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Is my daughter suffering from vitiligo?

Q: My nine years old daughter has a white patch at the corner of her right eye. We took her for a biopsy, which showed the absence of melanocytes in the basal layer of the epidermis and there is a scant inflammatory cell infiltration in the periappendigeal and perivascular region of the dermis. The doctor then prescribed Melgain. But after applying Melgin on the affected area for two weeks, we found that the patches were becoming more visible. Now, the doctor has prescribed Imograf. Why is my daughter having white patches at the corner of her right eye? Is it vitiligo?

A:Biopsy of the skin is not diagnostic for vitiligo. It only helps to exclude other conditions. Further, interpretation will also depend upon the site from where the biopsy was taken - from the edge or center of a big lesion, and upon the changes in the skin other than loss of pigment. Clinical examination is the most important part in diagnosis. Ideally the lesion should be examined before modifying it with medication. It has to be remembered that the vitiligo skin is normal in all respects except that it has no pigment. Once the diagnosis is established, the treatment choice becomes easier.

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