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Leukoderma

Leukoderma or vitiligo as it is sometimes called, is a chronic skin condition that causes loss of pigment leading to pale spots of skin. Leukoderma can be described as an autoimmune skin disease where the body destroys its own pigment cells, melanocytes. After the pigment disappears, small or even larger areas of skin become white with sharp margins where they join unaffected parts of skin. The hair in these areas also grow white rather than pigmented. Leukoderma is more noticeable during summer when the normal skin darkens. The causes for leukoderma could be a combination of genetic and environmental factors. Inheritance seems to be a dominant trait for this condition.


Leukoderma may also occur at sites of injury to the skin and may show itself as scars or burns. Recent studies suggest that leukoderma could be caused by the development of an antibody to an enzyme in the pigment cell. Leukoderma may be caused due to several other factors as well - congenital as in tuberous sclerosis, partial albinism and Piebaldism and Waardenburg's syndrome. The immunological causes of leukoderma are Vitiligo and Halo mole. Thermal burns, Dermatitis or eczema and Psoriasis may also result in leukoderma. Infectious conditions such as Pityriasis versicolor, leprosy, lichen planus and syphilis could also result in leukoderma. Some occupational hazards that could cause leukoderma are exposure to depigmentation agents such as tertiary butyl phenol and exposure to chemicals.


The spots can spread, shrink or remain the same. It is often noticed that patches occur in symmetrical fashion across both sides of the body. Some times mild trauma to an area of skin can cause new spots as around ankles caused by friction due to shoes or sneakers. Corticosteroid ointment or cream of appropriate strength is used depending on the site involved. Normally a mild steroid is used on the face and a stronger one for the trunk and limbs. A specialized form of light treatment PUVA is also of value to some patients.

Wood's Lamp Examination

A wood's lamp examination helps the doctor confirm a fungal infection or bacterial infection. The doctor is able to determine the cause of any light or dark colored spot on the skin using this examination. This is a test using Ultraviolet or UV light to look more closely at the skin.


In case of fair skinned individuals, Wood's lamp can detect Vitiligo or any other depigmentation even when it is not visible to the eye under normal conditions. In case of detection, Vitiligo can be treated at an early stage even before it is visible to the normal eye, thereby minimizing treatment and preventing further expansion of the disorder.


What is Wood's lamp?

Also known as Black Light Test, or Ultraviolet Light Test, this is based on the use of ultraviolet light which is shined on the area being examined, when performed in a dark room. It emits ultraviolet light in the 365 nanometer range and when the light is shined directly on the area in darkness, the dermatologist looks for any change in color or fluorescence. While normal skin does not fluoresce under the light of the Wood's lamp, affected skin 'glows' in dark. if any fungal or bacterial infection or pigment is present, the Wood's lamp can strengthen or lessen the suspicion of a particular diagnosis based on the color of florescence of the affected skin being illuminated. Even subtle color changes can be detected very well using Wood's lamp.


Procedure

You will be seated in a dark room usually in the dermatologist's office. The doctor turns on the Wood's lamp and holds it approximately 5 inches from the skin to look for color changes. It will reveal skin color changes not visible to the mere eye examination. The patient is advised not to look directly into the light when being examined. This portion of the examination usually lasts for less than a minute and the patient feels no discomfort from the examination.


Pre and post procedure

Before the Wood's lamp examination do not wash the area or apply any cream to the skin to avoid inaccurate results. Following the procedure, the dermatologist may decide to treat the skin condition based on the results of the Wood's lamp examination. Additional tests are sometimes done to arrive at the correct diagnosis. No aftercare is recommended specific to the examination and depending on the result of the examination the physician may recommend treatment of a skin disorder.


Why is Wood's lamp examination done?

Certain skin problems including bacterial and fungal infections, Porphyria, skin coloring changes in Vitiligo, head lice and nits, Erythrasma and other pigmentary disorders can be performed using this test.

The test also reveals different colors according to the type of the skin disease which includes:


  • Golden Yellow: Tinea Versicolor
  • Pale Green: Trichophyton Schoenleini
  • Bright Yellow green: Microsporum Audouini or M. Canis
  • Aquagreen To Blue: Pseudomonas Aeruginosa
  • Pink To Pink orange: Porphyria Cutanea Tarda
  • Ash-Leaf-Shaped Spot: Tuberous Sclerosis
  • Blue white: Leprosy
  • Pale White: Hypopigmentation
  • Purple brown: Hyperpigmentation
  • Bright White, Or Blue white: Depigmentation, Vitiligo
  • Bright White: Albinism If it is a normal result, the skin will not shine under the ultraviolet light.

Risks

Exposure to Ultra violet Light for prolonged duration can result in skin damage and cancer of the skin. But this test hardly lasts for a minute and the intensity of the light is minimal. Patients should avoid looking directly into the UV light and since the time for the procedure is very minimal - less than a minute - the procedure is well tolerated as there is no associated pain and no side effects as a result. Beware that the presence of other materials like certain kind of makeup, deodorants, perfume, body lotion or soap can also fluoresce leading to difficulty in arriving at a conclusive diagnosis. Equally if the room is not dark enough, it may present difficulty for proper examination. Not all bacteria or fungi show up under the UV light.



Polypodium Leucotomos Extract

Polypodium Leucotomos is a fern plant that is native to Central and South America. The extracts from this plant are rich in antioxidant compounds such as Caffeic acid and Ferulic acid that have both anti-inflammatory and anti-aging properties on the skin. Indigenous people of Central and South America have used Polypodium Leucotomos extract for centuries for the treatment of skin ailments. It is a herb that not only promises to treat several skin disorders but also offers sun protection against harmful UV Rays.


Polypodium Leucotomos extract is ingested orally and is highly effective in inhibiting UVA-induced damage and sunburn. Taking this supplement in the morning and some time before extensive sun exposure can prevent your skin from the damaging effects of UV rays. Though oral ingestion of the extract is highly recommended, it can even be applied topically to protect against UV Rays. PLE is known to benefit persons suffering eczema, psoriasis, vitiligo, and even skin cancer.


Polypodium Leucotomos Extract Benefits

The oral Polypodium extract is a photo protectant with phenolic compounds of 4-hydroxycinnamic acid (p-coumaric), 3 methoxy-4-hydroxycinnamic acid (ferulic), 3,4-dihydroxycinnamic acid (caffeic), 3-methoxy-4-hydroxybenzoic acid (vanillic) and 3-caffeoilquinic acid (chlorogenic). Long exposure to UV radiation causes inflammation, oxidative stress and DNA damage resulting in premature aging of the skin.

Polypodium Leucotomos extract offers substantial skin photo protective benefits. Oral ingestion of the Polypodium Leucotomos extract suppresses erythema. The photo-carcinogenic effects of UV radiation are arrested thereby preventing free radicals. The antioxidants in PLE play a role in arresting cell damage and oxidative stress.


Use of Polypodium extract helps those suffering from psoriasis as Caffeic acid suppresses the inflammatory activity. It arrests the production of cytokines that are inflammatory in nature. Oral ingestion of PLE along with UV photo therapy helps vitiligo patients by causing re-pigmentation.


Pregnant and lactating mothers and heart patients are not advised to take PLE supplements.

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Bibliography / Reference

Collection of Pages - Last revised Date: October 21, 2019