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Melanocyte Transplant For Vitiligo

By April 10, 2013 - 12:36am

Q:What is Vitiligo (Phul-Behri or Leucoderma)?
A: In Indo-Pakistan region, Vitiligo is commonly known as (Phul-Behri) or Leukoderma. It is a disease in which the skin color is permanently lost from a small or a large area of the skin. It can affect the skin of the face, especially around the eyes, nostrils & mouth. It can affect virtually any part of the body including hands, feet, genitalia (private parts), scalp and hair. It usually affects children and adults less than 20 years of age. More than 90% of cases occur before 40 years of age.
Q: What is the cause of Vitiligo:
A: Most of the scientific evidence suggests that the immune system (body defence system that protects us from germs and infections) gets hyper-activated and rather than attacking on the foreign elements such as germs, starts to kill bodys own normal structures. In the case of Vitiligo, the bodys defence system starts to attack melanocytes (pronounced as Me-lan-o-cytes) these are the cells that produce the color in the skin. So these color producing cells are killed and white or colourless spots of vitiligo are produced.
Q: Can milk & fish is taken together cause vitiligo?
A: NO. Absolutely not. This myth exists only in India and Pakistan. Many cuisines in various parts of the world cook fish in milk routinely. If this were true, all of them should have gotten vitiligo. To date no substantial scientific evidence has ever been given to support this is whim which is no more than a regional mumbo jumbo existing in our part of the world.
Q: Is Vitiligo treatable?
A: Yes. In most of the cases vitiligo is a treatable disease, especially if diagnosed early and if the affected area is small.
Q: What are the different treatment options?
A: Following are some of the treatments available for Vitiligo:
1. Medical Treatment:
Different creams and lotions that contain certain specific medicines can be prescribed to be applied on the affected area. In most instances, such medicated creams and lotions are very effective especially if the area of vitiligo is small and relatively new.
2. Light Therapy / Phototherapy (PUVA & Narrow Band Ultra Violet B):
A special kind of light with a specific wavelength and frequency is used to treat the affected area. The patient is given timed and controlled exposure to light in a special chamber. We use highly advanced machines by some of the finest brands in United States for PUVA and Narrow Band UVB therapy. Treatment with this special light is especially indicated if the area involved is too large to be handled with topical medicines or if the later has failed to regenerate colour in the area. Narrow Band UVB (NBUVB) therapy is the latest and highly recommended treatment available in the world today which now is available in our clinic in Pakistan as well.
3. Surgical Treatments:
a. Skin Grafting (Old method): The white skin from the diseased area is removed and a small piece of normal skin is transferred in its place. Major disadvantage associated is that this procedure leaves a visible scar. Consequently, you end up trading an unsightly white patch with an equally unsightly scar. We do not recommend this surgery.
b. Punch Grafting: Still an old method but better than skin grafting. In this method small (less than cm circles of normal skin) are cut from the normal skin and then transferred to the Vitiligo struck spot of skin. The color of the skin returns to its normal but with uneven skin surface leaving small bumps or elevations where these punch grafts were placed.
c. Melanocyte Transplant (The most advanced & latest method): In this very sophisticated method, the cells which make color (Melanocytes) are transferred from the normal skin to the diseased area. Once they are transferred, they start to make the color in the white diseased vitiligo area. It is a difficult method to learn for surgeon but is the most satisfying procedure for the patient, as it does not leave any scars and the results are amazing. Dr.Azim Jahangir Khan is the only dermatologist / cosmetic surgeon who is trained and licensed to perform this refined surgical technique in the country.
Q: When can the surgery be considered?
A: Surgical treatment should be considered for all those patients in whom the course of Vitiligo has not changed over a period of six months to one year and/or if the medical treatments/phototherapy did not render desired or routinely anticipated results. Best and most satisfactory results are seen in patients who have only a few small areas of vitiligo, and no new areas have developed in the last one to two years. Small and stable (not increasing in size) areas are the most successfully treatable areas with the melanocyte transplant.
Q: Is the melanocyte transplant surgery painful?
A: No. The donor area (where the colour producing cells will be picked from) as well as the diseased/recipient area , both will be duly numbed with anesthetizing creams or injections using a very fin needle. All this ensures painlessness during the procedure.
Q: Is general anesthesia required?
A: No. Only local anesthesia is used for vitiligo surgery. Patient is awake and talking throughout the procedure while not experiencing any discomfort or pain.
Q: How long does the surgery take to perform?
A: It takes about 2-3 hours to perform this very delicate surgery.
Q: What happens after the surgery?
A: Patient goes home with bandages on the donor (area from where the color producing cells were taken) was well as the recipient area(the diseased area of vitiligo). The bandages are taken off after about ten days. Patient can resume his daily activities in a couple of days.

Q: When does the color starts to appear in the vitiligo area?
A: Usually it takes between 3 to 6 months for the color to appear in the melanocyte transplanted area.
Q: How long does it take to see the full results?
A: It may take from 6 months to a year before the color can spread to the whole treated area. Remember, it takes some time for the tiny color producing cells to make color, so the patient has to be patient!

Q: Would anyone be able to tell that I had the surgery done after a year or so?
A: Most likely not. It is sometimes difficult even for us to locate the exact spot where surgery was performed. Since stitches are not placed, scar is not visible. In some cases, the color may not match 100%, but it is so close to the surrounding skin that it is almost impossible to find out that the vitiligo ever existed there.

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Skin diseases A to Z (Information about skin diseases) COMMON SKIN DISEASES ACNE (PIMPLES / ZITS): This is a very common skin disease in adolescence, young girls and boys and even in adults. It is a common mistake to think that it is normal to have acne at puberty and no treatment should be done. In fact, this is a skin disease and wonderful treatments are available that can get rid of the old acne and prevent the new ones from forming. If treated appropriately pimples should leave no mark on the face. When not treated in time they can leave ugly and permanent marks. The treatment usually consists of some medicine to apply on the face couple of times a day and sometimes oral medications may be needed. It is a common mistake to apply steroid creams like “Dermovate” for pimples which, in fact, can worsen the pimples and damage the skin. Acne in most cases is neither caused by any food nor is the lack of water responsible for it. But in general, eating healthy food, avoiding fast food and drinking enough water is good for the body anyway. . Many commercial creams and lotions, to treat acne and make the skin fair, contain steroids that can permanently damage the skin and should not be used without the doctor’s advice. You should consult a qualified skin specialist for the treatment. With the latest treatments available, there is no reason to be walking around with pimples. To learn more about acne Click Here DANDRUFF (SEBORRHEIC DERMATITIS): Dandruff is a skin disease caused by mold / fungus and the overproduction of the body oil by the skin oil glands. Simply dry skin does not cause dandruff, so not washing the head is not the solution. Similarly putting the oil in the hair may mask the condition temporarily but is not the cure. Regular showers and the use of a good antidandruff shampoo may be your first step towards the treatment. If not improved a skin specialist can be consulted. With proper treatment this condition can be treated effectively. WARTS: These small growths are caused by a germ (virus) and can be transmitted from one person to another. Also, scratching a wart and then putting the same finger on another part of the body can transfer the disease to that body part as well. These warts can be easily treated by burning with extreme heat or cold using special devices in your skin specialist’s clinic. Self medication by burning them with acids or picking at them can leave unsightly marks and even spread the disease. HEAD LICE: Head lice can cause severe itching in the head and is an extremely common problem in school going children. If commonly available remedies like combing hair with a very fine comb after shampooing with anti-lice shampoo do not work, a dermatologist may be consulted. SLIGHTLY WHITE SPOTS ON THE FACE (PITYRIASIS ALBA): These light colored spots are NOT caused by Calcium deficiency. It is a form of eczema and can be easily treated by your skin specialist. Avoiding the sun following the treatment may help lighten the surrounding skin thereby making the spots less visible during the recovery period. It usually takes a few months to regain the color in these spots after the treatment. VITILIGO (LEUKODERMA): These markedly white spots are not caused by drinking milk with fish. Sour food or Vitamin-C does not cause leukoderma. These are the common myths spread by non qualified medical practitioners. In fact every human being has an immune system (body defense system) to fight off infections caused by germs. Sometimes this defense system starts working against the cells which produce the skin color. These cells are called melanocytes (pronounced as MAY-LANO-SITE). In the beginning of the disease, the defense system just paralyzes the melanocytes and they stop making the color. At this stage they can be salvaged with the proper treatment. If not treated early, the defense system can permanently damage these cells, making the treatment difficult. The treatment usually consists of medicated creams, treatment with ultraviolet light in your dermatologist’s clinic, and sometimes oral medications with ultraviolet light. If no improvement occurs, a latest treatment called ‘Melanocyte Transplant’ is now available in Pakistan. In this treatment the color producing cells are transferred from the normal skin to the white spots, where they start producing the skin color. UNEVEN TONE & DARK SKIN: This can be easily prevented by avoiding harsh sun and staying in the shade. Different sun blocks with Sun Protection Factor (SPF) of 35 or more and UVA + UVB protection, along with physical protection with clothing, hats and umbrellas can prevent uneven skin tone. Remember, the intense and prolonged sun exposure can darken the skin and make the skin older looking sooner. Normal exposure to the sun is necessary for Vitamin-D production in the body. So try to avoid the direct sun between 10 am and 4 pm when the harmful rays of the sun are at their peak. http://www.cosmetique.com.pk/


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