See the Video >>

www.youtube.com/watch?v=CbrMS6evGFI

Cheryl and I have met April and Lori at several Vitiligo conferences over the years. Lori has written a book called “DIFFERENT -- Just Like Me”

April and Lori are remakable people in an ever changing world.

Please watch the video!

Chris

A question that comes up quite often is “Should I use Protopic?” or perhaps “Should I use Elidel?” and then the question continues “… while using UVB Narrow Band?”.

Generally speaking, any drug or cream should be avoided and not be applied immediately before or during UVB Narrow Band treatment. Elidel and Protopic and most other things you apply to your skin, change the skin’s sensitivity to UV light. Some drugs increase your sensitivity (Psoralens & others) while others reduce your skin’s sensitivity (sun blocks and the like). All of these should be avoided UNLESS SPECIFICALLY PRESCRIBED by your Dermatologist.

I do recommend that if Protopic, Elidel or other Corticosteroid has been prescribed that you use it following UV treatment or on the alternate days. Do not apply these creams before treatment UNLESS SPECIFICALLY PRESCRIBED by your Dermatologist. It is not safe to apply these creams before treatment as they can increase your skin’s sensitivity to UV light and increase the risk of severe erythema (sunburn).

Do no assume that you know more than your dermatologist!

Avoid sunlight, sun lamps, tanning beds, and phototherapy treatments with UVA or UVB light. If you must be outdoors, wear loose clothing over the skin areas treated with Protopic. Do not use sunscreen on treated skin unless your doctor has told you to.

• Read more: http://www.drugs.com/protopic.html
• Read more: http://www.drugs.com/elidel.html

Folks with Psoriasis and Eczema usually respond quickkly to treatment and begin to see results with in the first week or so and treatments then continue for a month or two with most people clearing within a few months.

Here’s a page at National Psoriasis Foundation on UVB Phototherapy
Excerpt from page “Several studies indicate that narrow-band UVB clears psoriasis faster and produces longer remissions than broad-band UVB. Narrow-band UVB may be effective with fewer treatments per week than broad-band UVB. Narrow-band UVB is also emerging as an alternative to PUVA, the light-sensitizing medication psoralen plus exposure to ultraviolet light A. Although not as effective as PUVA, narrow-band UVB is easier for people to undergo and may be safer over the long term. The use of narrow-band UVB may increase as doctors and patients learn more about its effectiveness and safety…” See http://www.psoriasis.org/treatment/psoriasis/phototherapy/uvb.php

With Eczema and Psoriasis, what do you do when clearing has happened?

1. Wait for a re-occurence and start treatments again or
2. Perform a weekly maintenance dose at perhaps 75% of the last treatment time.

In either case, check with your dermatologist or medical professional. As a reminder, please read our disclaimer.

They report, Compared with broadband UVB:

• Exposure times are shorter but of higher intensity.
• The course of treatment is shorter.
• It is more likely to clear the skin condition.
• Longer periods of remission occur before it reappears.

They also mention that “This range of UV radiation has proved to be the most beneficial component of natural sunlight for psoriasis. Narrowband UVB may also be used in the treatment of many other skin conditions including atopic eczema, vitiligo, pruritus, lichen planus, polymorphous light eruption, early cutaneous T-cell lymphoma and dermographism.”

The original can be found at http://dermnetnz.org/procedures/narrowband-uvb.html - Enjoy!

CIGNA actually have the balls to say that Vitiligo is a cosmetic problem and not worthy of insurance coverage! What a load of crap!

The new policy can be found at http://uvbnarrowband.com//wp-content/uploads/pdfs/Cigna_Insurance_Coverage_2010.pdf. This is a true shame.

IN CLINIC PHOTOTHERAPY

Page 2 of 13

HOME PHOTOTHERAPY

They seem to be quite emphatic.

All I can say is that this is a huge step backwards for folks with Vitiligo. Their earlier policy’s did cover Vitiligo!

May 4, 2010 – By: Bill Gillette – Dermatology Times E-News

London — Results of a new study suggest that people with vitiligo may have natural protection against skin cancer, BBC News reports.

A University of London study of 4,300 people identified a common gene mutation that both increases the chance of vitiligo and cuts cancer risk. The finding, reported in the New England Journal of Medicine, is based on genetic testing of 1,514 patients with vitiligo and 2,813 without. Researchers identified a total of seven genes that were linked to vitiligo.

According to the study authors, about 70 percent of people in the general population have the gene combination that increases the risk of vitiligo while reducing the risk of malignant melanoma. Thirty percent have a different version that raises melanoma risk while lessening the chances of vitiligo.

The study notes that while everyone has one of the two variants, neither guarantees that either vitiligo or melanoma will actually develop — just as neither guarantees protection.

The new Dermalume 2X uses the National Biological Corp CPT or Controlled Prescription Timer to help the doctor and the patient work together for optimal treatment.

It’s interesting to see the sales of our Dermalight 80 drop slightly as our sales of the Dermalume ramp up.

The Dermalume 2X arrives ready for use in a handy briefcase type case allowing the user to easily pack it away between treatments and carry it with them while traveling.

The unit allows the user to treat only affected areas – and use comb to maintain consistent distance from skin or separate hairs for scalp psoriasis treatment.

The clever hinge allows multiple wand positions can be held where you want while the two lamps with the large output window allow for faster treatment. The DermaLume is shipped fully assembled with an optional comb attachment (includes) , goggles, and carrying case.

You can learn more about the Dermalume 2X at our website. Please visit http://www.homephototherapy.com/dermalume2X.htm for more information.

Dr. James Nordlund

Today I was reading the Winter Newsletter from Vitiligo Support International and one of the articles was edited and vetted by Dr. James Nordlund here in Cincinnati.

An often-expressed concern of both vitiligo patients and dermatologists is whether having vitiligo increases one’s risk for non-melanoma and/or melanoma skin cancer and if ultraviolet light therapy is a safe treatment. Though there are limited, but growing data, on this subject, key observations have been made which can help both the individual with vitiligo and dermatologist to better assess this risk. To effectively address the question, the information has been separated into these categories.

• Do vitiligo patients in general have an increased incidence of skin cancer?
• Do vitiligo patients have an increased risk of non melanoma skin cancer (NMSC) in their depigmented lesions?
• Do vitiligo patients have an increased risk of melanoma and/or NMSC in their “normal” skin?

Melanin is the substance that gives the skin its color, with darker skin having higher melanin levels. Melanin acts as a sunscreen and protects the skin from ultraviolet light which helps prevent sunburn damage that could result in DNA changes and, subsequently, melanoma. The assumption by many has been that that because the depigmented skin affected by vitiligo has no melanin, that the patient would be more susceptible to some types of skin cancer.

Because there are no melanocytes in depigmented skin, it would be biologically impossible to develop in depigmented skin a melanoma the most serious type of skin cancer. The other forms, the so called basal epithelioma, could develop but are easily treated and are not life threatening.

Unfortunately there are no great statistical studies on cancer in vitiligo. However most research and/or observations indicate that while non melanoma skin cancers do occur in vitiligo patients, they are very rare and melanomas in the normal skin occur at most, in no greater incidence than within the normal population.
An interesting observation on this subject was reported in the book Vitiligo: A Monograph on the Basic and Clinical Science, by Seung-Kyung Hann and James J. Nordlund. Dr. Nordlund observed that in East African countries near the equator, where few work indoors and sunscreen is unavailable, that people with vitiligo not only do not appear to get skin cancer, they exhibit little sun damage to their skin. Other studies also agree that vitiligo patients generally do not demonstrate sun-induced skin damage, despite the lack of protective melanin in the skin.

Ultraviolet light, both natural sunlight and artificial light in PUVA, Excimer laser and narrowband UVB, is an important therapeutic tool for vitiligo. To date, most studies agree that light used in accordance with a supervised treatment plan is a safe, effective method for treating vitiligo. More long term studies will be needed to further assess any skin cancer risk from these treatments.

VSI would like to thank Dr. James J. Nordlund, Professor of Dermatology, Group Health Associates, Cincinnati, OH and Wright State School of Medicine, for his significant contributions to, and medical review of this article.

I’ll keep reading this blog for a while but it would be nice to know who is publishing it and why?

Link to full article <Click Here>
PDF of Article <Click Here>

AUTHORS: Y Hari Kishan Kumar¹, G Raghu Rama Rao¹, K.V.T Gopal, G Shanti, K Veerabhadra Rao

Background: Very few studies have been performed to evaluate the efficacy and safety of narrow-band ultraviolet B (NBUVB) therapy in Indian patients with vitiligo and are of small sample size.

Aims: The purpose of this study is to know the efficacy and safety of NBUVB in 150 vitiligo patients of various age groups.

Methods: One hundred fifty patients (69 males, 81 females), aged 3-70 years, with vitiligo were treated twice weekly with NBUVB. The starting dose was 250 mJ/cm 2 in adults and 150 mJ/cm 2 in children, with 20% dose increments at each subsequent visit given for a maximum period of 1 year and were followed-up for 6 months for stability of repigmentation. Statistical methods were employed to establish the relation between the response and the number of exposures, duration of treatment, cumulative dose and the compliance.

Results: Analysis of our study showed that a majority of our cases, about 73, achieved 25-75% repigmentation, with an average of 51 ± 19 exposures, 51 had <25% repigmentation, with an average of 19 ± 11 exposures and 26 had >75% repigmentation, with an average of 74 ± 24 exposures. Good response to therapy was directly associated with good compliance, more number of exposures and increasing cumulative dose, which was statistically significant (P < 0.01). Adverse effects were minimal. Only three patients developed depigmentation of repigmented sites during follow-up.

Conclusion: Our study proves that NBUVB therapy is an effective and safe tool in the management of vitiligo, with good stability of repigmentation and cosmetic appearance.