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A Handbook of Vitiligo and Colour Atlas
© 2003, SK Punshi
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2003
Publishing Director: RK Yadav
9788180611605
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A-14, Sector 60, Noida
5Foreword
Dr Punshi introduces this book with the sagacious comment of Stephen Rothman that “Some diseases do not take life, but they just ruin it”. What better thought might introduce a book on vitiligo or any pigmentary disorder for that matter. The personal pain and sorrow suffered by those afflicted by vitiligo is great. Who could not be disappointed to see themselves disfigured by leukoderma? And society imposes additional, almost greater burdens on those who have vitiligo. Successful marriages and employment can be difficult to achieve because of vitiligo. The impact of vitiligo was highlighted by Jawaharlal Nehru, then Prime Minister of India from 1947 to 1962, when he noted that vitiligo imposed a heavy burden on the development of India. For these and other reasons, many workers throughout the world studied vitiligo and other forms of leukoderma but the cases and optimal treatment for these disorders have been defied their very best attempts.
Dr Punshi has compiled in this book an enormous amount of data about vitiligo and pigmentation in general. He has included extensive data on the basic science surrounding leukoderma, pigmentation and pigmentary disorders. In addition he includes information for the clinician caring for those afflicted. Approaches to evaluation and treatment are included. In addition to standard medical therapies, he includes information about new therapy, he has devised, use of lasers, surgery, tattooing and other treatments.
One of the important sections is on the aetiology of vitiligo. Possibly some young dermatologists when reading this section will be inspired to investigate leukoderma and will find the causes of vitiligo. If just one young reader is motivated to pursue a career studying pigmentation and its disorders, this book will be a complete success.
James J Nordlund md
Department of Dermatology
University of Cincinnati
College of Medicine
7Preface
Vitiligo is not only a cosmetic problem, but also a social and psychological problems in dark-skinned people throughout the globe. It is a real disease as Prof Aaaron B. Lerners, authority on vitiligo says and advocates that vitiligo is a disorder important to both patients and dermatologists. It is still an interesting/fascinating disorder to the pigment cell biologists, immunologists, and dermatologists.
I have made as humble attempt to collect few gems of knowledge on the subject of vitiligo which shall interest the treating physicians and dermatologists, ultimately it will prove to the benefit of vitiligo patients and thereby a service to the suffering humanity at large.
SK Punshi
8Acknowledgements
It is my pleasure and privilege to acknowledge great indebtedness to the following; Dr James J Nordlund for graciously consenting to write Foreword. Dr Porter, Dr SJ Yawalkar, Dr Behl, Dr Saraf, Dr AK Bajaj, Dr Agrawal, Prof. Hachiro Tagami, Dr RG Valia, Dr AK Dutta, Dr Bhanu Iyengar, Dr Taywade, Dr Marfatia, Dr Bose, Dr Pranav Sheth and so many for sending clinical photographs and sending quite good pieces of advice and best wishes for the publication of this book.
Dr Rakesh and Dr Rekha for arranging photographs and secretarial help. Sandip Dawande for computerised typesetting of the manuscript. Thanks to various surgical companies for the photographs of appliances and instrument for the vitiligo-surgery and derma-surgery.
Last but not the least, my profuse thanks to Mr JP Vij and Mr RK Yadav of M/s Jaypee Brothers Medical Publishers, New Delhi for publishing this book.
I am also grateful to my patients who allowed me to take clinical photographs during my 35 years of clinical dermatology practice.
9Introductory Note
About 40 years ago, I came in contact with Dr SK Punshi for the first time. He had been my postgraduate student in the skin department of GT hospital, Grant Medical College, Mumbai. I was impressed by his keen interest in the skin diseases in general and especially in vitiligo and leprosy. He used to be very kind to patients and treated them as his near and dear relatives. After successfully completing his training in Mumbai, he has dedicated his whole life for the welfare of his patients in Vidarbha.
Due to his sincere and devoted service to the community, the citizens had honoured him in a grand function in Amravati in 1994. He has participated in National and International symposiums and seminars in vitiligo, and he was the winner of the “Ambady Oration Award” in 1986. He had introduced placental extract therapy in the treatment of vitiligo and had received All India Award from the Skin Institute, Delhi, in 1977. He was the Vice-president of the Indian Association of Dermatologists, Venereologists and Leprologists.
Dr Punshi is a modest person with scientific vision and religious mission. He knows very well that the medical science prolongs and improves life but the religion deepens it.
He is the author of many books on medical and religious topics. Dermatology for General Practitioners, Handbook of Leprosy, Vitiligo-diagnosis and Treatment are his famous medical books. He had also received International Lions Club Award for his book on helping eradication of leprosy.
It gives me great pleasure in writing the introductory note for Dr Punshi's recent Handbook of Vitiligo and Colour Atlas. This book incorporates his many years clinical and research experience in vitiligo. It includes 15 well written chapters and many colour figures. Bibliography have been given to help further reading. In my opinion, this book would be very useful to medical practitioners and skin specialists in treating patients with vitiligo. I sincerely hope that this book will help to create better understanding about this disease. In spite of its harmlessness, vitiligo unfortunately shares the same prejudices as leprosy in some countries. This book should be available in all medical college libraries in India and abroad.
I wish the author every possible success for its wide distribution.
SJ Yawalkar
md (munich) dvd (mumbai)
Formerly Dermatologist, Medical Department
Ciba-Geigy Ltd., Basle, Switzerland
Head, Skin Department, GT Hospital
Hon. Professor of Dermatology
Grant Medical College, Mumbai