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Approach to Treatment of Patients with Vitiligo
Wright State University School of Medicine, Dayton, OH
And Group Health Associates of Cincinnati, Ohio
James J. Nordlund, MD
Updated 7 January 2007

GENERAL WORKUP

Patient history and complete skin examination
Discussion about pathogenesis and treatment
Ophthalmologic examination is optional and indicated only for those with signs or symptoms of chorioretinitis
Thyroid studies only for those with family history of thyroiditis or symptoms of thyroid disorder.
(Refer to PCP for workup if preferred)
Photographs (selected cases)
Make patients aware of National Vitiligo Foundation and local chapter

OPTIONS FOR TREATMENT

Sunscreen: Makeup:
- DyoDerm Vitadye (stains)
- Covermark, Dermablend
Repigmentation: Topical steroids used cautiously on face and intertriginous areas
Immunomodulators: tacrolimus or pimecrolimus used with topical steroids
Natural sunlight in sub erythemal doses
Narrow band ultraviolet light or excimer lasers
Tanning parlors with assistance of dermatologist
PUVA: Topical, Oral-8-MOP (Indoor only) is indicated only for the more complex cases where repigmentation is necessary and all other therapy has been unsuccessful.
Surgical therapies are available for carefully selected patients, especially those with focal or segmental vitiligo.
Depigmentation: - Monobenzylether of hydroquinone it should be assumed this is permanent and irreversible but some repigmentation can occur following sun exposure.) It takes several years to depigment the face, neck, hands and arms.

FOLLOW-UP OBJECTIVES

Access effectiveness of treatment
Explore old and new options (such as tattooing, micro grafting refractory macules)

Vitiligo treatment protocol

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Information Library Medical Newsletter Bulletins Current Research Treatment Guidance Meet & Greet Books & Publications Patient Studies Ask the Experts Ask the Physician Support Groups Photo Gallery Research Grants Awarded Yellow Pages Community Forums	Approach to Treatment of Patients with Vitiligo Wright State University School of Medicine, Dayton, OH And Group Health Associates of Cincinnati, Ohio James J. Nordlund, MD Updated 7 January 2007 GENERAL WORKUP Patient history and complete skin examination Discussion about pathogenesis and treatment Ophthalmologic examination is optional and indicated only for those with signs or symptoms of chorioretinitis Thyroid studies only for those with family history of thyroiditis or symptoms of thyroid disorder. (Refer to PCP for workup if preferred) Photographs (selected cases) Make patients aware of National Vitiligo Foundation and local chapter OPTIONS FOR TREATMENT Sunscreen: Makeup: - DyoDerm Vitadye (stains) - Covermark, Dermablend Repigmentation: Topical steroids used cautiously on face and intertriginous areas Immunomodulators: tacrolimus or pimecrolimus used with topical steroids Natural sunlight in sub erythemal doses Narrow band ultraviolet light or excimer lasers Tanning parlors with assistance of dermatologist PUVA: Topical, Oral-8-MOP (Indoor only) is indicated only for the more complex cases where repigmentation is necessary and all other therapy has been unsuccessful. Surgical therapies are available for carefully selected patients, especially those with focal or segmental vitiligo. Depigmentation: - Monobenzylether of hydroquinone it should be assumed this is permanent and irreversible but some repigmentation can occur following sun exposure.) It takes several years to depigment the face, neck, hands and arms. FOLLOW-UP OBJECTIVES Access effectiveness of treatment Explore old and new options (such as tattooing, micro grafting refractory macules) Vitiligo treatment protocol >> Back to Top	<SCRIPT language='JavaScript1.1' SRC="http://ad.doubleclick.net/adj/N2581.NVFI/B2629636;abr=!ie;sz=160x450;&cm_mmc=Banner-_-NVFI-_-ROS-_-160x450;ord=[timestamp]?"> </SCRIPT> <NOSCRIPT> <A HREF="http://ad.doubleclick.net/jump/N2581.NVFI/B2629636;abr=!ie4;abr=!ie5;sz=160x450;&cm_mmc=Banner-_-NVFI-_-ROS-_-160x450;ord=[timestamp]?"><IMG SRC="http://ad.doubleclick.net/ad/N2581.NVFI/B2629636;abr=!ie4;abr=!ie5;sz=160x450;&cm_mmc=Banner-_-NVFI-_-ROS-_-160x450;ord=[timestamp]?" BORDER=0 WIDTH=160 HEIGHT=450 ALT="Click Here"></A> </NOSCRIPT>

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