A 58-years-old eminent government officer (PIN 29373) visited Life Force on 29th July 2016 to get his vitiligo treated effectively. The patient had discovered a small hypopigmented spot on the right side of his upper lip since a month. On inquiring about the cause, he mentioned that the spot had been prominent after a hair-pull in that area after shaving. He also mentioned a history of dying the hair of his mustache. And, he had already started applying steroid ointments as suggested by a dermatologist. 

The hypopigmented spot was not significant since he had been applying steroid ointments regularly. In the Wood’s lamp examination, the patch illuminated significantly. 

He was quite skeptical about his recovery and concerned about the spread. All other reports like thyroid profile, vitamin B12, vitamin D, and blood sugar level were normal. 

Physical generals:

He was a vegetarian by diet and enjoyed a good appetite. He had a craving for sweets. His thirst was adequate and bowel movements were normal. Thermally, he was sensitive to the cold weather. 

Past History:

There was a history of frequent allergic colds in the past. 

Family History:

In his family, his father was asthmatic and his mother was suffering from age-related joint complaints. 

Self And Family Set-Up:

The patient was working in the RBI at an honorable position. His wife was a homemaker. He had two sons. There were both pursuing their career in their respective fields. There had been a strenuous relationship with one of his sons due to the differences in opinion.

Mental Generals:

By nature, he was quite reserved and sensitive. He would never express his anger, as he had developed this habit to remain silent since his childhood. He belonged to a family where his father was strict and so he never expressed himself much. There had been persistent stress at work. There were phases in his life where he had to suffer insult and humiliation in spite of being sincere at his work.

He liked peace, and he was sympathetic towards people. Further, the disorder had made him more conscious of himself. Due to such life space situation, he had always been an insecure person. 

Prescription:      

Dr. Rajesh Shah reviewed the patient’s case in detail and prescribed him medicines accordingly. The patient was educated regarding his condition and was advised not to worry much about it, since this was not a serious disease. He was advised to taper the use steroid applications and was well-informed about the slight increase in the patch post the complete stoppage of the ointment application. He was given necessary instructions about diet and lifestyle modifications which would help support his recovery. Besides this, he was advised to stop worrying and have a positive approach towards life.

Follow-Ups:

The patient reported to the clinic for his first follow-up on 17th October 2016. He observed a significant improvement in regards to the brightness of the patch. He was getting exposed to the early morning sun as was advised since it would help in re-pigmentation. The steroid application was completely stopped by him for a week. The patient was now quite positive about his recovery since the medicines had already started acting, and, fortunately, there were no flare-ups after the complete stoppage of steroid application.    

The second follow-up dated 2nd January 2017 was a remarkable one. He was elated while informing that there was no clear appearance of the spot if he kept the mustache. He informed that he no more worries about the spot, and now he is much focused on his life and his priorities. He was following a healthy lifestyle by practicing meditation and exercise regularly. Now, he could also manage his stress levels effectively.

The patient had requested the same medicine for the next four months since he was traveling. He then visited the clinic on 9th August 2017. He was now a confident person, and, on examination, the spot was no more illuminating under the lamp. Thus, the patient showed significant signs of recovery. He mentioned that there was about 70% recovery in the patch and now the spot was not significantly visible even after being clean shaved. 

The patient rated a recovery of 90% in the latest follow-up dated 16th November 2017. The current status of his condition was compared with the photos taken during his first visit. There was a huge change and patient was happy with his recovery. He also thanked Dr. Shah for giving him this life-changing experience. He also mentioned that, during his journey with Life Force, he had now evolved into a positive person that helped him overcome his stress effectively and manage his strenuous relation with people in the family and at the workplace. The patient is still continuing the treatment at Life Force as advised. 

Conclusion:

Vitiligo is a chronic recurring pigment disorder. It is not a serious condition, hence a positive approach towards life itself helps you fight back the social effects of the disease in an effective way. Hence, counseling and educating the patient regarding this disease is an important part of the treatment.  

- Written by Dr. Kanchan, Associate doctor to Dr. Rajesh Shah