Views and Beliefs of Vitiligo Patients in Online Discussion Forums: A Qualitative Study.

Individuals with chronic illnesses turn to online communities to engage in asynchronous peer-to-peer exchanges to better understand and manage their disease. Messages and advice exchanged by online users with vitiligo are not well characterized. We conducted a qualitative study to explore the content exchanged by individuals with vitiligo in online forums. An interpretive research paradigm was utilized to assess public online forum content. A systematic search using the phrases online forum vitiligo support, vitiligo online message board, and vitiligo forums identified 39 relevant forums; 9 of them met inclusion criteria, with 382 total anonymous users. Major themes and subthemes included vitiligo disease management, homeopathy/home remedies, psychosocial impact, public perceptions, and camouflage/concealment.

Homeopathic Treatment of Vitiligo: A Report of Fourteen Cases.

BACKGROUND Vitiligo, also known as leukoderma, is an autoimmune skin condition that results in the loss of melanin pigment. Vitiligo is not a rare condition but is difficult to treat and is associated with psychological distress. CASE REPORT A series of 14 cases of vitiligo are presented that were treated with individualized homeopathic remedies that were based on plant, animal, or mineral compounds. There were 13 women and one man in the case series, with a mean age 29.8 years, and a mean follow-up from treatment of 58 months. The mean time between the onset of the appearance of vitiligo and the first consultation at our clinic was 96 months. Homeopathic treatment for patients is holistic and was performed on an individualized basis as described in this case series. Photographic images of the skin are presented before and after treatment. CONCLUSIONS In 14 patients with vitiligo treated with individualized homeopathy, the best results were achieved in the patients who were treated in the early stages of the disease. We believe that homeopathy may be effective in the early stages of vitiligo, but large controlled clinical studies are needed in this area.

Integrating modern dermatology and Ayurveda in the treatment of vitiligo and lymphedema in India.

BACKGROUND: Globally, governments have recognized the growing popularity of Complementary and Alternative Medicines and the possibility of their combined use with biomedicine. Decisions within the Government of India have led to a conducive environment for conducting clinical studies, to achieve integration of more than one system of medicine, so that their combined benefits can be brought to bear on chronic, difficult-to-treat conditions. AIM: To develop integrative dermatology treatment protocols for patients with long-standing skin diseases who have received treatment from many centers. MATERIALS AND METHODS: A team of doctors from modern dermatology, Ayurveda, yoga therapy, and homeopathy studied recruited patients to develop mutual orientation on each therapeutic system and a working knowledge of approach to their clinical diagnosis. Six-hundred thirty-eight patients affected by lower limb lymphedema requiring skin care as a major part of treatment were treated integrating modern dermatology and Ayurveda. Three-hundred eighty-one vitiligo patients were examined and treated to understand the clinical presentations and treatment options in Ayurveda. RESULTS: A two-step cluster analysis performed by SPSS Version 16 showed average volume reductions of 13.3% and 23% on day 14, 19.7% and 31.1% on day 45, and 23.4% and 39.7% on day 90 of treatment in small and large lymphedematous limbs. Inflammatory episodes before the onset on this treatment was reported by 79.5% of our lymphedema patients, and 9.4% reported this at the end of three months after our treatment. Among vitiligo patients, we found that 39.6% of patients had kapha, 39.8% pitta, 10.8% had vatha and 0.52% has tridoshaja presentation. There are over 100 treatment options available in Ayurveda to treat vitiligo. DISCUSSION: Each system of medicine recognizes the same disease albeit with minor difference in description. Skin care procedures like washing and emollients restore the barrier function and skin health. We have converged Ayurvedic skin care with that of dermatology with an aim of achieving patient management that is better than that achievable by a single system alone. Overload of the lymphatic system due to loss of epidermal barrier function and consequent inflammation from bacteria and soil irritants is responsive to selected Ayurvedic herbal preparations. CONCLUSION: It is evident that integration at the therapeutic level is possible, although the pathological basis is interpreted differently. Irrespective of background understanding of the given disease, a mutually oriented multisystem therapeutic team was able to effectively use medicines from more than one system of medicine and to develop guidelines for their prescription and a patient care algorithm.

Homoeopathic treatment of vitiligo: an open observational pilot study

Background: Vitiligo is a common hypopigmentation disorder with significant psychological impact. An evaluation of homeopathic treatment was performed in individuals with vitiligo in a hospital outpatient clinic in West Bengal, India. Methods: Thirty participants (median age 27 years old, 57% female) were recruited for a prospective open-label pilot study and treated with individualized homeopathic medicines for 6 months. Efficacy was assessed after 3 months and 6 months using Vitiligo Area Scoring Index (VASI) score, Vitiligo European Task Force (VETF) score, and Dermatological Life Quality Index (DLQI) score, which are validated outcome measures evaluating the area, intensity, spread of depigmentation of vitiligo lesions, and quality of life (QoL). Results: A total of 27 participants completed the trial; 3 dropped out. After 6 months of treatment, the median VASI total score improved significantly by 0.1 units (p=0.003), from 0.8 (0.5, 1.5) to 0.7 (0.3, 0.8) on a scale from 0 (no depigmentation) to 100 (completely depigmented). Similarly, the VETF median score improved by 2 units (p=0.0001) from 1 (0, 1) to –1 (–1, 0) and the staging score changed from 1 (1, 2) to 1 (0, 1), p=0.002. The total DLQI median score exhibited significant reduction from 21 (17, 22) to 13.6 (10, 17), change 7.4 (p=0.0001), as also did its components. Conclusions: Individualized homeopathic treatment associated with significant improvement of VASI, VETF and DLQI scores. The extent to which the observed effects were due to placebo needs clarification in future randomized double-blind clinical studies preceded by feasibility studies. (AU)

Introdução: Vitiligo é uma desordem de hipopigmentação de ocorrência comum, com impacto psicológico significativo. Foi avaliado o tratamento homeopático de indivíduos com vitiligo no ambulatório de um hospital em Bengala Ocidental, Índia. Métodos: Trinta participantes (idade mediana 27 anos, sendo 57% do gênero feminino) foram recrutados para o presente estudo piloto prospectivo aberto e tratados com medicamentos homeopáticos individualizados por 6 meses. A eficácia do tratamento foi avaliada aos 3 e 6 meses mediante Vitiligo Area Scoring Index (VASI) score, Vitiligo European Task Force (VETF), e Dermatological Life Quality Index (DLQI), que são medidas validadas de desfecho correspondendo à área, intensidade e disseminação da depigmentação causada por vitiligo, assim como a qualidade de vida (QV). Resultados: Um total de 27 participantes completou o estudo, sendo que 3 abandonaram. Depois de 6 meses de tratamento, a mediana do escore total do VASI apresentou melhora significativa de 0,1 unidade (p=0,003) passando de 0,8 (0,5, 1,5) para 0,7 (0,3, 0,8), numa escala de 0 (sem depigmentação) a 100 (depigmentação completa). De modo similar, a mediana do escore VETF de disseminação melhorou em 2 unidades (p=0,0001) de 1 (0, 1) a –1 (–1, 0), e o escore de estadiamento variou de 1 (1, 2) para 1 (0, 1), p=0,002. O escore total mediano de DLQI diminuiu de 21 (17, 22) a 13,6 (10, 17), com uma variação de 7,4 (p=0,0001); variação também foi constatada nos componentes de DLQI. Conclusões: O tratamento homeopático individualizado se associou com melhora significativa nos escores de VASI, VETF e DLQI. A parte dos efeitos possivelmente devida a efeito placebo precisa ser determinada em futuros estudos clínicos randomizados e duplo cego, após a realização de estudos de factibilidade. (AU)

Homoeopathic treatment of vitiligo: an open observational pilot study

Background: Vitiligo is a common hypopigmentation disorder with significant psychological impact. An evaluation of homeopathic treatment was performed in individuals with vitiligo in a hospital outpatient clinic in West Bengal, India. Methods: Thirty participants (median age 27 years old, 57% female) were recruited for a prospective open-label pilot study and treated with individualized homeopathic medicines for 6 months. Efficacy was assessed after 3 months and 6 months using Vitiligo Area Scoring Index (VASI) score, Vitiligo European Task Force (VETF) score, and Dermatological Life Quality Index (DLQI) score, which are validated outcome measures evaluating the area, intensity, spread of depigmentation of vitiligo lesions, and quality of life (QoL). Results: A total of 27 participants completed the trial; 3 dropped out. After 6 months of treatment, the median VASI total score improved significantly by 0.1 units (p=0.003), from 0.8 (0.5, 1.5) to 0.7 (0.3, 0.8) on a scale from 0 (no depigmentation) to 100 (completely depigmented). Similarly, the VETF median score improved by 2 units (p=0.0001) from 1 (0, 1) to –1 (–1, 0) and the staging score changed from 1 (1, 2) to 1 (0, 1), p=0.002. The total DLQI median score exhibited significant reduction from 21 (17, 22) to 13.6 (10, 17), change 7.4 (p=0.0001), as also did its components. Conclusions: Individualized homeopathic treatment associated with significant improvement of VASI, VETF and DLQI scores. The extent to which the observed effects were due to placebo needs clarification in future randomized double-blind clinical studies preceded by feasibility studies.

Introdução: Vitiligo é uma desordem de hipopigmentação de ocorrência comum, com impacto psicológico significativo. Foi avaliado o tratamento homeopático de indivíduos com vitiligo no ambulatório de um hospital em Bengala Ocidental, Índia. Métodos: Trinta participantes (idade mediana 27 anos, sendo 57% do gênero feminino) foram recrutados para o presente estudo piloto prospectivo aberto e tratados com medicamentos homeopáticos individualizados por 6 meses. A eficácia do tratamento foi avaliada aos 3 e 6 meses mediante Vitiligo Area Scoring Index (VASI) score, Vitiligo European Task Force (VETF), e Dermatological Life Quality Index (DLQI), que são medidas validadas de desfecho correspondendo à área, intensidade e disseminação da depigmentação causada por vitiligo, assim como a qualidade de vida (QV). Resultados: Um total de 27 participantes completou o estudo, sendo que 3 abandonaram. Depois de 6 meses de tratamento, a mediana do escore total do VASI apresentou melhora significativa de 0,1 unidade (p=0,003) passando de 0,8 (0,5, 1,5) para 0,7 (0,3, 0,8), numa escala de 0 (sem depigmentação) a 100 (depigmentação completa). De modo similar, a mediana do escore VETF de disseminação melhorou em 2 unidades (p=0,0001) de 1 (0, 1) a –1 (–1, 0), e o escore de estadiamento variou de 1 (1, 2) para 1 (0, 1), p=0,002. O escore total mediano de DLQI diminuiu de 21 (17, 22) a 13,6 (10, 17), com uma variação de 7,4 (p=0,0001); variação também foi constatada nos componentes de DLQI. Conclusões: O tratamento homeopático individualizado se associou com melhora significativa nos escores de VASI, VETF e DLQI. A parte dos efeitos possivelmente devida a efeito placebo precisa ser determinada em futuros estudos clínicos randomizados e duplo cego, após a realização de estudos de factibilidade.

Tratamiento homeopático para el vitiligo: un estudio piloto abierto observacional / Homoeopathic treatment of vitiligo: an open observational pilot study

Antecedentes: El vitiligo es un trastorno común de hipopigmentación que genera un impacto psicológico muy importante. En una clínica de atención ambulatoria en Bengala Occidental, India, se realizó una evaluación del tratamiento homeopático en individuos con vitiligo. Métodos: Se reclutaron 30 pacientes (edad media de 27 años; 57% femeninos) para un estudio piloto prospectivo abierto, y se manejaron con tratamiento homeopático individualizado durante seis meses. Se evaluó La eficacia del tratamiento a los tres y seis meses, utilizando el Índice de Puntuación del Área con Vitiligo (Vitiligo Area Scoring Index, VASI), la escala de la Comisión Europea de Vitiligo (Vitiligo European Task Force, VETF) y el Índice de Calidad de Vida en Dermatología (Dermatological Life Quality Index, DLQI), los cuales validaron el índice de mejoría tomando en cuenta el área, la intensidad, la extensión de La despigmentación de las lesiones de vitiligo y la calidad de vida (QoL). Resultados: Un total de 27 pacientes completaron el estudio; tres desertaron. Después de seis meses de tratamiento, la medida media de VASI mejoró significativamente en 0.1 unidades (p=0.003), de 0.8 (0.5, 1.5) a 0.7 (0.3, 0.8) en una escala de 0 (sin despigmentación) y 100 (completamente despigmentada). Del mismo modo, la media del VETF mejoró su puntuación por 2 unidades (p=0.0001), de 1 (0.1) a -1 (-1.0), y el marcador de estadificación varió de 1 (1.2) a 1 (0.1), p=0.002. La media de La puntuación total de DLQI disminuyó de 21 (17, 22) a 13.6 (10, 17), con variación de 7.4 (p=0.0001); dicha variación también fue corroborada por los componentes del DLQI. Conclusiones: El tratamiento homeopático individualizado se asoció con una mejoría significativa de las puntuaciones en VASI, VETF y DLQI. La premisa de que los efectos observados se deben a placebo se debe aclarar en futuros ensayos clínicos aleatorios doble ciego, precedidos por estudios de viabilidad.

Background: Vitiligo is a common hypopigmentation disorder with significant psychological impact. An evaluation of homeopathic treatment was performed in individuals with vitiligo in a hospital outpatient clinic in West Bengal, India. Methods: 30 participants (median age 27 years old, 57% female) were recruitedfor a prospective open-label pilot study and treated with individualized homeopathic medicines for six months. Efficacy was assessed after three months and six months using Vitiligo Area Scoring Index (VASI) score, Vitiligo European Task Force (VETF)score, and Dermatological Life Quality Index (DLQI) score, which are validatedoutcome measures evaluating the area, intensity, spread of depigmentation ofvitiligo lesions, and quality of life (QoL). Results: A total of 27 participants completed the trial; 3 dropped out. After 6 months of treatment, the median VASI total score improved significantly by 0.1 units (p=0.003), from 0.8 (0.5, 1.5) to 0.7 (0.3, 0.8) on a scale from 0 (no depigmentation) to 100 (completely depigmented). Similarly, the VETF median score improved by 2 units (p=0.0001) from 1 (0, 1) to -1 (-1, 0) and the staging score changed from 1 (1, 2) to 1 (0, 1), p=0.002. The total DLQI median score exhibited significant reduction from 21 (17, 22) to 13.6 (10, 17), change 7.4 (p=0.0001), as also did its components. Conclusions: Individualized homeopathictreatment associated with significant improvement of VASI, VETF and DLQI scores. The extent to which the observed effects were due to placebo needs clarificationin future randomized double-blind clinical studies preceded by feasibility studies.

Tratamiento homeopático para el vitiligo: un estudio piloto abierto observacional / Homoeopathic treatment of vitiligo: an open observational pilot study

Antecedentes: El vitiligo es un trastorno común de hipopigmentación que genera un impacto psicológico muy importante. En una clínica de atención ambulatoria en Bengala Occidental, India, se realizó una evaluación del tratamiento homeopático en individuos con vitiligo. Métodos: Se reclutaron 30 pacientes (edad media de 27 años; 57% femeninos) para un estudio piloto prospectivo abierto, y se manejaron con tratamiento homeopático individualizado durante seis meses. Se evaluó La eficacia del tratamiento a los tres y seis meses, utilizando el Índice de Puntuación del Área con Vitiligo (Vitiligo Area Scoring Index, VASI), la escala de la Comisión Europea de Vitiligo (Vitiligo European Task Force, VETF) y el Índice de Calidad de Vida en Dermatología (Dermatological Life Quality Index, DLQI), los cuales validaron el índice de mejoría tomando en cuenta el área, la intensidad, la extensión de La despigmentación de las lesiones de vitiligo y la calidad de vida (QoL). Resultados: Un total de 27 pacientes completaron el estudio; tres desertaron. Después de seis meses de tratamiento, la medida media de VASI mejoró significativamente en 0.1 unidades (p=0.003), de 0.8 (0.5, 1.5) a 0.7 (0.3, 0.8) en una escala de 0 (sin despigmentación) y 100 (completamente despigmentada). Del mismo modo, la media del VETF mejoró su puntuación por 2 unidades (p=0.0001), de 1 (0.1) a -1 (-1.0), y el marcador de estadificación varió de 1 (1.2) a 1 (0.1), p=0.002. La media de La puntuación total de DLQI disminuyó de 21 (17, 22) a 13.6 (10, 17), con variación de 7.4 (p=0.0001); dicha variación también fue corroborada por los componentes del DLQI. Conclusiones: El tratamiento homeopático individualizado se asoció con una mejoría significativa de las puntuaciones en VASI, VETF y DLQI. La premisa de que los efectos observados se deben a placebo se debe aclarar en futuros ensayos clínicos aleatorios doble ciego, precedidos por estudios de viabilidad. (AU)

Background: Vitiligo is a common hypopigmentation disorder with significant psychological impact. An evaluation of homeopathic treatment was performed in individuals with vitiligo in a hospital outpatient clinic in West Bengal, India. Methods: 30 participants (median age 27 years old, 57% female) were recruitedfor a prospective open-label pilot study and treated with individualized homeopathic medicines for six months. Efficacy was assessed after three months and six months using Vitiligo Area Scoring Index (VASI) score, Vitiligo European Task Force (VETF)score, and Dermatological Life Quality Index (DLQI) score, which are validatedoutcome measures evaluating the area, intensity, spread of depigmentation ofvitiligo lesions, and quality of life (QoL). Results: A total of 27 participants completed the trial; 3 dropped out. After 6 months of treatment, the median VASI total score improved significantly by 0.1 units (p=0.003), from 0.8 (0.5, 1.5) to 0.7 (0.3, 0.8) on a scale from 0 (no depigmentation) to 100 (completely depigmented). Similarly, the VETF median score improved by 2 units (p=0.0001) from 1 (0, 1) to -1 (-1, 0) and the staging score changed from 1 (1, 2) to 1 (0, 1), p=0.002. The total DLQI median score exhibited significant reduction from 21 (17, 22) to 13.6 (10, 17), change 7.4 (p=0.0001), as also did its components. Conclusions: Individualized homeopathictreatment associated with significant improvement of VASI, VETF and DLQI scores. The extent to which the observed effects were due to placebo needs clarificationin future randomized double-blind clinical studies preceded by feasibility studies. (AU)

Anamnese homeopática ou consulta homeopática? A propósito do relato de um caso de vitiligo / Anamnesis homeopathic or consultation homeopathy? The purpose of the report of a case of vitiligo

O presente artigo apresenta o relato de caso de um paciente de 12 anos de idade do sexo masculino, portador de vitiligo. tratado no ambulatório da Associação Paulista de Homeopatia. Os dados da história clínica e, acima de tudo seu exame físico, que revelou sinais de valor individualizador, possibilitaram a prescrição de medicamento similar que o vem ajudando na evolução de sua patologia. O artigo, finalmente, discute aspectos do medicamento homeopático Calcarea silicata e o sal que o origina de acordo com a matéria médica homeopática.

This paper reports the case of a 12 year-old patient, suffering from vitiligo since 6, who was treated at the Outpatient Clinic of Associação Paulista de Homeopatia. Clinical data, especially the ones arising from physical examination, revealed highly individualizing signs that allowed us to prescribe an effective homeopathic remedy. Finally, some features of homeopathic remedy Calcarea silicata are discussed, particularly from the viewpoint of the salt from which it derives, accordingly to the homeopathic materia medica.

Anamnese homeopática ou consulta homeopática? A propósito do relato de um caso de vitiligo / Anamnesis homeopathic or consultation homeopathy? The purpose of the report of a case of vitiligo

O presente artigo apresenta o relato de caso de um paciente de 12 anos de idade do sexo masculino, portador de vitiligo. tratado no ambulatório da Associação Paulista de Homeopatia. Os dados da história clínica e, acima de tudo seu exame físico, que revelou sinais de valor individualizador, possibilitaram a prescrição de medicamento similar que o vem ajudando na evolução de sua patologia. O artigo, finalmente, discute aspectos do medicamento homeopático Calcarea silicata e o sal que o origina de acordo com a matéria médica homeopática.(AU)

This paper reports the case of a 12 year-old patient, suffering from vitiligo since 6, who was treated at the Outpatient Clinic of Associação Paulista de Homeopatia. Clinical data, especially the ones arising from physical examination, revealed highly individualizing signs that allowed us to prescribe an effective homeopathic remedy. Finally, some features of homeopathic remedy Calcarea silicata are discussed, particularly from the viewpoint of the salt from which it derives, accordingly to the homeopathic materia medica.(AU)