Vitiligo external medicine

Vitiligo is a relatively common acquired skin depigmentation disease in clinical practice. The common clinical manifestation is the appearance of white spots on the skin surface. Young women are generally the main patient population. There is currently no specific medicine for the treatment of vitiligo, but there are external medications and internal medications, and these types of medications need to be prescribed based on the progression of the disease. This article introduces the differential diagnosis of vitiligo. You can take a look at it if necessary.

Differential Diagnosis

1. Anemic nevus

The disease occurs in childhood and is mostly seen on the face as light-colored spots. The local area does not turn red due to stimulation or friction, but the surrounding skin turns red.

2. Pityriasis alba

It may be related to dry skin and sun exposure, manifesting as hypopigmented spots with unclear edges and a small amount of white scales on the surface.

3. Non-pigmented mole

The disease occurs at birth or shortly after birth, and the skin lesions are localized pale white spots with jagged edges.

4. Tinea versicolor

The lesions occur on the trunk and upper limbs and are pale white round or oval spots with unclear boundaries and fine scales on the surface. Fungal tests are positive.

5. Albinism

It is a congenital non-progressive disease, often with a family history. The skin and hair all over the body lack pigmentation, the irises of both eyes are transparent, and the choroidal pigment disappears, making it easy to distinguish from vitiligo.

6. Leprosy leukoplakia

It is an incomplete hypopigmented macules with unclear boundaries, loss of surface sensation, and other symptoms of leprosy.

7. Leukoplakia of secondary syphilis

It occurs on the neck, is not pure white, and is positive for syphilis serology.

8. Others

It should also be differentiated from discoid lupus erythematosus, mucosal leukoplakia, etc.

complication

Common complications include uveitis. Severe uveitis is seen in Vogt-Koyanagi-Harada (VKH) syndrome. Rare complications include Alezzandrini syndrome (eye-skin-ear syndrome).

treat

1. Hormone therapy

(1) Systemic treatment is mainly suitable for patients with generalized progressive vitiligo. Oral or intramuscular injection of hormones can stabilize progressive vitiligo as quickly as possible.

(2) Local treatment: Topical corticosteroids are effective in treating localized vitiligo, but attention should be paid to the adverse reactions caused by long-term use of topical corticosteroids. Commonly used drugs in clinical practice include halometasone ointment, mometasone furoate cream, etc.

2. Phototherapy and photochemotherapy

(1) Narrowband ultraviolet (NB-UVB) phototherapy has a certain effect in treating localized or generalized vitiligo.

(2) Photochemotherapy (PUVA): For localized vitiligo, topical application of furanocoumarins (8-MOP, psoralea corylifolia tincture) + sun exposure is a good treatment option and can be used in adults and children over 5 years old.

3. Transplantation therapy

It is suitable for patients in the stable period, with few skin lesions in the past few days and no scarring constitution. Commonly used methods include autologous epidermal transplantation, microskin graft transplantation, autologous cultured melanocyte transplantation, etc.

4. Immunosuppressants

For areas that are not suitable for the use of hormones, or to avoid adverse reactions to long-term use of hormones, topical calcineurin inhibitors (tacrolimus, pimecrolimus) have a certain effect.

5. Vitamin D3 derivatives

Vitamin D3 derivatives can be combined with NB-UVB, PUVA, etc. for treatment. It can also be combined with topical corticosteroids and calcineurin inhibitors.

prevention

1. Reduce the intake of contaminated food, correct picky eating, and develop a scientific diet recipe.

2. Reduce the inhalation of harmful gases and choose a place with fresh air when doing morning exercises or sports.

3. Pay attention to labor protection.

4. Pay attention to the pollution caused by house decoration.

5. Keep a happy mood.