|Year : 1991 | Volume
| Issue : 1 | Page : 45-46
A new comouflage for vitiligo
P Sugathan, R Nejeeba
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sugathan P, Nejeeba R. A new comouflage for vitiligo. Indian J Dermatol Venereol Leprol 1991;57:45-6
Treatment of vitiligo could be a frustrating experience for the practicing dermatologists in places like India where people expect fast and predictable results with modern medicine. Psoralen, the only effective drug used in the treatment of vitiligo is unpredictable in its results and can cure only about 20% of patients. Another 60% have to be satisfied with a' not so perfect' repigmentation appearing in about 6 months to 2 years. Therefore during this period prescription of a camouflage, will boost their morale.
There are several ways of doing this. Alteration in dresses and hair styles, as far as permissible in the society they live in, is one. Cosmetics and make-ups are also used by some. Chemicals which can temporarily mask the area of depigmentation are popular in the west. Among these Potassium permanganate 2 Indigo carmine, Bismark brown 3 and Dihydroxy acetone are the best known. None of these give an acceptable match for the pigmented skin of the Negro or the brown skinned South Indians.
In our experience, the only acceptable camouflage suitable for any shade of skin colour is a snuff coloured powder made by the local Ayurvedic practitioners for the treatment of anaemia. It is made by exposing iron filings to sun light with liberal lacing of vegetable extracts for several days. It is called "Loha Bhasma (Loha = iron metal and bhasma-powder). The only disadvantage observed was that it is rubbed off easily. Our attempts to produce a chemical complex with this substance such that it would bind with the stratum corneum failed.
The availability of a non-toxic effective, and easy to use camouflage developed by a frustrated patient who could not accept any of the available treatment modalities is hence reported. A 40-year-old person, driver by occupation developed vitiligo about 9 years ago. Six months later it started spreading rapidly and involved his whole body leaving only a small patch of pigmentation in his right axilla. The sensible thing to do then was to bleach it with benoquin. But he refused to accept that advice because of the severe social ostracism he had to face in public places. So he consulted various specialists in other systems of Medicine available in India. Finally dejected and dispirited, he sought solace in the scriptures. While reading the Ramayana-the epic story of Rama he came across the name of a medicine, SUVARNA KARINI (Word meaning 'one that makes golden colour').
After exhaustive enquiries to practitioners of indigenous medicine he learnt that it is a kind of brownish clay available in one of the northern districts of Kerala State. He obtained a sample and went about experimenting with it to produce a mixture to match his original skin colour. The procedure was as follows.
The powdered clay (suvarnakarini) was sifted through a fine sieve. 25 ml of a mixture of vegetable oils consisting of equal volumes of coconut oil, sesame oil and chaulmoogra oil was heated over low fire for 30 minutes with 15 gms of green leaves of henna (Lawsonia inermis L). The oil was then filtered and mixed with the powered clay and heated over slow fire with constant stirring. Small quantity of charcoal obtained from the twigs of Neem
(Azadirachta Indica L) was added to give a lighter or darker shade. The mixture was allowed to cool in a semisolid form and was ready for use.
It spreads easily and is washed off only with soap and water.
He claimed that he could produce a wide range of skin colour by adjusting the concentration of the ingredients. Best results were seen in uniformly depigmented individuals. he has been applying this mixture on his face, head neck and forearms for the past 4 years without any ill effect. As the ingredients were not toxic it was offered to several patients for trial and the results of one are shown in [Figure - 1] and [Figure - 2].
| Comments|| |
Undoubtedly this is a very useful preparation for generalized vitiligo even though it is greasy. It was accepted by all our patients, even those who could not get a perfect camouflage. The results were not satisfactory in the trichrome variety and early vitiligo. If it could be
manufactured in a cream base and in several shades it could be a very useful camouflage
for treatment of vitiligo in pigmented people. Whether Suvarna Karini will nullify the effect of Psoralens by absorbing the ultra violet radiation requires further investigation.
| References|| |
|1.||EL-Mofty A M, Nada M M; Vitiligo and its treatment. In Essays in tropical Dermatology. 2; Marshall J (Ed) Amsterdam, Excerpta Medica Monograph; 1972, 41-49. |
|2.||Griffiths W A D, Ive F A and Wilkinson J D : Topical therapy In Text Book of Dermatology 4th edition Vol. 3. Rook A, Ebling F J G Wilkinson D S et al (Eds) Bombay, Oxford University Press, 1987; pp 2571. |
|3.||Sutton R L Jr : Dermatoses due to pigmentary disorder In Diseases of the Skin. 11th edition St. Louis, The C. V. Mosby Company, 1956; pp 796. |
|4.||Blau S Kanof N B and Simonson L : Dihydroxy acetone (DHA) : A Keratin Coloring Agent. Arch Dermatol 1060; 82. 501-504. |
[Figure - 1], [Figure - 2]