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Besides the information provided below,

does anyone know the latest treatments for vitiligo or an expert on vitiligo that you can direct me to so I can ask them about clinical trials or the newest approved vitiligo drugs?

Treatments and drugs
By Mayo Clinic staff
Medical treatment for vitiligo isn't always necessary. Self-care steps, such as using sunscreen and applying cosmetic camouflage cream, may improve the appearance of your skin. For fair-skinned individuals, avoiding tanning can make the areas almost unnoticeable.

Depending on the number, size and location of the white patches, you may decide to seek medical treatment. Medical treatments for vitiligo aim to even out skin tone, either by restoring color (pigment) or by destroying the remaining color.

Treatment for vitiligo may take as long as six to 18 months, and you may have to try more than one treatment before you find the one that works best for you.

Medical therapies

Topical corticosteroid therapy. Corticosteroids may help return color to your skin (repigmentation), particularly if the medication is started early in the disease. Milder topical corticosteroid cream or ointment may be prescribed for children and for people who have large areas of depigmented skin. It may take as long as three months of treatment before you begin to see any changes in your skin's color. This treatment is easy and effective, but your doctor needs to monitor you closely for side effects, such as thinning of the skin (atrophy) and streaks or lines on your skin (skin striae). Calcipotriene (Dovonex), a vitamin D derivative, also may be used topically and is sometimes used with corticosteroids or ultraviolet light.
Topical immunomodulators. Topical ointments containing tacrolimus or pimecrolimus are effective for people with small areas of depigmentations, especially on the face and neck. This treatment may have fewer side effects than corticosteroids and can be used in combination with UVB treatments. However, studies conducted on these treatments have been small, and there is concern that they may be associated with an increased risk of lymphoma and skin cancer.
Topical psoralen plus ultraviolet A (PUVA). This option, which is also called photochemotherapy, may be effective for you if less than 20 percent of your body has depigmented patches. You'll have to visit the doctor once or twice a week for treatment. The topical psoralen is applied in a thin coating by your doctor or nurse about 30 minutes before the light exposure. Psoralen makes your skin more sensitive to ultraviolet light. Your skin is then exposed to UVA light, which turns the treated areas pink. As the skin heals, a more normal skin color appears.

Possible side effects include severe sunburn and blistering, though you can minimize your risk of complications by avoiding direct sunlight after each treatment. Hyperpigmentation — over darkening of the skin — is usually temporary and eventually lightens when treatment stops.

Oral psoralen photochemotherapy, or oral PUVA. If you have depigmented areas that cover more than 20 percent of your body, your doctor may recommend oral psoralen. For this treatment, you take the oral psoralen about two hours before exposure to UVA light. You'll have to visit the doctor two or three times a week, allowing for at least a day in between treatments. As with topical psoralen, the treated skin becomes pink after UVA exposure, and then eventually fades to a more normal skin tone.

This treatment can also be done using natural sunlight if you don't have access to a doctor's office with the proper equipment. Your doctor will let you know how much exposure you need, and will want to monitor your skin changes frequently.

Sunburn, nausea, vomiting, itching, abnormal hair growth and overdarkening of the skin are potential short-term side effects of this treatment, whether it's done in the doctor's office or using natural sun. Your risk of skin cancer may be increased if you use this therapy long term. Oral PUVA is not recommended for children under 10 due to a greater risk of damage to the eyes, such as cataracts.

You can reduce your odds of skin cancer and sunburn by staying out of direct sunlight for one to two full days after treatment. The use of sunscreen can also help reduce your risk of side effects. To protect your eyes from serious damage, such as cataracts, wear UV-protective sunglasses for up to 24 hours after each treatment when you're exposed to the sun.

Narrowband ultraviolet B (UVB) therapy. Narrowband UVB, a special form of UVB light, is an alternative to PUVA. This type of therapy can be administered like PUVA and given up to three times a week. However, no pre-application of psoralen is required, which simplifies the treatment process. Because it is simpler to administer, this type of phototherapy is gaining wide acceptance. However, more research is needed to determine if it is superior to PUVA and to assess its long-term safety. Narrowband wavelengths of light can also be delivered to smaller areas of vitiligo using either an intense light source (focal) or a laser. Small trials have shown positive results. However, due to the added expense of these devices they may not be available in all dermatologists' offices.
Depigmentation. Depigmentation may be an option for you if you have vitiligo that covers more than half of your skin. Depigmentation therapy lightens the unaffected parts of your skin to match the areas that have already turned white. For this treatment, you apply a medication called monobenzene ether of hydroquinone twice a day to the areas of your skin that still have pigment. Treatment continues until the darker areas of your skin match the already-depigmented areas.

Redness and swelling are potential side effects of depigmentation therapy, and you have to be careful to avoid skin-to-skin contact with other people for at least two hours after you've applied the drug, so you don't transfer it to them. Other potential side effects include itching and dry skin.

Depigmentation is permanent and will make you extremely sensitive to sunlight permanently.
Surgical therapies

Autologous skin grafts. This type of skin grafting uses your own tissues (autologous). Your doctor removes tiny pieces of skin from one area of your body and attaches them to another. This procedure is sometimes used if you have small patches of vitiligo. Your doctor removes very small sections of your normal, pigmented skin, often containing a small hair, and places them on areas that have lost pigment. Possible complications include scarring, a cobblestone appearance, spotty pigmentation, or failure of the transferred skin to repigment.
Blister grafting. In this procedure, your doctor creates blisters on your pigmented skin, primarily by using suction. The tops of the blisters are removed and transplanted where a blister of equal size has been created and removed in an area that has no pigment. Blister grafting may cause a cobblestone appearance and scarring, and the area may not repigment. However, there's less risk of scarring with this procedure than with other types of skin grafting.
Tattooing (micropigmentation). Tattooing implants pigment into your skin with a special surgical instrument. For the treatment of vitiligo, tattooing is most effective around the lips and in people with dark skin. Sometimes the tattoo color doesn't match skin color closely enough. Additionally, tattoo colors fade and they don't tan.
Experimental therapies
Doctors are continuing to try to find better ways to treat vitiligo. One newer option is a procedure called an autologous melanocyte transplant. Using a sample of your normal skin, researchers can grow melanocytes in the lab. These newly developed melanocytes are then transplanted to the areas on your body that lack pigment. This treatment is still considered experimental and isn't widely available.

Another treatment in development uses a compound found in black pepper called piperine. In trials on mice, piperine was found to be effective at causing repigmentation. Piperine was even more effective when it was used in combination with UV light. Redness and skin peeling were temporary side effects of this treatment.

DS00586
April 21, 2009

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.
 

Doublecortin

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Jan 21, 2007
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Do you have vitiligo?

I started presenting with it in my 2nd year of college and it really took a huge psychological toll on me. I had always been a fairly outgoing guy but once I started to get patches on my eyebrows, face and neck, I started to retreat pretty heavily by skipping classes and staying in my room for weeks at a time. I swear, I felt like a leper. It took me a while to realize that all things considered, the ailment isn't going to kill me and that's what matters. If you're starting to present, I feel truly sorry for what you're about to go through. Feel free to reach out to me if you need to talk things over.

Anyway, I guess you probably don't care about my experiences and want to know about treatment. According to the literature I've read thus far (I'd have to look it up again to give you references), tacrolimus has the best risk:reward ratio for minor (<20%) depigmentation. Studies I've read have shown that a large majority (>75%) of those that apply the ointment twice daily with a 5minute period of UV exposure in between see at least some repigmentation. "Most" see "significant" repigmentation within 4 months. Additional studies suggest that increasing folic acid/B12 consumption may help.

Personally, treatment for me has reduced depigmentation from 20%->15% over 2 years. I'd be interested in trying PUVA but right now, it doesn't seem to be financially possible. There's good research and case studies out there that I'm sure you can find. Talk to your academic professionals about how to conduct medical research and it might help you out. There's an overwhelming amount of homeopathic "studies" out there that you should take care to avoid. Best of luck to you.
:idea:

ahm, did you notice his avatar? :laugh:
 

Doublecortin

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Jan 21, 2007
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Besides the information provided below,

does anyone know the latest treatments for vitiligo or an expert on vitiligo that you can direct me to so I can ask them about clinical trials or the newest approved vitiligo drugs?

Treatments and drugs
By Mayo Clinic staff
Medical treatment for vitiligo isn't always necessary. Self-care steps, such as using sunscreen and applying cosmetic camouflage cream, may improve the appearance of your skin. For fair-skinned individuals, avoiding tanning can make the areas almost unnoticeable.

Depending on the number, size and location of the white patches, you may decide to seek medical treatment. Medical treatments for vitiligo aim to even out skin tone, either by restoring color (pigment) or by destroying the remaining color.

Treatment for vitiligo may take as long as six to 18 months, and you may have to try more than one treatment before you find the one that works best for you.

Medical therapies

Topical corticosteroid therapy. Corticosteroids may help return color to your skin (repigmentation), particularly if the medication is started early in the disease. Milder topical corticosteroid cream or ointment may be prescribed for children and for people who have large areas of depigmented skin. It may take as long as three months of treatment before you begin to see any changes in your skin's color. This treatment is easy and effective, but your doctor needs to monitor you closely for side effects, such as thinning of the skin (atrophy) and streaks or lines on your skin (skin striae). Calcipotriene (Dovonex), a vitamin D derivative, also may be used topically and is sometimes used with corticosteroids or ultraviolet light.
Topical immunomodulators. Topical ointments containing tacrolimus or pimecrolimus are effective for people with small areas of depigmentations, especially on the face and neck. This treatment may have fewer side effects than corticosteroids and can be used in combination with UVB treatments. However, studies conducted on these treatments have been small, and there is concern that they may be associated with an increased risk of lymphoma and skin cancer.
Topical psoralen plus ultraviolet A (PUVA). This option, which is also called photochemotherapy, may be effective for you if less than 20 percent of your body has depigmented patches. You'll have to visit the doctor once or twice a week for treatment. The topical psoralen is applied in a thin coating by your doctor or nurse about 30 minutes before the light exposure. Psoralen makes your skin more sensitive to ultraviolet light. Your skin is then exposed to UVA light, which turns the treated areas pink. As the skin heals, a more normal skin color appears.

Possible side effects include severe sunburn and blistering, though you can minimize your risk of complications by avoiding direct sunlight after each treatment. Hyperpigmentation — over darkening of the skin — is usually temporary and eventually lightens when treatment stops.

Oral psoralen photochemotherapy, or oral PUVA. If you have depigmented areas that cover more than 20 percent of your body, your doctor may recommend oral psoralen. For this treatment, you take the oral psoralen about two hours before exposure to UVA light. You'll have to visit the doctor two or three times a week, allowing for at least a day in between treatments. As with topical psoralen, the treated skin becomes pink after UVA exposure, and then eventually fades to a more normal skin tone.

This treatment can also be done using natural sunlight if you don't have access to a doctor's office with the proper equipment. Your doctor will let you know how much exposure you need, and will want to monitor your skin changes frequently.

Sunburn, nausea, vomiting, itching, abnormal hair growth and overdarkening of the skin are potential short-term side effects of this treatment, whether it's done in the doctor's office or using natural sun. Your risk of skin cancer may be increased if you use this therapy long term. Oral PUVA is not recommended for children under 10 due to a greater risk of damage to the eyes, such as cataracts.

You can reduce your odds of skin cancer and sunburn by staying out of direct sunlight for one to two full days after treatment. The use of sunscreen can also help reduce your risk of side effects. To protect your eyes from serious damage, such as cataracts, wear UV-protective sunglasses for up to 24 hours after each treatment when you're exposed to the sun.

Narrowband ultraviolet B (UVB) therapy. Narrowband UVB, a special form of UVB light, is an alternative to PUVA. This type of therapy can be administered like PUVA and given up to three times a week. However, no pre-application of psoralen is required, which simplifies the treatment process. Because it is simpler to administer, this type of phototherapy is gaining wide acceptance. However, more research is needed to determine if it is superior to PUVA and to assess its long-term safety. Narrowband wavelengths of light can also be delivered to smaller areas of vitiligo using either an intense light source (focal) or a laser. Small trials have shown positive results. However, due to the added expense of these devices they may not be available in all dermatologists' offices.
Depigmentation. Depigmentation may be an option for you if you have vitiligo that covers more than half of your skin. Depigmentation therapy lightens the unaffected parts of your skin to match the areas that have already turned white. For this treatment, you apply a medication called monobenzene ether of hydroquinone twice a day to the areas of your skin that still have pigment. Treatment continues until the darker areas of your skin match the already-depigmented areas.

Redness and swelling are potential side effects of depigmentation therapy, and you have to be careful to avoid skin-to-skin contact with other people for at least two hours after you've applied the drug, so you don't transfer it to them. Other potential side effects include itching and dry skin.

Depigmentation is permanent and will make you extremely sensitive to sunlight permanently.
Surgical therapies

Autologous skin grafts. This type of skin grafting uses your own tissues (autologous). Your doctor removes tiny pieces of skin from one area of your body and attaches them to another. This procedure is sometimes used if you have small patches of vitiligo. Your doctor removes very small sections of your normal, pigmented skin, often containing a small hair, and places them on areas that have lost pigment. Possible complications include scarring, a cobblestone appearance, spotty pigmentation, or failure of the transferred skin to repigment.
Blister grafting. In this procedure, your doctor creates blisters on your pigmented skin, primarily by using suction. The tops of the blisters are removed and transplanted where a blister of equal size has been created and removed in an area that has no pigment. Blister grafting may cause a cobblestone appearance and scarring, and the area may not repigment. However, there's less risk of scarring with this procedure than with other types of skin grafting.
Tattooing (micropigmentation). Tattooing implants pigment into your skin with a special surgical instrument. For the treatment of vitiligo, tattooing is most effective around the lips and in people with dark skin. Sometimes the tattoo color doesn't match skin color closely enough. Additionally, tattoo colors fade and they don't tan.
Experimental therapies
Doctors are continuing to try to find better ways to treat vitiligo. One newer option is a procedure called an autologous melanocyte transplant. Using a sample of your normal skin, researchers can grow melanocytes in the lab. These newly developed melanocytes are then transplanted to the areas on your body that lack pigment. This treatment is still considered experimental and isn't widely available.

Another treatment in development uses a compound found in black pepper called piperine. In trials on mice, piperine was found to be effective at causing repigmentation. Piperine was even more effective when it was used in combination with UV light. Redness and skin peeling were temporary side effects of this treatment.

DS00586
April 21, 2009

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.
OK, I'll pretend you are not joking, considering your screen name . . .

Check out pseudocatalase. It's used mainly in Europe and can be very effective, but it's not available in the US due to some political/patent bs issues:

http://www.homephototherapy.com/vit-pcat.htm
 

Mr hawkings

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Yeah I caught it but didn't think he would be trolling...its what I get for being naive @[email protected]

Did MJ even have vitiligo? I thought he had some sort of systemic lupus o_O
His only other thread was about propofol. Think again

On vitiligo, his dermatologist did confirm on larry king that he had it. he said that he had it in patches so they opted to bleach the rest of the skin to match the pale patches intead of putting dark makeup on them.
 
OP
M
Jul 15, 2009
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Hello All!

Actually, I am just a huge Michael Jackson fan. That's why I am named michaeljackson.

As for the propofol question, that was out of curiosity...

And as for Vitiligo, it just so happened that a Chinese native came to me and asked me to help her find some good treatment options for her relative who was just diagnosed with Vitiligo (in China). They believe that the US may have some better drugs available, so they asked me to talk to any doctors I know. I spoke with the head of Dermatology at my school, and he said he didn't know much about the "best" vitiligo treatments.

The Vitiligo issue and michaeljackson avatar is purely coincidental!!!

I just don't know what to tell my labmate.

Oh yeah, I'm an MD/PhD and just took step 1 last month. Now, I'm doing research in Cell Biology!
 
OP
M
Jul 15, 2009
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Here's the information I found on the American Vitiligo Research Foundation:


by Thomas B. Fitzpatrick, MD , Ph.D
Myths About Vitiligo Treatment
Three myths about the treatment of vitiligo prevail in the medical profession.
The first myth is that treatment of vitiligo is "impossible." This is clearly not true and the majority of patients can achieve good results.
The second myth is that oral psoralens, which form the basis for some vitiligo treatments are "toxic to the liver." Oral psoralens are not toxic to the liver.
The third myth is that psoralen + UVA (PUVA) treatments for vitiligo "cause cancer of the skin." When used to treat vitiligo, PUVA therapy requires only a limited number of treatments-approximately 150 in number that has not been shown to cause skin cancer. By comparison, PUVA treatments for psoriasis can be as many as double the number for vitiligo. It has been shown that a small percentage of patients who receive more than 250 PUVA treatments can develop treatable squamous cell cancers of the skin.
Vitiligo Treatment Options
Four options are currently available for the treatment of vitiligo: sunscreens; cover-up; restoration of normal skin color; and bleaching of normal skin with topical creams to remove normal skin pigment to make an even color.
Sunscreens
The two goals of sunscreen treatments are: to protect unpigmented involved skin from sunburn reaction and to limit the tanning of normal pigmented skin. The sun protection factor (SPF) of sunscreens should be no less than SPF 30, as this grade blocks not only erythema, but also the affects of sunlight on the DNA of the skin cells. Sunscreen treatment skin phototypes 1, 2, and sometimes 3 (those who burn, then tan to some degree).
Cover-up
The goal of cover-up with dyes or make-up is to hide the white macules so that the vitiligo is less visible. Self-tanning lotions and camouflage are quite helpful for some patients.
Restoring Normal Skin Color
Restoration of normal skin color can take the form of spot treatments or whole body treatment.
Spot Treatment: Topical Corticosteroid Creams
Initial treatment with certain topical corticosteroid creams is practical, simple, and safe. If there is no response in 2 months, it is unlikely to be effective. Physician monitoring every 2 months for signs of early steroid atrophy (thinning of the skin) is required.
Spot Treatment: Topical Oxsoralen
Much more complicated is the use of topical Oxsoralen (8-MOP). Oxsoralen is highly phototoxic (likely to cause a sunburn), and the phototoxicity lasts for 3 days or more. This should be performed only as an office procedure, only for small spots, and only by experienced physicians on well-informed patients. As with oral psoralens, 15 or more treatments may be required to initiate a response, and 100 or more to finish.
Spot Treatment: Mini Grafting
Mini grafting, which involves transplanting the patient's normal skin to vitiligo affected areas, may be a useful technique for refractory segmental vitiligo macules. PUVA may be required following the procedure to unify the color between the graft sites. The demonstrated occurrence of Koebnerization in donor sites in generalized vitiligo restricts this procedure to patients who have limited skin areas at risk for vitiligo. "Pebbling" of grafted site may occur.
Whole Body Treatment: PUVA Photochemotherapy (Oral Psoralens + UVA Irradiation)
For more widespread vitiligo, treatment with oral psoralen + UVA (PUVA) is practical. This may be done with sunlight and trimethylpsoralen (Trisoralen) or with artificial UVA (in the doctor's office or at an approved phototherapy facility) and Trisoralen or Oxsoralen-Ultra.

Ophthalmologic examination and ANA blood tests are required before starting PUVA therapy. Outdoor therapy may be initiated with 0.6 mg/kg Trisoralen followed 2 hours later by 5 minutes of New England sunlight (less in southern regions). Treatments should be twice weekly, not 2 days in a row, and sunlight exposure should increase by 3 to 5 minutes per treatment until there is a sign of response, and in a few this causes koebnerization. Individualization is required: treatment options are either 0.4 mg/kg of Oxsoralen-Ultra (well absorbed, efficient potentially very phototoxic, significant risk of nausea) or 0.6 mg/kg of Trisoralen (variably absorbed, not very phototoxic, little nausea).

Initial UVA exposure should be 1.0 J and increments (twice weekly, not two days in a row) 0.5 (Oxsoralen-Ultra) to 1.0 (Trisoralen) J per treatment until there is evidence of response of phototoxicity. The later is the sustaining UVA dose until reasonable repigmentation has been established.

PUVA is up to 85% effective in over 70% of patients with vitiligo of the head, neck, upper arms, legs, and trunk. Distal hands and feet are poorly responsive and alone are not usually worth treating. Genital areas should be shielded and not treated. Macules that have totally repigmented usually stay in the absence of injury/sunburn (85% likelihood up to 10 years), macules less than fully repigmented will slowly reverse once treatments have been discontinued. Maintenance treatments are required.

Risks of treating vitiligo with PUVA include nausea, GI upset, sunburn, hyperpigmentation, and acute dryness. We advise against oral PUVA treatments for children under age 10. Treatment is most likely to be successful in highly motivated patients who clearly have reasonable objectives and understand the risks and benefits. While PUVA is not a cure, most patients who are responding well to treatment are not at the same time developing new vitiligo macules.

Topical Creams To Remove Normal Skin Pigment And Unify Skin Color
The goal of depigmentation is to unify skin color in patients with vitiligo virtually all over the body and those who have failed PUVA, who cannot use PUVA, or who reject the PUVA option. Bleaching with monobenzylether of hydroquinone 20% cream (Benoquin) is a permanent, irreversible process. Since application of Benoquin may be associated with distant depigmentation, Benoquin cannot be used to selectively to bleach certain areas of normal pigmentation, because there is a real likelihood that new and distant white macules will develop over the months of use. Bleaching with Benoquin normally requires twice-daily possible side effects. Uncommonly, contact dermatitis is observed. The success rate is about 93%. Periodically following sun exposure, an occasional patient will observe focal repigmentation, which will require a month or so of local use of Benoquin to reverse.
The end-stage color of skin bleached with Benoquin is the same chalk-white as the vitiligo macules. Most patients are quite satisfied with uniformity and the finality of the results. An occasional patient may wish to take 30 to 60 mg beta-carotene to impart on off-white color to the skin. The only side effect of beta-carotene is the uncommon risk of diarrhea.
Patients who undergo bleaching are at risk for sunburn. They should avoid midday sun exposure and should use a high-SPF sunscreen. To date no long-term untoward effects have been reported from the use of monobenzylether of hydroquinone for skin bleaching.
Why Is It Important To Treat Vitiligo?
Many physicians, and even some dermatologists, fail to recognize the profound social and psychological impact vitiligo may have on its victims. Vitiligo is painless and non-pruritic and, unlike psoriasis, it is not associated with shedding of skin scales. But the disfigurement of vitiligo, accentuated among persons with brown or black skin, can be devastating.
The recent media publicity about Michael Jackson's battle with vitiligo has helped raise public awareness of the disease. While vitiligo is worldwide and affects all races equally, it is a particularly troubling social problem for persons whose normal skin color is brown or black. The contrast between brown skin and white vitiligo spots can create a grotesque "harlequin" appearance. The same kind of disfigurement can become a problem for vitiligo victims with normally fair skin who tan deeply during the summer months or, among those who live in sunny climates, throughout the year.
In India, vitiligo, or "leukoderma" as it is called there, is regarded as "white leprosy." The late Prime Minister Jawaharlal Nehru ranked vitiligo as one of three major medical problems in India, alongside malaria and leprosy. A woman in India cannot marry if she has even one spot of vitiligo, and if a woman develops vitiligo after marriage it is considered grounds for divorce.
It is no wonder vitiligo patients can turn aggressive, feel a sense of shame, or become withdrawn and resentful. For many, vitiligo is not just a cosmetic problem-it is a major social dysfunction that seriously curtails their ability to lead a normal work, social or married life. Reversal of the white spots and restoration of normal skin color is therefore the primary hope for all these disfigured vitiligo patients.
Bibliography
Fitzpatriack TB, Eisen AZ, Wolff K, etal. "Disorders of Pigmentation"
In: Dermatology In General Medicine, 4th ed., edited by TB Fitzpatrick et al. New York, McGraw-Hill, 1993.
Fitzpatrick TB, Johnson RA, Woff K etal. "Vitiligo" In: Color Atlas and Synopsis of Clinical Dermatology, 3rd ed. New York, McGraw-Hill, 1997. Ortonne JP. Mosher DB. Fitzpatrick TB. Vitiligo and Other Hypomelanoses of Hair and Skin. New York, Plenum Publishing Corporation, 1983.
 

mjl1717

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Good info MJ..

1) Vitiligo is a hot topic...(I see the the word autoimmune is associated with it)

2)Always thought of it along with siezures as one of the more devastating/ dramatic disease...

3)Poor Michael Jackson- he had a few issues..{Althought to the average knucklehead the grass may have looked greener on the other side}

4)I think his death may have been preventable..

:xf:
 

GoSpursGo

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I don't see any particular reason to revisit this 4 year old thread. Closed.
 
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