Haematological problems
Catherine Nelson-Piercy in Handbook of Obstetric Medicine, 2020
Iron deficiency is by far the commonest cause of anaemia and iron deficiency anaemia is the commonest haematological problem in pregnancy. Pernicious anaemia is associated with other autoimmune conditions (Addison's disease, vitiligo) and is caused by intrinsic factor antibodies, leading to vitamin B 12 malabsorption. Essential thrombocythaemia, causing an isolated thrombocytosis, is a myeloproliferative disorder and is rare in women of childbearing age. Women with essential thrombocytosis have an increased risk of adverse pregnancy outcome, including FGR, possibly related to placental thrombosis. Danazol, vincristine, rituximab, dapsone and thrombopoietin receptor agonists (e.g. eltrombopag) have been successfully used for severe resistant cases in pregnancy. The obstetric patient with massive bleeding should be managed according to pre-defined and agreed protocols in close collaboration with haematology and anaesthetic staff. Various complement abnormalities (including specific deficiencies and antibodies) are screened for at the National Renal Complement Therapeutics Centre in Newcastle, UK.
Vitiligo
Steven R. Feldman, Michael D. Zanolli in Phototherapy, 2016
All patients designated for the narrowband ultraviolet B (NBUVB) protocol for treatment of vitiligo will have the routine introduction to the Phototherapy Treatment Center (PTC) facility.
Problems with pigmentation
Manu Shah, Ariyaratne de Silva in The Male Genitalia, 2018
The male genitals are normally more pigmented than other areas of skin. This is particularly noticeable in the pigmentation of the scrotum. Genital pigmentation may be isolated or may be a part of a widespread pigmentation disorder. Systemic disorders such as Addison's disease will give hyperpigmentation over various parts of the body, not just the genitals. A lentigo (plural lentigines) is a melanocytic lesion of the skin clinically similar to a freckle. Lentigines on the genitals and mucosal surfaces may indicate a genetic disorder. Vitiligo is a common skin condition resulting in destruction of melanocytes. It occurs in all races at a rate of 1–2%. It commonly presents between 10 and 30 years of age. Diagnosis is made clinically but may be facilitated by the use of the Wood's light in order to visualise areas of pigment loss. Treatment options on the genitals are limited. There are some normal variants that may present as a pigmentary problem.
Advances in the treatment options for vitiligo: activated low-dose cytokines-based therapy
Published in Expert Opinion on Pharmacotherapy, 2015
Torello Lotti, Jana Hercogova, Giuseppe Fabrizi
Introduction: Vitiligo is a skin disorder characterized by a progressive depigmentation, which is caused by the loss of melanocytes at the cutaneous level. A shift of the immune system with a prevalence of T helper (Th)1/Th17 response instead of a Tregs/Th2 one and may be part of etiology of 10 vitiligo. Areas covered: This review describes the major points of vitiligo onset and shows the cutting-edge results in the field of low-dose medicine in the treatment of dermatologic diseases and, in particular. in vitiligo. In this review on advances in vitiligo pharmacotherapy, the most pertinent recent publications are reported. Electronic databases such as PubMed were searched for terms ‘low-dose medicine’ or ‘low dose and vitiligo’ or ‘low dose and psoriasis.’ Expert opinion: The availability of a systemic treatment for vitiligo, based on the oral administration of low-dose activated signaling molecules represents an opportunity for the dermatologists to overcome some specific pitfalls of currently available therapeutic protocols.
Vitiligo – The story from within: A transmission electron microscopic study before and after narrow-band ultraviolet B
Published in Ultrastructural Pathology, 2016
Marwa M. Fawzy, Zeinab M. El Maadawi, Rehab A. Hegazy, Nesrin S. Abd El Fatah
Melanocyte loss is the main feature of vitiligo, but evidence refers to pathological multiplayers. Transmission electron microscopy was utilized to further explore vitiligo before and after narrow-band ultraviolet B (NB-UVB) therapy. Skin biopsies were retrieved from lesional and perilesional skin and compared to normal control skin. Sections were examined for melanocytes and keratinocytes and the number of melanosomes and thickness of basal lamina were measured. In lesional skin, keratinocytes revealed two types of degeneration with a significant increase in the mean thickness of basal lamina and decrease in the number of melanosomes. After treatment, lesional and perilesional skin showed variable ultrastructural features.
Transplantation of autologous minigrafts for the treatment of stable vitiligo
Published in Journal of Dermatological Treatment, 2012
Xuecheng Sun, Guopei Qian, Yule Wu, Hong Shen, Tao Wang, Jingjing Hu, Bo Guo, Jilong Wu, Aie Xu
Background: Surgical treatment of vitiligo is indicated when lesions are localized in poorly responding areas. Various surgical procedures are used to treat stable vitiligo with an inherited shortage in each one. Objectives: To evaluate the usefulness of the treatment of transplantation of autologous minigrafts for (local and generalized) stable vitiligo. Methods: Eight patients (three males and five females) with stable vitiligo qualified for the study. They were treated with autologous minigrafts after ultrapulsed carbon dioxide laser abrasion. Results: Seven patients showed excellent to good repigmentation with an average of 84.4% coverage of the treated patches. One patient had a poor response after at least 6 months of follow-up. Conclusions: Autologous minigrafts with ultrapulsed carbon dioxide laser abrasion appear to have the potential to achieve complete repigmentation in patients with stable vitiligo who fail to respond to medical treatments.
Related Knowledge Centers
- Hypopigmentation
- Oxidative Stress
- Skin Color
- Melanocyte
- Lesion
- Autoimmune
- Nostril