Vitiligo

VITILIGO BASICS

Vitiligo is a chronic autoimmune disease. Such diseases cause the immune system to react to the patient’s own body cells. When a patient suffers from vitiligo, their own white corpuscles attack their pigment-building skin cells. These so-called melanocytes are being harmed under this attack or, in the worst case, destroyed. As a result, no more pigments can be produced at the affected areas, turning them white. It is not known what causes this attack. However, it is known that people with vitiligo often also have other diseases like thyroid diseases, diabetes, anaemia, celiac disease or alopecia areata at the same time. Whether or not these accompanying illnesses cause the vitiligo is not known.

Known triggers are psychological stress and sun burns. A genetic inheritance is present in about 30% of the cases.

The non-pigmented body regions often appear symmetrically, e.g. on both hands or both knees. Generally, each body part can be affected but it is extremely rare for the entire body surface to be affected. Vitiligo most often occurs on the face, the hands, the armpits, the chest, at the navel as well as in the genital and anal areas.

There are normally no symptoms and itching or light burning only occur in acute phases while the melanocytes are being harmed, if at all. It is possible, however, that the light skin areas are more prone to sun burns as the UV protection is missing there. Therefore, the areas being affected by vitiligo must be protected from the sun by using sunscreen in the summer.

COURSE OF VITILIGO

  • In a third of the cases, the areas affected by vitiligo regress fully or partially. This can happen spontaneously or with medical aid.
  • In the second third of the patients, the vitiligo remains constant and does not worsen over time.
  • In the last third of the cases, the vitiligo progresses regardless of medical intervention. In the most extreme case, which is very rare, the entire skin can be affected.

TREATMENT OF VITILIGO

It is of particular importance to design a detailed treatment plan for vitiligo that takes into account – for example – extent, development speed, duration of existence, nature and scope of previous therapies as well as pre-existing conditions.

One of the important fundamentals of the therapy is the suppression of the autoimmune reaction. There are various immunosuppressive medications available for this in the forms of pills or creams. Especially the development of the substance class of calcineurin inhibitors in cream form has become an innovative pillar of the therapy.

Also important are the cosmetic covering of the depigmented areas, artificial tanning through self-tanning lotions and UV therapies. The latter should not, however, be used on the whole body as this would unnecessarily expose healthy skin to the UV radiation. A targeted radiation with the Excimer System is preferable.

The 308 nm Excimer System by Alma Lasers is a highly effective treatment solution for intensive monochromatic UVB therapy. With its wavelength of 308 nm the system is particularly suitable for the treatment of autoimmune diseases like vitiligo and many others. The 308 nm Excimer System is thereby equally quick and effective as an Excimer Laser but significantly smaller, lighter and more flexible.

The 308 nm Excimer System precisely targets the lesions and, hence, enables an especially intensive and effective treatment. The energy density can be individually regulated to between 50 and 6,000 mJ per cm². The 16 cm² spot is accurately adaptable to the lesions in size and shape through stencils. This way, a significantly larger UV dosage than in UV cabins can be applied while the surrounding healthy skin is protected. This lowers the number of necessary treatment sessions, increases the patient’s comfort and improves the clinical results considerably. The large colour touch screen and intuitive menu navigation with automated MED test (minimum erythema dose) make the 308 nm Excimer System especially effective.

The 308 nm Excimer System

Excimer