In de zomer 2010 nieuwsbrief van Vitiligosupport.org staat nuttige info over contacten met artsen, en het goed voorbereiden op (eerste) consulten mbt vitiligo. Zie
http://www.vitiligosupport.org/newsletters/summer10.html en hieronder:
How Can I Benefit the Most
From My Visit to Doctor?
Before making an appointment, you'll need to do your homework.
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You will begin by doing your own research on current vitiligo treatments in order to decide which treatment/s you are comfortable with and best fit your lifestyle and budget.
You want to locate a vitiligo specialist or doctor willing to prescribe current treatments and be encouraging and supportive.
You can begin with the telephone. If you are looking for a doctor or have been given the name of a doctor who is not a recognized vitiligo specialist, it will be a good idea to call the office and find out if they are treating other vitiligo patients.
If they are not treating other vitiligo patients, you may want to call another doctor's office.
If they say yes, you should ask what types of treatments the doctor prescribes for vitiligo patients. It will be important to know if they are prescribing the treatments you are interested in.
If the patient is a child, you'll want to know if they have experience treating children with vitiligo and what treatments are offered for children. Some doctors won't use all available treatments for children, depending on the age of the child.
VSI has its own Doctor Search of patient recommended doctors.
Prepare for your visit.
Be prepared to provide basic information to the physician such as
When did you first notice pigment loss?
Were there precipitating factors, such as sunburn or illness?
Did the vitiligo begin slowly with a single depigmented area?
Did you notice many small areas over the entire body?
Did it begin rapidly and spread quickly?
If you have been on treatment, be prepared to describe your experience including:
How long ago did you see the prescribing doctor?
Are you currently using any type of treatment? If so, what?
Which treatment/s have you tried?
How did you use the treatment? For example, if it was a topical treatment, how many times a day did you apply it? How long did you leave it on? How many days a week did you apply it?
How long did you use the treatment? (days, weeks, months)
Did you see results?
Did you experience side effects? If so, what were they?
You may be asked to provide background information on your family such as have you or anyone in your family experienced any of the following:
Early graying/white hair
Alopecia areata
Thyroid disease (either hypo or hyperthyroid)
Psoriasis
Insulin-dependent diabetes
Pernicious anemia
Addison's disease
Celiac disease
Other medical, surgical, environmental, social or emotional issues
Do your own research on vitiligo in order to be in the best position to discuss which treatments are best for you. The specific treatments a physician may recommend will depend on the type of vitiligo and the age and health of the patient. You can find detailed information on the full range of vitiligo treatments and factors affecting choice of treatment at Treatments
Having a friend or family member along and/or taking a tape recorder on
this first visit may be useful in recalling instructions or information later.
Know what to expect from your visit.
Diagnosis and evaluation procedures:
Each doctor's protocol will differ, but the following are common procedures to expect.
a total body skin examination
observation with a Wood's lamp (similar to a black light)
photographs of representative areas in order to track progress on follow-up exams
The doctor will also order laboratory tests to assist his/her evaluation of the vitiligo. Typical lab tests for vitiligo include all or part of the following:
Antinuclear Antibody (ANA) - This test helps determine if the patient has other autoimmune diseases.
Thyroid peroxidase antibody (TPOAb) - Thyroid antibody testing is primarily ordered to help diagnose an autoimmune thyroid disease and to separate it from other forms of thyroiditis.
Complete Blood County (CBC) with differential,
comprehensive metabolic panel,
thyroid panel, including Free T3, Free T4 and TSH
25-Hydroxy-Vitamin D
folate/B12
Some doctors will prescribe vitamins or supplements to help stabilize the immune system. These are not so much a treatment but an adjunct therapy. Listed below are some of the more typical supplements recommended, as frequently vitiligo patients have decreased levels of these vitamins:
Multi Vitamin
Vitamin B12
Folic acid
Vitamin D
While these supplements are generally considered safe, age and health may affect the dosage and appropriateness of some or all of these supplements for certain individuals.
If your doctor recommends a treatment, important questions to ask that can help you decide whether you want to go forward with the treatment are:
How does this treatment work to help vitiligo?
What are its possible side effects?
How is it used and how often?
If topical, can it be washed off? If so, after how long?
If you want to apply sunscreen and the topical medication, which would you apply first?
What type of results might you expect to see?
How long will it take for me to see results?
How long will you use this treatment?
Does insurance normally cover the treatment? If not, can the doctor help to secure coverage?
How much will the treatment cost?