Idiopathic lesion Flashcards
1
Q
Vitilgo
dipegmentation of the skin cause by the loss off…
A
Melanocytes
2
Q
Vitiligo
% seen before the age of 20
% seen before the age 12
A
50% before age 20
33% before age 12
3
Q
Vitiligo
what is the theroy behind the loss of melanocytes ?
A
the theory is its an autoimmune disorder. melanocytes destroyed by CD8+ T cells.
4
Q
Vitilgo
Px:
A
- Flat, hypo or depigmented macules, “chalky” or pale white
- Well demarcated without secondary changes
- May note Koebner’s phenomenon
- Often starts at face, hands/feet, or genitals
- Progressive enlargement overtime- may affect all skin
5
Q
Vitiligo
Dx
A
- Mostly clinical diagnosis
- Punch biopsy for definitive diagnosis: absence of melanocytes
- Wood’s lamp can help define lesions/ depigmintation, not a dx
- Adjunctive testing (if associated ssx):
-TSH
-Blood glucose (DM) - ANA
6
Q
Vitiligo
Tx:
A
- Natural history: flares and periods of stability (triggered by stress)
- First line tx: topical steroids (need high dose- clobetasol)
- Calcineurin inhibitors are better for face, neck, intergious areas, better for kids
- Treatment dependant on severity & %BSA involved:
-If active and/or rapidly spreading→ oral steroids (prednisone, dexamethasone)
-If <5% BSA→ topical steroids (calcineurin inhibitors- for repigmentation)
-If extensive >80% → depigmentation (monobenzone but can depigment ALL SKIN)
-If localized→ can consider skin/tissue grafting
