Edited By Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan
CONTENTS
Editors xiii
Contributors xv
I
The Basics of Vitiligo
Chapter 1 HISTORY AND CULTURAL ASPECTS OF VITILIGO 3
George Millington
Chapter 2 DEFINITION, EPIDEMIOLOGY, AND PREVALENCE 7
Ishmeet Kaur and Archana Singal
Chapter 3 VITILIGO: AN INDIAN SCENARIO 9
Sunil K. Gupta and Sandeep Kaur
Chapter 4 BASIC SCIENCE 13
Neha Kumar and S.N. Bhattacharya
Chapter 5 ETIOPATHOGENESIS 21
Dario Didona, Biagio Didona, Giovanni Paolino, and Raffaele Dante Caposiena Caro
II
Clinical Profile of Vitiligo
Chapter 6 CLASSIFICATION OF VITILIGO 31
Vineet Relhan and Rubina Jassi
Chapter 7 VITILIGO VULGARIS 33
Huma Jaffar and Aditi Manu Sobti
Chapter 8 SEGMENTAL VITILIGO 39
Pooja Agarwal
Chapter 9 ACROFACIAL VITILIGO 43
Rajesh Kumar and Neetu Bhari
Chapter 10 MUCOSAL VITILIGO 47
A.S. Savitha, B.M. Shashikumar, and Reddy R. Raghunatha
Chapter 11 LEUKOTRICHIA IN VITILIGO 49
Ramesha Bhat M. and Jyothi Jayaraman
Chapter 12 OTHER SUBTYPES AND VARIANTS OF VITILIGO 53
Sam Shiyao Yang and Emily Yiping Gan
Chapter 13 VITILIGO AND ASSOCIATED COMORBIDITIES 59
Vibhu Mehndiratta and Anuja Yadav
Chapter 14 REPIGMENTATION IN VITILIGO 63
Bharat Bhushan Mahajan and Richa Nagpal
Chapter 15 SPECIAL GROUPS 67
15.1 VITILIGO AND PREGNANCY 67
Chander Grover and Prachi Desai
15.2 PEDIATRIC VITILIGO 71
Sandipan Dhar and Sahana M. Srinivas
15.3 VITILIGO AND IMMUNODEFICIENCY 77
Chander Grover and Prachi Desai
15.4 VITILIGO ONSET IN LATE AGE 79
Chander Grover and Prachi Desai
III
Diagnosis and Assessment of Vitiligo
Chapter 16 DIFFERENTIAL DIAGNOSIS 85
Hemant Kumar Kar and Gunjan Verma
Chapter 17 NONINVASIVE TESTS 91
Hemant Kumar Kar and Gunjan Verma
Chapter 18 INVASIVE TESTS 95
Hemant Kumar Kar and Gunjan Verma
Chapter 19 ASSESSMENT OF VITILIGO 97
Sneha Ghunawat
Chapter 20 QUALITY-OF-LIFE MEASURES AND PSYCHOLOGICAL ASPECTS IN VITILIGO (COUNSELING AND SUPPORT GROUPS) 99
Rashmi Sarkar and Shilpa Garg
IV
Topical Treatment for Vitiligo
Chapter 21 TOPICAL CORTICOSTEROIDS 107
Deepika Pandhi and Vandana Kataria
Chapter 22 TOPICAL CALCINEURIN INHIBITORS 115
Iffat Hassan and Safia Bashir
Chapter 23 TOPICAL VITAMIN D ANALOGS 119
Mualla Polat and Özge Uzun
Chapter 24 NEWER AGENTS FOR TOPICAL TREATMENT 125
Devinder Mohan Thappa and Malathi Munisamy
Chapter 25 COSMETIC CAMOUFLAGE IN VITILIGO 129
Feroze Kaliyadan, Karalikkattil T. Ashique, and Ambika Kumar
V
Systemic Treatment for Vitiligo
Chapter 26 ORAL CORTICOSTEROIDS 137
Sanjeev Handa and Manju Daroach
Chapter 27 OTHER IMMUNOSUPPRESSIVE AGENTS IN VITILIGO 141
Sanjeev Handa and Manju Daroach
Chapter 28 ROLE OF ANTIOXIDANTS IN VITILIGO 145
Mehmet Yildirim, Selma Korkmaz, and İjlal Erturan
Chapter 29 NEWER AGENTS IN SYSTEMIC TREATMENT 149
Rachita Dhurat and Shilpi Agarwal
VI
Phototherapy and Lasers
Chapter 30 UVA THERAPY IN VITILIGO 157
Surabhi Dayal and Priyadarshini Sahu
Chapter 31 UVB THERAPY IN VITILIGO 163
Surabhi Dayal and Priyadarshini Sahu
Chapter 32 TARGETED PHOTOTHERAPY 169
Christopher Tzermias
Chapter 33 LASERS IN VITILIGO 175
Manjunath Shenoy, Ganesh S. Pai, and Anusha H. Pai
VII
Other Therapies for Vitiligo
Chapter 34 ALTERNATIVE MEDICINE IN VITILIGO INCLUDING HOME REMEDIES 183
Bela J. Shah
Chapter 35 DEPIGMENTING AGENTS 187
Rashmi Kumari
VIII
Surgical Treatment of Vitiligo
Chapter 36 SURGICAL TREATMENT: PATIENT EVALUATION AND EXPECTATION ASSESSMENT 197
Venkataram Mysore, Madhulika Mhatre, and Revanta Saha
Chapter 37 TISSUE GRAFTING TECHNIQUES 203
37.1 MINIGRAFTING 203
Koushik Lahiri
37.2 ULTRATHIN SKIN GRAFTING 213
Imran Majid and Tasleem Arif
37.3 SUCTION BLISTER GRAFTING 223
Somesh Gupta and Sanjay Singh
37.4 THE EPIDERMAL HARVESTING SYSTEM (CelluTOME™) FOR STABLE VITILIGO SURGERY 229
Debdeep Mitra
37.5 FLIP-TOP TRANSPLANTATION TECHNIQUE AND SMASH GRAFTING 235
Vineet Relhan and Sudhanshu Sharma
37.6 HAIR FOLLICLE TRANSPLANTATION IN VITILIGO 239
Kavish Chauhan
37.7 JODHPUR TECHNIQUE 243
Dilip Kachhawa
Chapter 38 CELLULAR GRAFTING TECHNIQUES 247
38.1 NONCULTURED EPIDERMAL CELL SUSPENSION 247
Thurakkal Salim
38.2 CULTURED MELANOCYTE GRAFTING 255
Ravinder Kumar, Seema Rani, Naveed Pervaiz, and Davinder Parsad
Chapter 39 MANAGEMENT OF DIFFICULT VITILIGO (ACRAL, GENITAL, LIPS, PALMS, AND SOLES) 259
Sanjeev Gupta and Swetalina Pradhan
Chapter 40 MICRONEEDLING IN VITILIGO 265
Vijay Zawar and Gayatri Karad
Chapter 41 PRP IN VITILIGO 269
Rajesh Kumar and Neetu Bhari
Chapter 42 DERMABRASION IN VITILIGO 273
Bharat Bhushan Mahajan, Shweta Sethi, and Shashank Tyagi
Chapter 43 ROLE OF DIET IN VITILIGO 277
Rachita Misri and Khushbu Mahajan
IX
Miscellaneous
Chapter 44 TATTOOING IN VITILIGO 283
Gurvinder P. Thami
Chapter 45 MYTHS IN VITILIGO 287
Sneha Ghunawat and Neha Dubey
Index 291
PREFACE
Vitiligo is a disorder with great psychological and social impact. It is referred to even in the great scriptures found all over the world. It is often considered a non-disease, a simple aesthetic problem. In spite of it stigmatizing the human race since ancient times, there have been many gaps in knowledge regarding the pathogenicity and therapeutics. One of the reasons for this has been the asymptomatic nature of the condition. With the evolvement of modern science, recent advances have been made in the medical and surgical treatments of the disease.
In the past, vitiligo has mostly been considered an autoimmune disorder by scientists. With recent molecular research theories, new dimensions have been added to its pathogenesis and treatment. It has always captured the interest of immunologists, biologists, and dermatologists around the world. The enigmatic nature of the disease has also garnered the interest of scientists and clinicians. This book was a dream project, as it is a comprehensive compilation of all aspects of the disease. It was our aim to highlight the links in the pathophysiology, clinical, and therapeutic aspects of the disease. A great attempt has been made to fill in the missing gaps pertaining to the unsolved issues of the disease as well as to understand the scope of future research.
The book exhaustively deals with all aspects of vitiligo, including basic biology, pathogenesis, clinical variants, psychological impact, and treatment aspects, both medical and surgical. We have aimed to present a complete practical guide on the disease. The contributors are experts from across the globe and have graciously shared their experiences and wisdom in their respective topics. We hope that readers benefit by reading the book and incorporating these pearls of wisdom in their practices. Emphasis has been placed on the clinical and therapeutic aspects to help readers enhance their skills. Pictorial depictions help in better understanding of the surgical procedures.
We thank all our global experts for their contributions. The information is compiled and presented in a comprehensible and scientific manner. The book has materialized due to the hard work and collective efforts of the entire editorial team and the dedicated authors. The cooperation of the juniors, technical staff, and the patients, has been of utmost importance in this journey. We also thank Shivangi Pramanik (Commissioning Editor, Medical) and Himani Dwivedi (Editorial Assistant, Medical) of CRC Press/Taylor & Francis, for their assistance with the publication process.
We would like to acknowledge our mentors, colleagues, trainees, and patients who have been a source of knowledge and inspiration.