New in the treatment of vitiligo in the world. Homeopathic treatment of vitiligo. “Cosmetic” treatment of vitiligo with tea

The disease vitiligo is expressed in the skin. It cannot be hidden from others, which significantly ruins the lives of those suffering from this disease. The disease is difficult to treat and remains poorly understood. Recently, scientists have found a new treatment in the fight against vitiligo; the medicine is also still under study, but doctors agree that a serious breakthrough has already been made. It is worth noting that until now, doctors have not yet been able to completely cure a person from vitiligo.

Description of vitiligo disease - causes and symptoms

Vitiligo is a disease associated with the pathological production of melanin (the pigment that gives color to our skin) and destructive processes leading to the destruction of melanocytes.

Visually, the disease manifests itself in the form of white spots on the skin. They can be localized anywhere: on the face, head, neck, torso, limbs. The size of the spots is ambiguous. For some, it may be small patches on a certain area of ​​the body, for others, vitiligo occupies about 70-80% of the skin.

On a note! The disease vitiligo is also known as leukoderma.

Some facts

• The disease affects about 2% of people worldwide.
• Vitiligo affects people, regardless of their gender, age, race.
• The probability of transmitting the disease from parents to child is approximately 35%.
• The lighter your skin color, the less noticeable the spots. Vitiligo affects black people the most.
• If light spots appear on the scalp, the hair in this area also turns white.
• The disease is not transmitted by contact, it is impossible to become infected with it.

Causes

The exact causes of vitiligo are unknown. Doctors identify several main factors contributing to the development of leukoderma:

• Autoimmune processes. Scientists have established the fact that vitiligo is more often observed in patients suffering from autoimmune diseases(lupus erythematosus, rheumatoid arthritis, thyroiditis, stage I diabetes mellitus). There are observations proving that they destroy their own melanocytes immune cells person.
• Diseases endocrine system . Thyroid controls hormonal background, and many depend on its condition metabolic processes in organism. Various pathologies this organ can lead to disruption of melanin production.
• Trophic disorders of the epidermis. Destructive processes in the trophism of the skin can occur as a result of burns, injuries, operations and other violations of the integral integument of the epidermis. Inflammatory processes provoke an autoimmune reaction, as a result of which melanin is destroyed. But in such cases, the spots usually do not spread throughout the body, but are localized in the area of ​​the damaged skin.
• Genetic factor. Some observations have shown that vitiligo developed in people who inherited the disease gene in their DNA. Moreover, this does not mean at all that the mother or father suffered from the disease. Someone from past generations could have had the disease.
• Some medications. Taking some heavy medications leads to disruption of melanin production and can provoke the development of the disease.

Vitamin therapy

Complete treatment of vitiligo is impossible without vitamins. It is the lack nutrients often leads to a malfunction of the immune system and gives rise to the development of complex diseases.

So, what vitamins are needed for the production of melanin:

• Vitamin C (ascorbic acid).
• B vitamins (B6, B1, B9, B5).
• Vitamin A (carotene).
• Vitamin E (tocopherol).

Microelements:

• Copper.
• Zinc oxide.
• Magnesium.

Vitamins for vitiligo should be selected by a doctor in accordance with the patient’s tests.

Comprehensive treatment of vitiligo

Doctors from all over the world agree that the treatment of the disease must be approached comprehensively.

Therapy should include medications, aimed at eliminating autoimmune processes, medications that regulate hormonal levels, vitamins that replenish the deficiency of valuable elements in the body, as well as methods for external use - UV lamp 311 nm and ointments that stimulate melanin production.

Important! Only complex treatment of vitiligo can give sustainable results and prevent relapses.

Vitiligo and the army – news 2018

The latest edition of the resolution of the Government of the Russian Federation “On approval of the Regulations on military medical examination” was made on July 19, 2016. The document states that patients with vitiligo, depending on the degree of the disease, have limited ability to military service or completely fit.

Thus, to the question that worries many, whether people with vitiligo are accepted into the army, the answer is unequivocal - “yes, they do.” Both doctors and military personnel are confident that with such an illness one can serve without any fear for one’s health.

In 2017, no amendments were made to the document.

Drawing conclusions

The study of vitiligo disease is far from over. Scientists still have a lot of work to do in this area. But 2018 marked the beginning of a completely new approach to anti-inflammatory therapy. of this disease. Everything new in the treatment of leukoderma is based on the impact on the root of the disease, which undoubtedly leads to lasting results. There is great hope that soon thousands of people around the world will be able to get rid of complexes and significant discomfort experienced from defects in their appearance.

During the new experimental research scientists at Tufts University School of Medicine, Boston, USA, determined that local application Janus kinase inhibitors are effective for the treatment of vitiligo. The results of the work were published in the Journal of the American Academy of Dermatology.

Vitiligo - autoimmune pathology, in which CD8 + T lymphocytes cause the destruction of melanocytes, which is manifested by the appearance of foci of depigmentation. This condition difficult to treat and can cause cosmetic defect leading to social difficulties and emotional disorders. The main method of treatment for patients with pathology currently is the use of local corticosteroid drugs or calcineurin inhibitors in combination with phototherapy. This approach may result in partial repigmentation of patches on the face and trunk, but peripheral lesions remain resistant to all treatment options.

Janus kinase inhibitors, such as ruxolitinib and tofacitinib, suppress the activity of cytotoxic T lymphocytes. The effectiveness of this group of drugs has been studied for the treatment of rheumatoid arthritis, psoriasis and psoriatic arthritis. Tofacitinib is currently used successfully to treat rheumatoid arthritis. In experiments on laboratory mice, scientists noted that inhibition of CD8 + T lymphocytes causes the disappearance of symptoms of alopecia areata, inflammatory disease skin, pathophysiological mechanisms the development of which is similar to the processes leading to the occurrence of vitiligo. In previous studies, experts found that patients with alopecia areata and vitiligo oral administration ruxolitinib promoted rapid repigmentation of lesions, and taking tofacitinib for 5 months led to the reappearance of pigmentation not only on the face, but also in peripheral areas. Experts noted that oral administration of Janus kinase inhibitors is associated with the development of dangerous side effects such as pancytopenia, malignancy and infections. At the same time, local use of these drugs does not lead to the development of such side effects, because specialists studying vitiligo and alopecia areata consider them as promising methods of therapy.

In this study, researchers evaluated the effectiveness of ruxolitinib 1.5% cream in patients with vitiligo (n=12; 54% men, average age- 52 years old). Participants applied the cream to the damaged areas; specialists assessed the severity of the pathology using the Vitiligo Area Scoring Index (VASI) at the beginning of work and after 20 weeks. After analyzing the results, the scientists noted that the prevalence of the disease in participants decreased by 23%, with the first signs of repigmentation appearing in the 4th week of the study. Experts emphasized that the lesions located on the patients’ faces decreased most significantly (by 76%), and in 3 participants, depigmentation spots on the hands decreased. The observed side effects were mild and consisted of erythema, mild acne and transient hyperpigmentation. Long-term repigmentation achieved during the study, in currently remains unknown.

In this small pilot study, the authors, according to their own statement, proved the promise of studying Janus kinase inhibitors as drugs for the treatment of vitiligo. They noted that during the work they did not evaluate factors influencing the progression of the pathology, such as fluctuations in the level of insolation; in addition, the small sample size does not allow for a full statistical analysis of the results obtained. However, Janus kinase inhibitors appear to improve the condition of patients with vitiligo and other inflammatory pathologies skin, the development of which is associated with the activity of cytotoxic T-lymphocytes. The next step will be to conduct a randomized placebo-controlled clinical trial to evaluate the effectiveness and safety of Janus kinase inhibitors for vitiligo.

• Lipper G.M.(2017) A promising new treatment for vitiligo? Medscape. July 12 (http://www.medscape.com/viewarticle/882782).
• Rothstein B., Joshipura D., Saraiya A. et al.(2017) Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib. J. Am. Acad. Dermatol., 76(6): 1054–1060.e1.

Yulia Kotikovich

Vitiligo is a type of skin disease in which the skin loses its natural pigmentation due to the destruction of melanin. The result of this is discoloration of areas of the skin and its variegation. The common Russian name for this disease sounds like “dog,” which is most likely due to the variegation of the skin in vitiligo.

Another name for the disease is leucoderma, which in Latin means White skin. The name vitiligo can come from the Latin “vitilum” (flaw, defect) or “vitilus” (calf), associated with both irregularities in skin color and the variegation of calf skin.

Causes of vitiligo

A person is not born with this skin feature, but acquires it under the influence of various external and internal factors. The highest frequency of onset of the disease occurs in the first ten years of life, puberty, as well as pregnancy and menopause in women. There is also a connection between the appearance of the first signs of the disease and periods of greater solar activity (spring and summer).

The factors that provoke the onset of the disease are very diverse.

Autoimmune processes

In which antibodies to own tissues, play an important role in the occurrence of vitiligo. This is confirmed by the fact that patients with vitiligo often have other autoimmune diseases (systemic lupus, rheumatoid arthritis, defeats thyroid gland eg Hashimoto's goiter, type 1 diabetes mellitus, Addison's disease, alopecia areata).

Genetic predisposition

Available genetic predisposition to vitiligo. This position was proven in experiments by R. Spritz from the University of Colorado. They established not only a relationship with a family predisposition to the disease, but also proved that people with light (gray or blue eyes) are less likely to suffer from vitiligo than brown-eyed people. Also, the incidence of the disease is higher in the Negroid race.

Neuroendocrine causes

This sharp fluctuations hormone levels and stressful conditions, which can initiate the onset of the disease.

Trophic disorders

These nutritional disorders of the skin and underlying tissues are associated with skin injuries (mechanical, chemical, radiation damage). So, after a mechanical violation of the integrity of the skin, an inflammatory reaction with an autoimmune component is triggered, which leads to the destruction of cells producing the melanin pigment. With frequent exposure to the sun, the existing process of skin depigmetation quickly and noticeably progresses.

Medicines

The effect of drugs and some chemical substances can also cause areas of skin depigmentation to appear.

Liver diseases

There is a relationship between vitiligo and liver pathologies (parnechymatous changes and bile stagnation), as well as helminthic infestations and giardiasis.

At the tissue level, vitiligo is associated with the death of melanocytes, and at the cellular level, with inhibition of tyrosinase, an enzyme that is involved in pigmentation.

Symptoms of vitiligo

The disease manifests itself in the appearance of clearly defined spots or foci of a milky white color on the skin. Their characteristic locations are areas around the mouth, ears, nose, eyes, back side hands and feet, fingertips, armpits, elbows and knees, groin and perianal area. The darker the patient's skin, the more distinct the boundaries of the lesions. May also be affected hairy part head or beard and mustache area in men.

There are several types of depigmented spots:

• Tricolors have a pigmented outline where the white skin transitions to healthy skin.
• The four-colored ones have an additional highly pigmented border.
• Inflammatory ones are limited to the raised shaft.
• The bluish ones have a corresponding coloration.

Localized form - lesions in limited areas of the skin

• The focal form of the disease is isolated, often single spots or lesions on one or two areas of the skin.
• Segmental vitiligo is a unilateral lesion within the dermatome (segment of skin supplied by one spinal or cranial nerve).
• Mucosal vitiligo is a lesion of the mucous membranes.

The generalized form is manifested by extensive skin changes

• Vulgar vitiligo - lesions are scattered throughout the body.
• Acrophysical – the face and limbs are affected.
• The total form is also called universal vitiligo and is characterized by extensive areas of depigmentation spread over many segments, occupying up to 80% of the skin.

In addition to skin lesions, other symptoms may be observed:

• lightening or graying of hair in affected areas,
• leucoderma,
• alopecia,
• eye damage with chorioretinitis (inflammation posterior section choroid eyes, including the retina).

For most patients, vitiligo progresses slowly but steadily without treatment. There are also cases of spasmodic depigmentation or independent restoration of pigment.

How to make a diagnosis

Diagnosis is carried out by a dermatologist. To do this, he is based on skin examination data and uses a special Wood's lamp, in the rays of which the areas of depigmentation have clear outlines and glow with white-blue fluorescent light. If necessary, areas of skin are taken for a biopsy, which confirms or refutes the diagnosis most accurately.

Not all white spots on the skin are caused by vitiligo, and this disease must be distinguished from large number pathological conditions.

Here are just a few: post-traumatic scars, hypopigmentation due to eczema or atopic dermatitis, chemical leucoderma, secondary syphilis, pityriasis versicolor, tuberous sclerosis, focal scleroderma. Selenium deficiency, hypomelanosis spotted, visceral leishmaniasis. Leprosy, lichen sclerosus.

Treatment methods for vitiligo

Despite the fact that the medical literature describes cases of spontaneous recovery from the disease and spontaneous restoration of skin pigment without any treatment, the risks of constant progression of the process are high. Therefore, a reasonable patient tactic should be limited to seeking medical care see a dermatologist.

Since the disease affects not only the skin, but also the immune system. endocrine and nervous system, then treatment involves A complex approach and is divided into the use of local and systemic drugs various groups.

Glucocorticoids

These are drugs that suppress inflammatory (including autoimmune) and allergic reactions.

For a localized form of the disease Local treatment with hormonal ointments is indicated.

• The first stage is ointments with medium activity: Hydrocortisone butyrate (Lokoid, Laticort), Hydrocortisone butyrate (Lorinden, Locacorten), (Flumetasone) Fluorocort, Triacort (Triamcinolone), Esperson (Dexamethasone), Alcomethasone (Afloderm). Course duration is 3-4 months.
• If there is no effect, switch to highly active ointments: Mometasone fuorate (Elocom), Fluticasone (Cutivate), Methylprednisolone aceponate (Advantan), Fluacinolone (Sinalar, Flucinar), Clobetasol (Dermovate), Betamethasone (Celestoderm, Beloderm) for two months with repeated courses in 1-4 months.

For generalized vitiligo resort to systemic administration of glucocorticoids in tablets. To reduce side effects from such treatment (Cushing's syndrome, diabetes mellitus) use pulse therapy or alternating withdrawal therapy with short high doses, alternating with certain breaks in taking the drugs. Prednisolone, Methylprednisolone, Dexamethasone, Triamcinolone are prescribed in tablets.

Photosensitizing drugs

They cause an increase in the sensitivity of melanocytes to the effects of ultraviolet radiation, under the influence of which skin pigments are actively formed. This group of drugs is plant furocoumarins.

• Beroxan contains two parsnip furocoumarins (bergapten and xanthoxin).
• Methoxalen, Puvalen, Oksoralen, Lamadin contain only xanthoxin.
• Meladinin – isolated from amia major (contains xanthoxin and imperatorin).
• Ammifurni - similar to beroxan with the addition of isopimpinellin, also isolated from amium.
• Psoralen is isolated from psoralea.
• Psoberan – made from figs.

Ultraviolet lamp for treatment

It is used to irradiate the skin after taking photosensitizing agents and has a long wavelength of radiation (320-420 nm). This method is called PUVA therapy. It is contraindicated during pregnancy, in children under five years of age and persons over 60 years of age, with cancer pathologies, hypersensitivity to ultraviolet radiation, blood diseases, of cardio-vascular system, liver, kidneys.

A more gentle way of ultraviolet irradiation of vitiligo areas is treatment with a lamp with medium length waves (311 nm) without prior photosensitization with drugs. This method is called narrowband phototherapy. It has a gentler effect on the body, almost no adverse reactions, but less effective. The duration of the procedure is from 1 to 5 minutes. Studies by Californian dermatologists claim that even long courses of ultraviolet irradiation (up to 36 months) do not lead to skin cancer in patients.

Other means

To combat vitiligo, treatments for psoriasis and dermatitis - Elidel and Protopic - are also used. These are preparations for external use, based on the anti-inflammatory drug macrolactam ascomycin. The drug suppresses T-lymphocytes and inhibits the body's immune response, while simultaneously providing an anti-inflammatory effect similar to glucocorticoids.

In children, 0.03% is used, and in adults, 0.1% ointment is used. The duration of the course is from three months to six months. The most pronounced results are achieved on the face. The area of ​​the hands and feet is less susceptible to therapy. The drug is used both in isolation and in combination with narrowband ultraviolet irradiation. The drug works only locally and is not absorbed into the blood.

Systemic therapy

Systemic therapy also involves the use of correction hormonal disorders, treatment of depression and neuropsychiatric diseases which could lead to the development of vitiligo. Drugs that restore the deficiency are also prescribed. ascorbic acid, copper, immunomodulators, .

New in treatment

• Laser therapy

• Skin whitening

This is an attempt to equalize the tone of the affected areas and healthy skin. Today, the most popular means for this procedure are injections of eloquin, hydroquinone (2-4%) and its monobenzyl ether (Monobenzone) externally. All drugs are quite aggressive and have a lot of side effects, so they cannot be considered a panacea in solving the problem of depigmentation. In addition, the price tags on them are quite steep (an injection of eloquin costs about 50 thousand rubles), and lightening occurs in sections, so it requires almost permanent use drugs.

• Surgical treatment or autologous skin grafting

More effective for patients with small lesions. This method is expensive, traumatic, and can lead to postoperative purulent complications or transplant rejection reaction and, unfortunately, does not guarantee a lasting effect.

• Melanocyte transplantation

This is the introduction of pigment cells taken from healthy areas of the patient’s skin into his problem skin.

• Melagenin plus

This is an alcoholic extract of human placenta produced in Cuba. Under the name Melagenin, the drug has been on the market since 1998 and is characterized by average effectiveness against localized forms of the disease.

• Creation of a vaccine

In 2013, scientists from medical school at the University of Chicago, in a series of experiments on mice, they tested a protein vaccine that suppresses the autoimmune reaction leading to vitiligo. However, until now there has been no information about the completion of work on the vaccine.

• Sceness drug

The Australian drug Sceness, registered in Europe for the treatment of erythropoietic protoporphyria, also holds promise for the treatment of depigmentation in vitiligo.

Treatment of vitiligo with folk remedies

• It is immediately worth noting that the uncontrolled use of herbal photosensitizing agents (St. John's wort, amia, psoralea) can lead not to a cure for vitiligo, but to sunburn.
• Natural immunomodulators such as duckweed also do not provide any positive effect.
• The course of herbal treatment also includes plants containing copper (, arnica, yarrow) and adaptogens (Rhodiola rosea, Eleutherococcus, Aralia).
• To the interesting folk methods drugs can also be included Chinese medicine Xiaodan and Xiaodianlin, which are unknown if they help anyone other than the followers of these areas of medicine.

Summing up the prospects for treating vitiligo, we must admit that this process is painstaking and time-consuming, leading to recovery in approximately 20% of cases, with spontaneous recovery in approximately 5% of patients.

Unfortunately, there are still many little-studied diseases in the world. But medicine does not stand still, and for a disease such as vitiligo, scientists have found a method to successfully combat it. What are the factors for the development of vitiligo and what is it? new method said Yulia Vitalievna Lanko, a dermatologist.

About the essence and reasons

– Vitiligo – little-studied disease, which was very difficult to treat until recently. However, attempts to understand it did not stop. There are still more hypotheses than proven facts. And yet, based on my own clinical experience and observations, I agree with those scientists who believe that in the development of vitiligo key role belongs to the infectious factor. Analyzing data on the incidence of vitiligo over several years, I noticed that there is a certain cyclicity, which can indirectly confirm infectious nature diseases.

Exactly what infection causes vitiligo is still a controversial issue. My observations showed that all patients who contacted me about vitiligo were diagnosed with cytomegalovirus. Turning to global sources medical literature, discovered that she was far from an innovator in her idea. It turned out that in the 80s. In the 20th century, European scientists tried to prove the involvement of cytomegalovirus in this disease. Unfortunately, due to disabilities laboratory diagnostics At that time, it was not possible to collect a sufficient amount of reliable data, and this question hung in the air. My assumption is also supported by the fact that I personally observed infants with intrauterine cytomegalovirus infection, manifested clinically as cytomegalovirus hepatitis and vitiligo.

Exactly what infection causes vitiligo is still a controversial issue. My observations showed that all patients who contacted me about vitiligo were diagnosed with cytomegalovirus.

The last year has been a breakthrough in the treatment of this complex process! appeared in the world effective technique, which guarantees the restoration of the pigment, as the authors claim, irrevocably, that is, completely and forever.

Pathogenesis

Of course, the leading role in the development of this disease belongs to immune system. The most recent scientific research has revealed that this is an immune inflammation, when certain immune cells cause such damage in the lesions that lead to the destruction of melanin - the very pigment that gives color to the skin. This is how white spots are formed - areas of “diseased” skin without melanin.

About treatment

Vitiligo has always been treated. How successful is the question. Previously, only about a third of patients who sought medical help were able to achieve at least some results. And even then only with a fresh process. The question was posed not “how to restore pigment in the lesions”, but “how to maintain the process at least without further dissemination" What kind of remedies were used: external preparations, complexes of vitamins and minerals, physiotherapeutic techniques with various irradiation of the lesions. They treated both with the help of the sun (even sent to Cuba) and without the sun, protecting the skin unprotected by pigment from solar radiation with photoprotectors. But Last year– a breakthrough in the treatment of such a complex process! An effective technique has appeared in the world that guarantees the restoration of pigment, according to the authors, irrevocably, that is, completely and forever. I know that this method is successfully used in Poland and France. Ideally positive results treatment in patients receiving course therapy this method in one of the clinics in St. Petersburg. Unfortunately, the equipment for treatment is very expensive, which does not yet make it possible to make a new method publicly available in every medical clinic. But I'm glad it's new effective method There is already a cure for vitiligo! So it will appear here too.

The importance of timely application

Do not self-medicate! Required application sunscreen for external use with a high protection factor (SPF 50+), especially on vitiligo lesions, but also on all skin. Vitiligo spots, lacking the melanin pigment that protects against sun exposure, are susceptible to sunburn, which is very harmful and can be dangerous.

Contact a dermatologist in a timely manner! Remember that the further the process goes, the more difficult it is to return to normal state skin. Timely identified pathology and correctly prescribed treatment for “background” diseases make it possible to reverse pathological process reverse, make vitiligo recede and return to the skin former beauty and health.

Health and prosperity to you!

Vitiligo.

Vitiligo is a skin condition in which the cells that produce the pigment, melanin, are destroyed. Melanin is responsible for giving the skin its color. When these cells, known as melanocytes, white patches appear on the skin various areas bodies. Hair present in the affected areas may also turn pale.

Spots of depigmentation are the most obvious symptom vitiligo. These spots can be seen more often in areas of the body that are exposed to the sun, such as the face, lips, arms and legs. In some cases, white areas may also be seen around the armpits and groin. Vitiligo tends to develop. Is not infectious disease and is not transmitted from one person to another.

The specific cause of this condition is unknown, but there are several theories as to why vitiligo develops in some people. Vitiligo is known to occur when there are autoimmune disorders. Another reason may be the self-destruction of melanocytes. In many cases, the onset of vitiligo was associated with a period of emotional stress.

Remedies for vitiligo

The main focus in the treatment of vitiligo is to improve appearance skin. Treatment usually continues for long period time. The type of treatment depends on the size and number of white spots, location and extent.

Treatment of Vitiligo with home remedies

• Folk remedies for the treatment of vitiligo include the use and mustard oil. Mix about 5 teaspoons of turmeric with 250 ml of mustard oil and apply the mixture on the pale areas twice a day.
• The leaves are believed to stimulate melanin production in the skin and can be mixed with lime juice to treat vitiligo. This is one of traditional methods treatment of vitiligo. Mix a few drops of basil leaf extract and lime juice and rub it on the affected areas. This treatment is known to cause improvement in 5-6 months.
• Other home remedy for vitiligo includes drinking water, which must be stored in copper containers. It is known to have a stimulating effect on melanocytes and thus helps in increasing melanin. The water should be kept in a copper vessel overnight. This is not an instant healing and you need to drink water long time to get a positive result.
• Psoralea drupes seeds are soaked in water for about 4 days and then dried and ground into a paste. Apply the paste to white spots for a month. It is advisable to use this remedy under the guidance of an expert. Psoralea seeds can also be soaked in ginger juice 2 to 3 days and then they are ground into powder. Add one gram of powder to a cup of milk and drink. You can drink this mixture for two months to get your pigmentation back.
• Psoralea can also be mixed with coconut oil, barberry roots and black cumin. Coconut oil is useful in treatment various diseases skin, while black improves immunity. Barberry roots contain substances that help protect the skin. Make a paste of the ingredients and apply to the white spots daily for 6 months.
• According to some reports, radish seeds can lead to melanin regeneration. Add a couple of teaspoons of vinegar to the powdered radish or radish seeds and grind everything into a paste. You can apply the paste to the affected areas every day for at least 6 months.
• Boil 2 teaspoons of dried roots with 2 glasses of water in an open container, leave for one hour and strain. You can take one tablespoon before meals no more than 2 times a day. This infusion is good for boosting immunity.

Vitiligo treatment 2016 - cure

Vitiligo treatment in 2016.