[ZKKL] Academic Sharing | A Brief Discussion on the Concepts and Nursing Experiences Related to Vitiligo

Release time：2019-11-29

Reprinted from: World Latest Medical Information Abstracts, Volume 19, Issue 39, 2019.

Author: Rezewan Guli Kebir, Yu Yanli

[Abstract] Vitiligo is a common, frequently occurring pigmentary skin disorder that is notoriously difficult to treat. Although numerous medications and therapeutic approaches are available, most yield unsatisfactory results. Moreover, as a relatively refractory dermatological condition, vitiligo is characterized by a prolonged course, a slow response to treatment, and a high propensity for recurrence, thereby adversely affecting patients’ physical and mental well-being and reducing their quality of life.

[Keywords] Vitiligo; Nursing

Vitiligo is a non‑contagious chronic condition caused by the loss of skin pigmentation. Dermatological condition characterized by the appearance of white patches of varying sizes on the skin. It commonly affects the face and extremities, typically without pain or itching, yet it can significantly impact the patient’s appearance and daily life.

Vitiligo is a difficult-to-treat, persistent skin disorder. It typically arises from changes in temperament and bodily fluids, as well as dysfunction of the major organs; in some cases, it is triggered by genetic factors, dietary habits, environmental influences, or various types of trauma. While it generally does not pose a direct threat to physical health, it can affect appearance and lead to psychological distress—particularly when white patches appear on the face, hands, or other visible areas, causing significant emotional suffering and impacting work and daily life.

Classification of Vitiligo

Based on the different causes of vitiligo, it can be classified into the following categories.

(1) Classified by size: ① Segmental vitiligo; ② Sporadic vitiligo; ③ Mixed-type vitiligo.

(2) Classified according to discrete form: ① Symmetrical vitiligo; ② Segmental vitiligo Wind; ③ Mixed-type vitiligo.

(3) Classified by distribution: ① Unifocal vitiligo; ② Multifocal vitiligo.

(4) Classified by progression: ① Stable-phase vitiligo; ② Unstable-phase vitiligo.

(5) Hereditary vitiligo and congenital vitiligo.

Dietary Care for Patients with Vitiligo

(1) Regardless of temperament or age, patients with vitiligo must avoid consuming cold water, milk, yogurt, eggs, fish, and cold noodles. These foods are considered damp‑cold in nature; consuming them can weaken the body’s nutritional reserves and lead to an excess of abnormal phlegm‑dampness.

(2) Children and adolescents should consume vegetables and fruits in moderation, but should avoid excessive intake of cold‑natured foods. Since adolescents tend to have a more pronounced damp constitution than adults, overconsumption of fruit can lead to an excess of internal dampness, which may disrupt pigment formation.

(3) Women with vitiligo do not need to follow any dietary restrictions during pregnancy. Because during pregnancy During this period, dietary restrictions can adversely affect the fetus’s normal development and the pregnant woman’s health.

(4) Patients with vitiligo should avoid beer, distilled spirits, and all beverages containing alcohol, and should refrain from frequent sexual activity. Excessive consumption of alcoholic drinks and overly frequent sexual intercourse can deplete the body’s nutrients, disrupt organ function, and accelerate the formation of abnormal bodily fluids, potentially leading to the appearance or spread of white patches.

(5) Patients with vitiligo should limit their intake of fruits and vegetables that are high in vitamin C. Because Vitamin C can weaken the enzymes that counteract oxidative stress in the bloodstream. Consequently, the levels of ketones and proteins in the body decrease, thereby affecting the synthesis and metabolism of melanin.

Psychological Care and Nursing Techniques for Patients with Vitiligo

(1) Patients with vitiligo and their family members refuse inpatient treatment due to fear and social stigma. Psychological responses such as discrimination and shyness underscore the critical importance of psychological care for patients with vitiligo. Tailoring conversation topics and approaches to each patient’s individual circumstances, showing genuine concern, respecting their personal dignity, and fostering a friendly rapport are essential.

This helps patients develop confidence in their recovery, fosters a positive mental state, and prevents negative emotions such as pain and anger from adversely affecting their condition [3].

(2) Maintain a positive mindset: Since vitiligo affects the patient’s appearance and self-esteem… Everyday life and other factors can have a significant impact, and given that vitiligo treatment often yields slow results, it is quite natural for patients to experience negative emotions such as impatience and low self-esteem. However, if these feelings are not addressed promptly, they may compromise the effectiveness of the treatment.

(3) Observe the patient’s psychological state and play soothing, melodious music for the patient. It can help patients temporarily forget about their condition and provide them with appropriate support and care.

(4) Patients with vitiligo must adopt healthy lifestyle habits and make appropriate dietary adjustments. Pay extra attention.

(5) Avoid chemical irritation of the skin: Severe chemical irritation of the skin… Stress is a common factor that can trigger the onset of vitiligo and exacerbate the condition. During treatment, to prevent the disease from spreading, patients should avoid chemical irritants and minimize direct contact with pesticides, fertilizers, and irritating cosmetics.

(6) Patients with vitiligo should pay particular attention to physical exercise to strengthen their immune system. Balance work with rest, avoid overexertion, and take precautions against conditions such as colds, fever, and tonsillitis.

(7) Oil‑Applying and Sunbathing Care Techniques: This is a key component of care for patients with vitiligo. In the initial phase, sun exposure should last about 20 minutes; as the skin becomes more tolerant, the duration can be gradually increased. Intact skin should generally not be exposed to the sun. Ambient temperatures should typically remain below 25–30°C. The period between noon and 5 p.m. is usually most suitable for sunbathing. The length of sun exposure should be tailored to the patient’s condition; patients must eat before sunbathing and drink plenty of warm water during the session to prevent heatstroke. Patients with hypertension should adjust their sun‑exposure time accordingly. After sunbathing, the body should be wrapped warmly and allowed to rest. Vitiligo‑affected skin is particularly sensitive; following sun exposure, symptoms such as erythema, erythematous patches, or blisters may occur. Moreover, patients are prone to isomorphic reactions—any inflammation or trauma to the skin can potentially trigger the spread or aggravation of vitiligo.

(8) During injection, frequently rotate the injection site to prevent the formation of indurations that may impair drug absorption.

(9) When applying medication to areas with blisters, start with small patches. If the patient has blisters all over the body, divide the application into sections corresponding to the size of each blister; otherwise, the condition may worsen.

References

[1] Cheng Aihua, Han Meihai, Han Xian. A Brief Discussion on the Psychological Issues and Nursing Experiences of Elderly Patients with Vitiligo [J].

Chinese Ethnic and Folk Medicine, 2013, 22(15):134.

[2] Liu Fenghong. A Brief Discussion on Nursing Experiences in Patients with Vitiligo [J]. Medical Aesthetics and Cosmetology Quarterly

Journal, 2014, 23(11): 536–537.

[3] Li Yuanjuan, Liu Erfeng, Liao Xiujie, et al. A Brief Discussion on Nursing Experiences in Patients with Gout [J]. Clinical Medicine

Electronic Journal of Literature, 2016, 3(58):11582.

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