PUVA therapy is used in all except: March 2010

Ans. B: Melasma Treatment is currently not very satisfactory for vitiligo. Topical steroid cream. A potent anti-inflammatory coisone cream may reverse the process if applied to the affected areas for a few weeks in their early stages. Calcineurin inhibitors such as topical pimecrolimus and tacrolimus have recently been shown to be safe and effective, and is especially useful on the face and neck where strong steroid creams may cause skin thinning. Narrowband UVB phototherapy is helpful in many patients, paicularly in combination with calcineurin inhibitors, and perhaps with calcipotriol cream (usually used in psoriasis). PUVA. This form of light treatment requires the patient to take a psoralen medicine and then be exposed to ultraviolet light (UVA). Gradual but paial repigmentation may results. Hands and feet respond poorly, faces and trunks do better. When the treatment is stopped, some of the pigment disappears again. PUVA takes less than five minutes twice weekly, and is continued for up to two years. PUVA is unsuitable for children or very fair skinned people. The pigment loss should have been present for less than 5 years. Surgical treatment: Melanocytes transfer Blister grafting