Due to the fact that the causes and mechanisms of development of vitiligo today remain completely known, the problem of the effective and complete treatment of this disease remains unresolved.
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In most cases, during the treatment of vitiligo, repigmentation is achieved only with the help of complex therapeutic, wellness and preventive measures aimed at medical and social rehabilitation of the patient.
Below, we present the main methods of treatment of vitiligo used in Russia and abroad.
A large group of treatment methods of vitiligo is associated with ultraviolet irradiation with a combination with various photosensitizers, drug susceptibility drugs to ultraviolet, and, therefore, stimulating melangegenesis. I would like to pay attention to that all techniques are strictly individual, have certain testimony and contraindications.
PuU-therapy of vitiligo treatment
One of the most common and long-applied physiotherapy methods is the PuU-therapy – Combined use of photosensitizers and UV irradiation in the range A (long spectrum). As photosensitizers: Meladinin (Egypt), Lamadin (France), Puvalen (Finland), ammoidin, Meloxin, Oxolen, Xantotoxin, Boxhan, Ammifurin, Psoberan, Psoralen, and DR. Currently given preference to new drugs, less toxic and fully absorbed in the body - «Metoksaralen» (Germany), trioxarable. To achieve results for pigmentation, more than 75% is required from 100 to 200 sessions. Contraindicated children up to 12 years.
UV irradiation in the range A, also combined with the system or local use of phenylalanine, Hellin.
When the vitiligo is also used and radiation of the range in (medium wavelength – 280-320 nm), which is used both independently and in combination with the local application of corticosteroids, bioskina (Italy), pseudocatalase, etc. There is a perspective of using not only broadband and narrowband (wavelength 311-312 nm) sources (lamps), but also excimer lasers with a wavelength of 308 nm. Vitiligo's laser treatment techniques include the effects of red (wavelength of 0.67 μm) and infrared (wavelength of 0.89 μm, pulse power 40-80 W) lasers in biocapulation mode (emission modulation of breathing frequencies and patient pulse).
In the treatment of vitiligo, both natural sunlight are actively used in combination with a photosensitizer trioxalen inside or psoralene externally or medinin inside and externally in the form of applications.
Systemic therapy vitiligo
- System Corticosteroids: Prednisolone, Betamethasone, Diproscp.
- Antimalyary preparations: chlorochine diphosphate.
- Immunomodulators: Cyclosporin A, Cyclophosphamide, Isopripozing, Levamizol, Polyoxide.
- Means affecting the gastrointestinal tract: Dalargin.
- Means affecting the hepatic exchange: Silibinin (Carsil), Esssential, Phosofglyph.
- Digestive enzymers: Pancreatin (Creon, Mesin Forte, Enzystal), Vesinzim.
- Vitaminative: ascorbic acid (vitamin C), pyridoxine (vitamin B6), thiamine (vitamin B1), vitamin E (tocopherol acetate, alpha-tocopherol acetate, vitamin E acetate, etc.), Folic acid (vitamin group B).eight. Microelements: copper sulfate, zinc oxide, zinc sulfate.
If necessary, a pharmacological pharmacological correction of neuroleptics, antidepressants, tranquilizers, sympatholytic (SONADAZ, RUDOTEL, APAZAPEN, Pyridazole, Rudotel, Relanium, Support, Novopalsit, Glycine, and DR.).
Surgical methods of vitiligo treatment
- epidermis transplantation (method of substitution of depigmented leather (patchwork autoplasty);
- Outworm minitransflants (a substrate method into microtransplant depigmentation foci);
- Cultivated epidermis transplantation;
- transplantation of non-cultized melanocytes (pigment cells);
- transplantation of cultured melanocytes;
Local therapy vitiligo
- Melaginine – 50% alcohol extract from human tabletrentes, produced drug «Melaginin Plus» with an elevated calcium ion content (0.2-0.5 mg, ml);
- Corticosteroid ointment – Fluorokort, PolcorTolon and DR.;
- Pimekrolimus (Eliode);
- Vityl + (Vitilem +) – The composition of which includes a row of Lamnaminor;
- Alcohol tinctures of the Hypericum, Pasternak;
- Photo protection cream with protection index 15-100;
- Masking cosmetics.
Nutrition of vitiligo patients should be with an elevated acid content of ascorbic, vitamins of group B, products rich in photodynamic substances (fruits of figs, buckwheat, nettle, parsley, sorrel, celery, spinach, rosehip fruits). From phytopreparations containing copper, you can recommend the grass of a turn, the tincture of Arnica mountain (inside and locally). Many copper is contained in beef liver, cheese, shrimp, peas.
