DEAR DR. DONOHUE: My grandson developed vitiligo when he was 6 years old. His mother has it. It breaks my heart when I see him. He is now 15 and in high school. The condition is affecting him emotionally. My son and daughter-in-law have taken him to the best doctors in New York. They used creams and special lights. Is there something else we can do for him? — D.S.

ANSWER: Vitiligo is patches of depigmented skin, white skin. Sometimes the patches are very large and cover much of the body. Melanocytes have disappeared from the skin. Melanocytes are cells containing the pigment melanin. Dark skin has many melanocytes; light skin, fewer. Aside from burning easily, vitiliginous skin isn’t usually a health problem. It is, however, a huge psychological and emotional problem.

It’s believed that vitiligo is an autoimmune illness, one where the immune system has turned against melanocytes. Sometimes it’s seen in association with other immune disorders, like thyroid malfunction, type 1 diabetes, adrenal gland failure and pernicious anemia. Most often, it occurs on its own. Heredity does have a role in causing it.

An impressive number of treatments exist. Cortisone drugs applied to the skin can sometimes coax melanocytes to return. Narrow-band ultraviolet light B has had success. Oral drugs called psoralens, which sensitize the skin to ultraviolet light, are another treatment. It takes many treatments before acceptable results are obtained. The laser beam in conjunction with tacrolimus or pimecrolimus offers another possibility. I haven’t mentioned all treatments. I’m sure your grandson would benefit from a revisit to a dermatologist if he hasn’t been seen since he was 6.

Another route is to apply cosmetics to the skin to hide the vitiligo patches. Dermablend and Covermark are two often recommended products. Dy-O-Derm and Vitadye are dyes that can blend the vitiligo patches with adjacent skin.

DEAR DR. DONOHUE: In regard to the questions asked about Lewy body dementia, I have had firsthand experience with it because my husband has it. Please tell people about the Lewy Body Dementia Association and its website, www.lbda.org. It is the best place I have found for current information on this disease. It’s updated every two months. — A.W.

ANSWER: I’m happy to spread the word about Lewy body disease and the Lewy Body Dementia Association. It’s one of those diseases, like Alzheimer’s disease, that robs people of clear thinking and remembering. Lewy body patients often exhibit signs of Parkinson’s disease, too. Lewy bodies are protein deposits in the brain that are named for the neurologist Dr. Friederich Lewy.

DEAR DR. DONOHUE: I am a 28-year-old college student pursuing a degree in a field I am passionate about, botany. I thank you for setting the facts straight on ECT, sometimes called electroshock therapy. I lived with bipolar disorder for 12 years. For the first six and a half years, I had severe symptoms that did not respond to medication. I was very negative about and afraid of ECT until I started having treatments myself. My symptoms quickly went away. I came through treatments without any memory loss. — J.L.

DEAR DR. DONOHUE: Thank you for telling the truth about ECT. My husband had it in the 1990s after drugs failed to bring him out of a deep depression. After her husband’s death, my daughter went into a deep depression and tried more than 20 different medications and three stays in the mental-illness ward at a hospital. I finally persuaded her to try ECT. She was able to return to her job as a school nurse and resume a normal life. Two episodes of a popular TV show recently portrayed ECT as a form of torture. I wrote an e-mail objecting to the outdated characterization. They replied that they had received too many letters to respond individually. I hope you will continue to speak out for ECT. — G.C.

ANSWER: Your statements will do more good in convincing people of the value of ECT than any words I might choose. Thank you both.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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