Occurs – ПроисходитEnlarging - РасширениеNoticeable – ЗаметныеCure - ВылечитьDesire - ЖеланиеAttempt - ПопыткаPremature – ПреждевременныеEyelashes - РесницыEyebrows – БровиBeard - БородаInner layer – Внутренний слойFocal - ФокусноеWidespread – Широкое распространениеEventually involve – В конечном итоге привлечьDue - ДолженHeredity - НаследственностьIncreased incidence – Повышенная заболеваемостьTriggered the condition – Привели условиеSuspect - ПодозреваемыйPremature graying – Преждевременная сединаGathering - СборDraw - НичьяThyroid function – Функции щитовидной железыAdditionally - ДополнительноApplying - ПрименениеImprove -УлучшатьAvoiding tanning – Избегать загараUnnoticeable - НезаметныйTopical corticosteroid therapy – Тематитиская кортикостероидная терапияTopical immunomodulators -
Показать все Тематические иммуномодуляторыTopical psoralen plus ultraviolet A (PUVA) – Тематический псорален плюс ультрафиолетOral psoralen photochemotherapy – Оральная псорален фотохемотерапияNarrowband ultraviolet B (UVB) therapy – Терапия в узкополосных ультрафиолетовых лучахOintment - МазьDerivative - ПроизводныеExposure - ВыдержкаSkin heals – Кожа лечитTemporary and eventually – Временная и к конечном итогеUnaffected - ЗатрагиваетсяEther of hydroquinone – Эфир гидрохинонаRedness and swelling – Покраснение и припухлостьItching - ЗудPermanent - ПостоянныйExtremely - ЧрезвычайноVitiligo is a condition in which your skin loses melanin, the pigment that determines the color of your skin, hair and eyes. Vitiligo occurs when the cells that produce melanin die or no longer form melanin, causing slowly enlarging white patches of irregular shapes to appear on your skin. Vitiligo affects all races, but may be more noticeable and disfiguring in people with darker skin. Vitiligo usually starts as small areas of pigment loss that spread with time. These changes in your skin can result in stress and worries about your appearance. There is no cure for vitiligo. The goal of treatment is to stop or slow the progression of pigment loss and, if you desire, attempt to return some color to your skin.SymptomsThe main sign of vitiligo is: Pigment loss that produces milky-white patches (depigmentation) on your skin. Other less common signs may include: Premature 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 (mucous membranes).Loss of or change in color of the inner layer of your eye (retina). Although any part of your body may be affected by vitiligo, depigmentation usually develops first on sun-exposed areas of your skin, such as your hands, feet, arms, face and lips. Although it can start at any age, vitiligo often first appears between the ages of 10 and 30. Vitiligo generally appears in one of three patterns:Focal. Depigmentation is limited to one or a few areas of your body. Segmental. Loss of skin color occurs on only one side of your body. Generalized. Pigment loss is widespread across many parts of your body, often symmetrically.The natural course of vitiligo is difficult to predict. Sometimes the patches stop forming without treatment. But, in most cases, pigment loss spreads and can eventually involve most of the surface of your skin.CausesVitiligo occurs when melanin — the dark pigment in the epidermis that gives your skin its normal color — is destroyed or not produced. The involved patch of skin then becomes white. Exactly why this occurs isn't known. Doctors and scientists have theories as to what causes vitiligo. It may be due to an immune system disorder. Heredity may be a factor because there's an increased incidence of vitiligo in some families. Some people have reported a single event, such as sunburn or emotional distress, that triggered the condition. However, none of these theories has been proven as a definite cause of vitiligo.Tests and diagnosisMedical history and examIf your doctor suspects you have vitiligo, he or she will ask about your medical history and examine you. Important factors in your medical history include: a family history of vitiligo or an autoimmune disease, a personal history of sun sensitivity or other skin conditions, a rash, sunburn or other skin trauma within two to three months of the start of pigment loss, premature graying of the hair (before age 35), stress or physical illness.Skin biopsy and blood drawAlong with gathering your personal and family medical history and examining your skin, your doctor may also:Take a small sample (biopsy) of your affected skin. Draw blood to check your blood cell count, thyroid function and to look for the presence of anti-nuclear antibodies (a type of autoantibody) that would indicate an autoimmune disease. Additionally, your doctor may recommend that you see an eye specialist (ophthalmologist) for an eye examination to check for inflammation in your eye (uveitis).Treatments and drugsMedical treatment for vitiligo isn't always necessary. Self-care steps, such as using sunscreen and applying cosmetic camouflage cream, may improve the appearance of your skin. For fair-skinned individuals, avoiding tanning can make the areas almost unnoticeable. Depending on the number, size and location of the white patches, you may decide to seek medical treatment. Medical treatments for vitiligo aim to even out skin tone, either by restoring color (pigment) or by destroying the remaining color. Treatment for vitiligo may take as long as six to 18 months, and you may have to try more than one treatment before you find the one that works best for you.Medical therapies (Topical corticosteroid therapy, Topical immunomodulators, Topical psoralen plus ultraviolet A (PUVA), Oral psoralen photochemotherapy, Narrowband ultraviolet B (UVB) therapy, Depigmentation)Topical corticosteroid therapy. Corticosteroids may help return color to your skin (repigmentation), particularly if the medication is started early in the disease. Milder topical corticosteroid cream or ointment may be prescribed for children and for people who have large areas of depigmented skin. It may take as long as three months of treatment before you begin to see any changes in your skin's color. This treatment is easy and effective, but your doctor needs to monitor you closely for side effects, such as thinning of the skin (atrophy) and streaks or lines on your skin (skin striae). Calcipotriene (Dovonex), a vitamin D derivative, also may be used topically and is sometimes used with corticosteroids or ultraviolet light.Topical psoralen plus ultraviolet A (PUVA). This option, which is also called photochemotherapy, may be effective for you if less than 20 percent of your body has depigmented patches. You'll have to visit the doctor once or twice a week for treatment. The topical psoralen is applied in a thin coating by your doctor or nurse about 30 minutes before the light exposure. Psoralen makes your skin more sensitive to ultraviolet light. Your skin is then exposed to UVA light, which turns the treated areas pink. As the skin heals, a more normal skin color appears. Possible side effects include severe sunburn and blistering, though you can minimize your risk of complications by avoiding direct sunlight after each treatment. Hyperpigmentation — over darkening of the skin — is usually temporary and eventually lightens when treatment stops.Depigmentation. Depigmentation may be an option for you if you have vitiligo that covers more than half of your skin. Depigmentation therapy lightens the unaffected parts of your skin to match the areas that have already turned white. For this treatment, you apply a medication called monobenzene ether of hydroquinone twice a day to the areas of your skin that still have pigment. Treatment continues until the darker areas of your skin match the already-depigmented areas. Redness and swelling are potential side effects of depigmentation therapy, and you have to be careful to avoid skin-to-skin contact with other people for at least two hours after you've applied the drug, so you don't transfer it to them. Other potential side effects include itching and dry skin. Depigmentation is permanent and will make you extremely sensitive to sunlight permanently.Surgical therapies (Autologous skin grafts, Blister grafting, Tattooing (micropigmentation))Autologous skin grafts. This type of skin grafting uses your own tissues (autologous). Your doctor removes tiny pieces of skin from one area of your body and attaches them to another. This procedure is sometimes used if you have small patches of vitiligo. Your doctor removes very small sections of your normal, pigmented skin, often containing a small hair, and places them on areas that have lost pigment. Possible complications include scarring, a cobblestone appearance, spotty pigmentation, or failure of the transferred skin to repigment.Tattooing (micropigmentation). Tattooing implants pigment into your skin with a special surgical instrument. For the treatment of vitiligo, tattooing is most effective around the lips and in people with dark skin. Sometimes the tattoo color doesn't match skin color closely enough. Additionally, tattoo colors fade and they don't tan.Experimental therapiesDoctors are continuing to try to find better ways to treat vitiligo. One newer option is a procedure called an autologous melanocyte transplant. Using a sample of your normal skin, researchers can grow melanocytes in the lab. These newly developed melanocytes are then transplanted to the areas on your body that lack pigment. This treatment is still considered experimental and isn't widely available. Another treatment in development uses a compound found in black pepper called piperine. In trials on mice, piperine was found to be effective at causing repigmentation. Piperine was even more effective when it was used in combination with UV light. Redness and skin peeling were temporary side effects of this treatment.Lifestyle and home remediesCertain self-care tactics may help you care for your skin and improve its appearance:Protect your skin. If you have vitiligo, particularly if you have fair skin, use a sunscreen with an SPF of at least 30 that protects against both UVA and UVB light to protect your skin from the sun's harmful rays. Sunscreen helps protect your skin from sunburn and long-term damage. Sunscreen also minimizes tanning, which makes the contrast between normal and depigmented skin less noticeable.Conceal imperfections. Concealing cosmetics may lessen the appearance of the white patches and help you feel better about yourself, especially if your vitiligo patches are on exposed skin. You may need to experiment with several brands of concealing cosmetics before finding a product that blends best with your normal skin tone. Sunless tanning products (self-tanners) also may help conceal imperfections by adding color to depigmented areas. The coloring doesn't wash off, but it gradually fades as the dead skin cells slough off in several days.Alternative medicineIn people with slow-spreading vitiligo, treatment with 40 milligrams of ginkgo three times a day may stop the spread of vitiligo. And, in one small placebo-controlled trial, ginkgo caused repigmentation in some cases. However, this treatment is not well studied, and as with any over-the-counter treatment, check with your doctor before taking ginkgo to be sure it won't adversely interact with any other treatments you may be on. Скрыть
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