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Skin Care and Diseases

Vitiligo/4years/Toal Depegimentation includin

03/09/2006

Question:

The old adage "the drowning man catches at a straw" in a way describes my situation and explains the reason why I write this note to you. I first wrote to National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894 whose Customer Service has, in turn, advised me to get hold of "A Handbook for Patients with Vitiligo" through which I found your name and address as appropriate consultative authority for Vitiligo Patients seeking help and guidance.

My 49 year old wife contracted vitiligo 4 years ago. Sadly, since then depigmentation has spread over her entire body discoloring even her hairs. She has received the UVB therapy twice when she first contracted vitiligo, but later decided to discontinue. I will be very grateful for any advice from your side in this regard or, alternatively, if you could direct me to where my wife could receive appropriate help. We are now both living in total darkness, and would therefore like to know the gravity of the situation if there is any and whatever help I could offer to my wife. In the event you can`t help can you may, at least, direct us to the right address where we could receive such help and advice.

Does exposing herself to the Sunlight, or any kind of direct heat, aggravate my wife`s situation? What are the precautions she needs to take to protect herself?

Your swift response will be very highly appreciated.

Answer:

The process of your wife's loss of color is distressing to her I am certain, and be assured that she can develop premature skin cancers and premature aging of her skin if she continues to expose herself to ultraviolet light regardless of the source.  Since it was ineffective in preventing the progression of her generalized vitiligo, I would urge her to begin using sunscreens immediately and to use them daily throughout the year to prevent premature aging, keratoses, and skin cancers. 

The chances of repigmenting your wife's skin is almost zero, and in extensive cases like this, it is even recommended that the remaining areas of hyperpigmentation be treated with depigmenting agents so that she is one color.

The editor of the new textbook on "Pigmentary Disorders" by James J. Nordlund would be another resource for you; but I would suggest that you contact James J. Nordlund, M.D. (his email address is: jjnordlund@fuse.net).  He is clearly a world authority on pigmentation in this part of the world and might offer you experimental treatments.  In any event, he is a world authority that can advise you on the prognosis and the proper care of your wife's skin.

Good luck!

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati