Kena Roots

Chronic skin disease Other name = Leukoderma White spots occur when the

skin no longer forms melanin (pigment that determines the color of your skin, hair, and eyes)

The white patches of irregular shapes begin to appear on your skin

White patches of skin Whitening or graying of the hair on

your scalp, eyelashes, eyebrows or beard

Loss of color in the tissues that line the inside of your mouth

Loss or change in color of the inner layer of your eye

Chalk white color

Convex margins 5mm to 5cm or

more in diameter

Round, oval, or elongated in shape

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Focal pattern—the depigmentation is limited to one or only a few areas

Segmental pattern—depigmented patches develop on only one side of the body

Generalized pattern—(most common) depigmentation occurs symmetrically on both sides of the body

Focal and segmental patterns do not spread. The generalized pattern is hard to predict and can randomly stop

Can appear at any age, usually first appears between the ages of 20 and 30

White patches may begin on your face above your eyes or on your neck, armpits, elbows, genitals, hands or knees

1-100 of the world population develops Affects both genders and all races

equally

When no melanin is produced, the involved patch of skin becomes white

When a white patch grows or spreads the cause may be Vitiligo

Exact cause is unknown May be due to an immune

disorder, heredity, or environmental causes like sunburn or emotional distress that trigger the condition

A family history of vitiligo

Look to see if there is a rash, sunburn, or other skin trauma that has occurred within 2 or 3 months after pigmentation was discovered

Premature graying of the hair (before age 35)

Stress or physical illness

Also they may ask for an eye examination (inflammation of your eye) and/or blood test (autoimmune disease)

Vitiligo is difficult to treatEarly treatment options include:

Exposure to intense ultraviolet light, such as narrow-band UVB therapy

Medicines taken by mouth such as trimethylpsoralen (Trisoralen)

Medicines: Corticosteroid creams Immunosuppressants such as pimecrolimus (

Elidel) and tacrolimus (Protopic) Repigmenting agents such as methoxsalen (

Oxsoralen)

The use of steroid creams may be helpful in returning the color to the white patches

Doctors often prescribe a mild topical corticosteroid cream for children under 10 years old and a stronger one for adults

Cream must be applied to the white patches on the skin for at least 3 months before seeing any results

Corticosteriod creams are the simplest and safest treatment for vitiligo, but are not as effective as psoralen photochemotherapy

SIDE EFFECTS occur in areas where the skin is thin, such as on the face and armpits, or in the genital region› They can be minimized by using weaker formulations

of steroid creams in these areas.

Topical Calcineurin Inhibitors

RDNL

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Most effective treatment available in the United States.

PUVA therapy is to repigment the white patches

time-consuming, and care must be taken to avoid side effects

Psoralen is a drug that contains chemicals that react with ultraviolet light to cause darkening of the skin.

Psoralen is injected orally or is applied to the skin

Then skin is carefully timed exposure to sunlight or to ultraviolet A (UVA) light that comes from a special lamp.

WWHT Dermatology

Used for children 2 years old and older who have small number white spots in a few areas

Treatments are done under an artificial UVA light once or twice a week. Psoralen is applied to your depigmented patches about 30 minutes before

exposing you to enough UVA light to turn the affected area pink. The doctor usually increases the dose of UVA light slowly over many weeks. Eventually, the pink areas fade and a more normal skin color appears. SIDE EFFECTS:

› (1) severe sunburn and blistering › (2) too much repigmentation or darkening (hyperpigmentation) of the

treated patches or the normal skin surrounding the vitiligo.

For people with extensive vitiligo (affecting more than 20 percent of the body) or for people who do not respond to topical PUVA therapy

Not recommended for children under 10 years of age because it increases the risk of damage to the eyes caused by conditions such as cataracts.

You take a prescribed dose of psoralen by mouth about 2 hours before exposure to artificial UVA light or sunlight.

Treatments are usually given 2 or 3 times a week, but never 2 days in a row.

For patients who cannot go to a facility to receive PUVA therapy, the doctor may prescribe psoralen that can be used with natural sunlight exposure.

SIDE EFFECTS include: Sunburn, nausea and vomiting, itching, abnormal hair growth, and

hyperpigmentation. May also increase the risk of skin cancer,

Used for people with small patches of vitiligo The doctor removes sections of the normal,

pigmented skin and places them on the depigmented areas

Infections may occur at the donor or recipient sites The recipient and donor sites may develop scarring, a

cobblestone appearance, or a spotty pigmentation, or may fail to cure the white spot area

Takes time and is very costly

Doctor creates blisters on your pigmented skin by using heat, suction, or freezing cold

The tops of the blisters are then cut out and transplanted to a depigmented skin area

SIDE EFFECTS: scarring and lack of repigmentation

Less risk of scarring with this procedure than with other types of grafting.

Implanting pigment into the skin with a special surgical instrument

Works best for the lip area, particularly in people with dark skin

Difficult to match perfectly the color of the skin of the surrounding area

The tattooed area will not change in color when exposed to sun, while the surrounding normal skin will.

Tattooing tends to fade over time Also tattooing of the lips may lead to episodes of blister

outbreaks caused by the herpes simplex virus

Takes a sample of your normal pigmented skin and places it in a laboratory dish containing a special cell-culture solution to grow melanocytes.

When the melanocytes in the culture solution have multiplied, the doctor transplants them to your depigmented skin patches

Currently experimental and is impractical for the routine care of people with vitiligo

Very expensive and its side effects are not known.

Sunscreen

Helps protect the skin from sunburn and long-term damage

Minimizes tanning, which makes the contrast between normal and depigmented skin less noticeable

Blue Lizard Baby& Sensitive Sunscreen

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Some vitiligo patients cover depigmented patches with stains, makeup, or self-tanning lotions.

Dermablend, Lydia O’Leary, Clinique, Fashion Flair, Vitadye, and Chromelin offer makeup or dyes that you may find helpful for covering up depigmented patches

Self tanning lotions have an advantage over makeup in that the color will last for several days and will not come off with washing.

AVRF

AVRF

April

1)National Vitiligo Foundation

2)Vitiligo Support International

3)American Vitiligo Research Foundation Inc.

SUPPORT organizations

Nation Library of Medicine (Medicine Plus) American Vitiligo Research Foundation National Institutes of Health, Department of Hea

lth and Human Services : National Institute of Arthritis and Musculoskeletal and Skin Diseases

Drugs.com (Treatments) youtube.com (Lee Thomas- Turning White 20/20

Interview) National Vitiligo Foundation (video gallery-

Elizabeth Vargas Interview)

1) National Vitiligo Foundation2) American Vitiligo Research Foundation In

c.3) Visualdxhealth4) Revolution Health5) WWHT Dermatology 6) Elidel7) National Vitiligo Foundation 8) Vitiligo Support International

Lee Thomas

Kids coping with Vitiligo

Elizabeth Vargas Interview

Ingredient Main active substance

Action

Cocos nucifera oil

Coconut oil contains essential saturated and unsaturated fatty acids, High concentration of Vitamin E and K, high concentration of Zinc and Iron.

Coconut oil is the only type of oil that one should use on one’s skin for it is absorbed easily and keeps the skin soft. Coconut oil contains Vitamin E Alpha Tocopherol. This kind of Vitamin is a well-known potent antioxidant and is beneficial to the skin.

Ingredient Main active substance

Action

Psoralea corylifolia extract

Psoralea corylifolia contains flavons, isoflavons, furanocoumarins, chalcones and coumesterol group of compounds which includes psoralen, isopsoralen and bavichinin2.

Psoralea corylifolia appears to have a purely local action with a specific effect on the arterioles of the subcapillary plexuses, which are dilated so that the plasma is increased in this area. The skin becomes red and the melanoblasts (pigment-forming cells) are stimulated. In leukoderma, melanoblasts do not function properly and their stimulation by the drug leads them to form and exudate pigments, which gradually diffuse into the white leukodermic patches.[ Also, the phytochemically induced covalent binding of the drug to pyrimidine bases is responsible for its therapeutic effect. The photoconjunction involves thymine dimer adducts on the opposite strands of DNA. Psoralen has been found to intercalate into DNA, where they form mono- and di-adducts in the presence of long wavelength UV light and thus are used for the treatment of hypo-pigmented lesions of the skin, such as leukoderma.

Ingredient Main active substance

Action

Berberis vulgaris root extract

Barberry includes such alkaloids as berbamine, berberine, oxyacanthine, resin and tannins, and chelidonic acid. Barberry Root also constituents the B-vitamin thiamine, vitamin C, lutein, zeaxanthin, the carotenoids beta-carotene, chromium, zinc, and cobalt .

Barberry root has antioxidant and cytoprotective properties.

Ingredient Main active substance

Action

Picrorhiza kurroa root extract

Picrorhiza kurroa root extract contains Kutkin, D-Mannitol and Vanillic acid

Picrorhiza kurroa was found to be a potent immunostimulant of both cell-mediated and humoral immunity. picrorhiza was reported to stimulate cell mediated and humoral components of the immune system including stimulation of phagocytosis.

Ingredient Main active substance

Action

Melaleuca Alternifolia (TeaTree) Leaf Oil

Terpineol, Cineol, Pinene, Terpinenes

Powerful and broad spectrum anti-microbial agent (Anti-bacterial, anti-fungal and anti-mycotic agent), and it has an immune system stimulant effect

Ingredient Main active substance

Action

Emu oil Linolinic acis and Oleic acid

Used by the Aboriginal people of Australia for the treatment of muscle and joint pain, contains a variety of fatty acids.  Modern research into the properties of emu oil has found that this is the greatest skin emollient in the world, with deep skin penetration properties better than any other natural oil .

Ingredient Main active substance

Action

Vitamin E (Tocopherol)

Alpha-tocopherol Powerful anti-oxidant agent

Natural pathway for PUVA therapy. Rich source of natural powerful anti-

oxidants. Rich source of essential minerals and

vitamins for vitiligo patients. Safe with minor side effects. Cost effective.

Great thanks for your listening

Kena Roots for therapeutic cosmetics

Dr. Hani Malkawi