Leucoderma - a Social Stigma for Ladies
NATIONAL JOURNAL HOMOEOPATHY 1993 Mar / Apr VOL II No 2.
Dr Wadia S R.
` Thuj / Bac/ Tub / Sil / Ars-s-f / Sulph / Nux-v / Cupr-acet / Carc / Calc / Merc / Psoralin.

Leucoderma, which causes white patches on the skin, has been known for centuries. Though it is not contagious, it causes a lot of embarrassment, particularly in females, who regard it as a social stigma. Hence, from a cosmetic point of view its treatment is important.

Human skin has different hues in different parts of the world The colour of the skin is due to a pigment called melanin, which is more in coloured people. When this pigment decreases, the skin turns white. The pigment increases when the parts are exposed to sun or ultraviolet rays. Hence, physicians ask their patients to expose these parts to the sun after applying their medicine. However, this effect is short-lived and at times may cause blisters. One of my patients who applied Bavchi powder mixed in water had huge blisters which had to be dressed. When the blisters healed, the skin still remained white.

Common Treatments used in the Past and Present

1. Psoralent compounds and Amimajus (Unani) were hailed as a great research. Side effect-digestive upsets and blisters with itching all over the skin.
2. Corticosteroids have many side effects and cannot be given for long.
3. Cuban cure for leucoderma is a placental extract and as a lotion is applied locally on the patches and then exposed to ultraviolet light.
4. Injections too have been tried, unsuccessfully. Research has to be made with Homoeopathic potencies.

1. Chronic amoebic dysentery and intestinal parasites. 50 percent of patients give a history of worms preceding the diseases.
2. Other skin disease suppressed by external application and by internal allopathic drugs.
3. History of repeated vaccinations as in frequent travellers and those in the Army and Navy.
4. P/H or F/H of Tubercular infection.
5. P/H or F/H of Diabetes.
6. Shock, anxiety, mental strain. Case have been mentioned, where continuous air raids in a war have turned the skin white in a couple of days!
7. A young Christian lady visited me for white spots. On questioning, she told me that her husband was at sea and she had two children to look after. She earned a little by giving tuitions but that was taken away by her mother in law. There was a constant friction between them. She burst into tears while narrating the story. Her deep grief was responsible for the white patches.
8. A family history of Leucoderma is seen in many patients. So I think that marriage between two individuals with Leucoderma should be avoided. Dr Mofti gives a case, where a young lady developed vitiligo during her pregnancy. The lady's mother had vitiligo. Her child also developed vitiligo at age of 6 years. I had a case of a 20 year old girl with leucoderma, where there was a history of leucoderma in the grand mother as well as mother.
9. Cauterisation done for warts or moles may result in subsequent leucoderma. A friends daughter had extensive white patches all over the body after cauterisation of warts.
10. Miasmatic conditions:
    1. From among the three miasms, Psora is maximally responsible for the condition. This is mainly in cases where skin complaints like eczema, ringworm, scabies etc have been suppressed by ointments. In such cases our greatest antipsoric remedy Sulphur is of great help.
    2. For Sycotic conditions with a history of vaccination, Thuja found to be useful.
    3. The third miasmatic condition, ie Syphilis: has bilateral patches, stomatitis and aggravation at night, Mercury preparations, or preferably Lueticum is useful.
    4. In some cases where there is Tuberculosis in the family and the patient suffers from chronic colds and cough, then Tuberculinum and Bacillinum are useful.
    There are some cases of Leucoderma, where there is no family history of Leucoderma, but the patient had suffered from gastro-intestinal diseases such as amoebic or bacillary dysentery, gastroenteritis, enteric fever, etc which were treated with antibiotics and chemo-therapeutic drugs. Here, probably as a result of the powerful drugs the intestinal mucosa is affected, causing a deficiency of Tyrosine, leading to a disturbed melanin formation. The choice of remedies here is Nux-vomica, Bacillinum, Chelidonium or Phosphorus followed with constitutional remedies.
11. In a paper on Vitiligo and albinism published in the Indian Journal of Medical Science 27-86, 1973 Dr J C Shroff, reported the findings of a relationship between Vitiligo and several autoimmune disorders like pernicious anaemia, thyroid disease and diabetes mellitus.
12. 1. Genetic predisposition is recognised. A number of vitiligo patients do give family history of the disease.
    2. Neurogenic factor- There is some evidence to suggest that the loss of pigment could be attributed to the failure of neural or neurochemical control of melanocytes, resulting from damage to nerve fibres.
    3. Vitamin B Complex- Since nutritional factors affects the process of pigmentation, direct proteins, vitamins and certain metals should not be lost sight of.
13. According to Vaidya, Journal of Gujarat University, B-Science of August 1975, the reasons for depigmentation are unknown. Many factors eg genetic, dietary, autoimmune bodies, vitamin deficiency, neuroendocrinal mechanisms, neurodermatosis and inhibition of some intracellular enzymatic process have been suggested. According to Siddick (1962) heredity seems to play a positive role and Fitzpatrick (1965) believes it is an irregular dominant trait.
14. Biochemistry and Endocrinology- Melanin formation depends on enzyme tyrosinase. Since optimum body levels of Vitamins are a prerequisite for Tyrosinase activity (Breathnach, 1971), Leucoderma is often associated with deficiency of Vitamins (Sieve, as cited by Sulzberger et al, 1965) Gonadal, adrenal, thyroidal as well as pituitary dysfunctions have been associated with skin depigmentation (Robert, 1951; Learner, 1959) and specific antigens in Saliva of vitiligo patients). Female hormones taken for a long time are often said as a block to curing Vitiligo.
15. Minerals: Copper has the highest catalytic activity on Tyrosine (Fleshch and Rotham 1948). It is more active than Manganum and 100 times more active than Ferrous ions. (Scalon 1969). The Tyrosin molecule itself contains 0.2 percent copper and is synthesized in the ribosomal fraction of melanocytes. Ghoshal (1959) has reported significantly high level of Ceruloplasmin (the form in which 90 percent of copper occurs in blood) in Leucoderma patients. Our studies of the blood mutabilities of normal and Leucoderma patients, have shown that both copper and ceruloplasmin level are low in Leucoderma patients. (V C Shah, NJ Chinoy, M V Majumdar and K S Sharma, Zoology department, School of Sciences, Gujarat University, Ahmedabad 380009)
16. Diet-Flesh of unhealthy animals mainly ham, bacon, pork harbour a lot of parasites, eggs and cysts. When digested they release tiny worms in the intestine and do havoc in Human beings. If cooked pork is pink it has not been properly cooked. The meat must be white to be safe. Citrus fruits should be avoided. Papaya and mangoes can be taken. Nonvegetarians can take fish, meat and eggs in moderation but no milk products. Chapattis with bran instead of white bread is recommended.

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