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Treating the Disease: Age, Gender, Ethnic Skin, and Specific Locations

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Vitiligo

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Abstract

Vitiligo treatment has to be tailored to every individual after considering several individual features, including age, gender, and ethnic skin type as well as the specific location of patches. Vitiligo affects people of all age groups though the highest incidence is seen in the second and third decades of life. Treatment options are limited in childhood vitiligo because some systemic therapies are contraindicated, phototherapy is difficult to administer, there are age-specific adverse effects of different medicines, and, finally, there are difficulties in undertaking surgical treatment in children. In spite of all these limitations, response to medical as well as surgical treatments is generally stated to be better in children compared to adults. Vitiligo in older patients does not usually produce as much distress as in young people since the psychosocial burden is considerably less at this stage of life when getting married and securing employment are not of concern. The social stigma and cosmetic disfigurement of vitiligo affect both men and women, but the burden is significantly heavier in women, particularly in communities where marriages are arranged by families. Treatment options and response are similar in men and women. Vitiligo in subjects with darker skin poses particular problems because of the greater visibility and disfigurement along with the widespread prejudices and taboos associated with the disease in these communities. The location of patches is an important determinant of response with vitiligo on the hands and feet, knees and elbows, and the mucosae responding poorly to all current treatment modalities. Choice of surgical technique, dressing, and postoperative care and instructions are guided by the site affected.

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  1. Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India

    Savita Yadav & M. Ramam

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  1. Savita Yadav
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  1. Cutaneous Physiopathology & CIRM, San Gallicano Dermatological Institute, Rome, Italy

    Mauro Picardo

  2. Hôpital Saint André, Service de Dermatologie Adulte et Pédiatrique, INSERM U 1035, Université de Bordeaux, Bordeaux, France

    Alain Taïeb

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Yadav, S., Ramam, M. (2019). Treating the Disease: Age, Gender, Ethnic Skin, and Specific Locations. In: Picardo, M., Taïeb, A. (eds) Vitiligo. Springer, Cham. https://doi.org/10.1007/978-3-319-62960-5_41

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