VITILIGO poster

1. INTRODUCTION
VITILIGO - A HOMEOPATHIC PERSPECTIVE
BACKGROUND
Based on dermatological outpatient
records, the incidence of vitiligo is found to
be 0.25-2.5% in India.Vitiligo occurs world
wide with an overall prevalence of
1% The highest incidence of the
condition
has been recorded in Indians from the
Indian subcontinent, followed by Mexicans
and Japanese.There is a stigma attached
to vitiligo and affected persons
and family.This disorder does not result
in restriction of capacity to work or
expectancy of life, but it
causes cosmetic disfigurement leading
to psychological trauma to the
patients.The spread of the disease
can be arrested and substantial amount of
repigmentation can be achieved in majority
of patients who undergo appropriate
treatment.
This paper unearthes homeopathic
treatment as a most viable treatment
modality in vitiligo .
Vitiligo is an acquired autoimmune
depigmentary condition characterized by
appearance of chalky or milky white
macules with well defined margins of
varying sizes and shapes.It has familial
predisposition. It is the only skin disease
which does not itch, pain or give any kind
of physical discomfort.
AIMS AND OBJECTIVE
Study design and settings
80 self reporting vitiligo patients attending out patient
department of a hospital were selected for the study.
It was a observational, descriptive study done in OPD of
SHMC.for a period of three yrs (April 2010 to march 2013.)
INCLUSIVE CRITERIA
Well diagnosed cases of vitiligo were taken for study. The
patients reported in three different stages:
V1 – Active stage, lesion size increasing and borders ill-defined
and hypo pigmented.
V2 - No new lesion, lesions stationary in size. Static stage.
V3- Lesions decreasing in size, no new lesion, re-pigmentation
of margins which become well defined. It is a recovery stage.
EXCLUSIVE CRITERIA
Albinism
Nevus achromicus
Tenia versicolor
Leprosy
Pityriasis alba
Lichen scelerosis
Piebaldism
Data collection The demographic and clinical data of the
patients were collected using a data collection form and also
from the medical records of patients.
MATERIALS AND METHODS
1) To highlight the efficacy of homeopathic medicines in
achieving and maintaining the remission state in natural
course of vitiligo.
2) The objective of the present study was to assess the
prevalence, precipitating factors clinical features
and concomitant disease in vitiligo patients.
CASES
Sulphur 200
Natrum mur 200
Lachesis 200
Natrum mur 200

2. The earliest onset was at 2 years of age,
whereas the latest was at 60 years of age.
Majority of the patients (45%) were in the
age group of 21-40yrs followed by
2-20yrs (37%) at time of onset of vitiligo.
Duration of the disease at the time
of presentation varied from
2 months to15 years.
Most cases (56.2%) were less than
5 years duration, regardless of
sex.Around8.8% patients had family
history of
vitiligo
First degree relatives (parents/ brother/
sister/ children) were affected in 6% of
the study population and second
degree relatives (grand parents/ maternal
and / or paternal uncle/aunt) in 2.8% of
patients. Positive family history
is considered to be a poor prognostic facto
r for vitiligo
Negative family history 91.2%.
Major precipitating factor of vitiligo
was found to be physicaltrauma/ injury
(18.8%).followedby emotional
trauma (16.2%),chemicals / drugs
(3.8%), footwear
(1.3%), pregnancy (1.3%) etc.
A record was made of the precise
distribution of lesions, and the clinical staging was
done as V1,V2 and V3.
Study approval
The study protocol was approved by Delhi
Homeopathic Anusandhan paris
RESULTS & DISCUSSION
Of the 80 patients Females (52.5%)
were affected more than males (47.5%)
giving a male female ratio of 1.1:1. The incidence
of 1.3% obtained in the present study of vitiligo
corresponds to the observations made by different
authors
Though vitiligo affects both sexes equally,] most of
the studies. show a female preponderance. The
cause of female preponderance in most of the
studies is probably because of a greater cosmetic
awareness among females.
Of the 80 patients, 32.5% of the study
population was within the age group of 21-40
years while 31.3% were within the age group
of 2 – 20yrs and 12.4% in 41- 60 years age
group .
The youngest patient was 4 years old and
the oldest was 65 years. .
MATERIALS AND
METHODS
Lycopodium 30
Lachesis 200
Tuberculinum
CASES
VITILIGO - A HOMEOPATHIC PERSPECTIVE
Flouric acid 30Lyco 200

3. Associated systemic(autoimmune) and cutaneous diseases
were observed in 38.8% of the patients.Thyroid disease being
the most common(17.3%) followed by diabetes mellitus (15.8%).
Association of Koebner phenomenon was observed in 20%
of the patients which is a common feature of active stage
(progressive) .
The associated cutaneous diseases noted in this study were
Alopeciaareata (12.5%), leukotrichia (6.3%). Leukotrichia is
considered to be a poor prognostic,factor.,atopic dermatitis (3.8
%),pruritis in (2.3%).
The distribution pattern of lesions which denotes the clinical
types of vitiligo were.
Vitiligo vulgaris / generalized vitiligo(53.7%) the most
common morphological pattern. Other patterns seen were
focal vitiligo (18.8%)
acrofacial vitiligo (13.8%),
segmental vitiligo (8.8%),
mucosal vitiligo (3.8%)
The most common site of onset of vitiligo lesion was
lower limbs (42.5%), followed by face (27.5%), upper limbs
(13.8%), finger
tips (7.5%), trunk (3.8%), scalp (2.5%), and genital mucosa (2.5
%) in the descending order of frequency
Drug analysis:
Medicines found to be most effective
Nat Mur=42% cases Pulsatilla=28%
Lycopodium=8 % arsenic album=6%
Sulphur=17% Tuberculinum-6%
Sepia=4 Medorrhinum=4%
Lachesis=3% Natrum silicate=2%
Nux Vom=2% Baryta sulph=2%
23%of patients shifted fromV1 to V2, 42%from V2 to V3 and
12% remained static in V2stage.92%patients completed the
study.52%of patients went into remission and there was no
appearance of new lesion and spread of old lesion for a
minimum period of 6 months.8% of patients had remission
of as long as period of 2 yrs.
CONCLUSION
This study shows the efficacy of
Homoeopathic medicines in
achieving remission, preventing
recurrence and checking its
further progression.
Prospectus for future: To study the
role of homeopathic medicines as
immunomodulators in the natural
course of vitiligo.
Key words: depigmentation,
autoimmunity, leucotrichia, koebners
phenomenon, constitutional
treatment, repigmentation,
remission,concomitant disease
ACKNOWLEDGEMENT
I express my gratitute to Dr V.K
Chauhan,principal,SHMC for his
constant support and encouragement
throughout the project.
I am thankful to Dr S.N.Jana,(co
guide) ,Drs pavneet,arushi
,kalpna,meenakshi parvez,neha
richa,himanshuand manu interns
who have helped me in the OPD.
Dr Neena Mehan
Asst.professor
Department of medicine,SHMC
Project guide
Sepia 200
Natrum mur 200
Calcarea silicata
Staph 200