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Introduction
Vitiligo is an acquired pigment disturbance which affects the melanocyte, a dendritic cell producing melanin pigment and which is derived from the neural crest. In the skin, it is located at the basal layer and follicular sheath [1]. The patients refractory to medical therapy are treated by surgical modalities provided that their disease is stable for at least 2 years. Various surgical methods that are being practiced, but in our study we did spot chemical wounding with TCA and Phenol [2]. Phenol or carbolic acid is one of the oldest antiseptic and antipruritic agents. It also acts as a local anaesthetic. Liquified phenol (88%) and TCA have been used for medium depth chemical peeling for facial rejuvenation [3]. In the present study, both TCA and phenol have been successfully used as a medium depth chemical peelant which causes wounding, to treat stable vitiligenous areas and patches of alopecia areata.
Materials and Methods
We selected thirty patients of stable vitiligo from the department of dermatology for the study. The patients were divided into two groups of 15 patients each. In Group I patients application of 100% TCA was done on the vitiliginous sites and in Group II patients 88% phenol was applied on the affected sites. Informed consent was taken from all the patients before the study. Prior approval of hospital ethical was taken. All the patients were photographed before the treatment. Most of the cases had received local or oral steroids or PUVA/PUVASOL prior to the therapy with limited or no improvement. The grading of the pigmentation was done starting from grade 0 to grade 3 as follows:
No pigmentation – Grade 0
Minimal pigmentation – Grade 1
Moderate pigmentation – Grade 2 (Up to 50% of 2×2 cm2 patches)
Marked pigmentation – Grade 3 (>50% of the 2×2 cm2patches)
Chemical peeling with 88% phenol and 100% TCA was carried on various sites of stable vitiligo. After cleansing and defatting, 100%TCA in Group I and 88% Phenol in Group II was applied on the affected areas till a uniform frost appeared. A routine urine examination, and tests for serum creatinine, blood urea nitrogen, SGOT and SGPT were carried out on all patients prior to the peel. BCG scars or old scars were examined for...