammad Reza Khademi - GUMS-Iran

×