0521779407-22 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:23
1542 Vitiligo Volume Depletion and Edema➣MBEH (monobenzylether of hydroquinone) 20% cream
permanent and irreversible depigmentation
BID application for 9–12 months
must avoid subsequent sun exposure
➣Q-switched ruby laser
■alternative therapies
➣multivitamin therapy (folic acid/vitamin B12/vitamin C)
L-phenylalanine with UVA or UVB
Pseudocatalase with UVA or UVB
Khellin with UVA
■Side Effects & Complications
■topical PUVA
➣severe sunburns, phototoxic response, hyperpigmentation,
■depigmentation with monobenzyl ether of hydroquinone
➣erythema, dryness, burning, pruritus
➣contact dermatitis in 15%
follow-up
■During Treatment – every 6–8 weeks
complications and prognosis
■cosmetic appearance is main complication
➣Squamous cell carcinoma may occur in depigmented skin
■prognosis excellent for segmental and focal vitiligo
■spontaneous regression is rare in generalized and universal
vitiligoVOLUME DEPLETION AND EDEMA
BIFF F. PALMER, MD
history & physical
Volume Depletion
■clinical setting and history usually can localize site of volume
loss
➣gastrointestinal loss: vomiting, diarrhea, external gastrointesti-
nal drainage
➣renal losses: diuretic use, uncontrolled diabetes
➣skin or respiratory losses: insensible losses, sweating, burns
■Signs & Symptoms