الفهرس 
Vitiligo 4
Systemic corticosteroidsOnly 14 pages are availabe for public view
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Abstract
Vitiligo is a disease that causes the loss of skin color. The extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair and the inside of the mouth.
There were different theories had been proposed to explain the pathogenesis of vitiligo as genetic, autoimmune, neural, intrinsic defect of MCs and viral theory. The disease may be a result of the convergence of these pathologic pathways. Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin. The condition is not life-threatening or contagious. It can be stressful or make you feel bad about yourself. Treatment for vitiligo may restore color to the affected skin, but it does not prevent continued loss of skin color or a recurrence.
Based on those hypotheses, many treatment modalities had been described. Treatment may be surgical or non-surgical. The surgical treatments include autologus punch grafts (minigrafting), thin thiersch grafts, autologus epidermal grafts, autologus melanocytic grafts and micro-pigmentation (tattooing). Medical treatments include topical, intralesional, systemic corticosteroids, immunomodulators, UVR, lasers and other adjuvant therapies.Electrocauterization is a semi-surgical technique that works by introducing high frequency current to a specific area of the body for many purposes such as eradication of unwanted tissue, blockade of blood vessels, or for creating a surgical incision. Usually the instrument uses a very high frequency of more than 100 kHz.
This study was aiming for treating localized stable vitiligo by a simple, old technique. This study was based on a minimal burn, insufficient to develop scar, might activate the repairing processes which would enhance in the same time the MCs proliferation.
The study was done on 30 patients presented with localized stable vitiligo. Superficial electrocautery was done every month for 4 months with application of daily closed wound care using combined fusidic acid cream followed by occlusion with vasline gauze till complete wound healing. Other patch in the same patient is treated only by the above mentioned topical treatment as a control.
The results of this study showed improvement of localized stable vitiligo patches treated by superficial electrocautery. The improvement was detected by the change in the score before and after electrocautery that determine the degree of depigmentation with a maximum score of 6 = no pigmentation; and minimum score of 0 = no residual depigmentation was present and by the percent of change in this score between the baseline score and the score at 4th session. The mean percent of change was 62.31%.
In our study of total 30 patients, 8 patients (27%) showed marked repigmentation after treatment, 16 patients (53%) showed moderate response and the remaining 6 patients (20%) showed mild or no response to treatment.
Disease duration seemed to have a role in response to treatment.There were statistically significant negative correlation between the percentage of improvement and duration of the disease. The shorter the duration of the disease, the better were the results.
No significant side effects were noticed during the course of treatment. Just mild erythema and prolonged burning sensation that resolved within 3 days were detected.