Metodología para la identificación de las mutaciones en los genes

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CHAPTER EIGHT

CONCLUSIONS AND RECOMMENDATIONS 8.1 CONCLUSIONS

Vitiligo is a depigmentary cutaneous disorder in which the skin of the face, trunk, extremities and genitals could be affected. The face is the part of the body mostly affected and the forehead and cheek are the sites of the face where the lesions mostly occur. The lesions on the face, in comparison with the other parts of the body affected, are most bothersome to the patients because they are easily noticed by the patients, their family members and friends.

Patients with vitiligo could also have ocular and auditory disorders due to the loss of pigmentary cells in the eyes and ears. The ocular and auditory disorders could be asymptomatic as was the case in this study and routine screening of the eyes and ears are recommended in patients with vititligo for detection of the occurrence of these disorders or worsening of pre-existing disorder(s). The simulataneous loss of pigmentary cells at both the skin and extracutaneous sites is likely from a pathogenic process affecting these cells which have a common origin from the embryonic ectoderm.

Photochemotherapy of vitiligo with PUVAsol could lead to partial or complete repigmentation of depigmented lesions in affected patients and this modality of treatment should be applied for at least six months to achieve its effect.

Vitiligo reduces the Quality of Life (QOL) of affected persons. The study highlights that patients living with vitiligo who have impaired QOL could have low self esteem with impairment of their daily activities and leisure. It is thus pertinent to identify and manage the psychological challenges that vitiligo patients are faced with.

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1. All patients with vitiligo should be screened for ocular and auditory disorders.

2. Patients living with vitiligo who develop ocular disorders should have regular follow-up visits at the Ophthalmology clinics.

3. Patients living with vitiligo who develop hypoacusis should have regular follow-up visits at the ENT clinics.

4. Efforts should be made by the various stakeholders in the health sector to ensure that patients with vitiligo have access to more effective therapeutic options. Tertiary health facilities and Specialist centres should have phototherapy units and the hospital pharmacies should also have the various drugs used in the management of vitiligo.

5. All patients with vitiligo should be managed by a multidisciplinary team which would consist of a Dermatologist, Ophthalmologist, Otorhinolaryngologist and Psychologist.

This would enhance effective and optimum care for affected patients and ultimately improve their Quality of Life.

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APPENDIX 1