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VITILIGO PATIENTS NEEDED!!!

Tony Apuzzo
Science Researcher
250 Palmer Ave.
Sleepy Hollow, NY 10591
phone: (914) 631-6567

FrieSkier@AOL.com

This project has been completed. The questionnaire will be left up to see, but the following link will take you to the final paper, including the results and conclusions.

To see final paper, click here.

Dear Vitiligo Patient,

I am a high school senior doing research on vitiligo for a three-year science project, the results of which I will eventually present at science competitions.

I am a vitiligo patient. In the course of my own treatment and research, I have become interested in the nutrition-related vitiligo research done by Dr. Leopoldo Montes of Argentina. My aim is to add to this research in a small way by determining the eating habits of the average vitiligo patient in the United States.

I am sending questionnaires to patients of dermatologists who have agreed to cooperate with me and to patients I contact on the World Wide Web through the National Vitiligo Foundation Institute web site or the Vitiligo LISTSERVE.

I hope that you will fill out this questionnaire carefully and send it back to me by copying it to an e-mail. Each response will help increase the knowledge we can put together about vitiligo, a condition which does not get much research funding.

I would appreciate it if you would also indicate whether or not you are willing to take part in a second stage of the research. This will involve having a vitamin profile done of your blood. Your doctor will have to prescribe the exact profile I need. The cost (not expensive) will be paid by you. You will arrange for the blood profile through your own personal physician.

We will, of course, maintain strict confidentiality with the results, not using any names in the analysis that will eventually be published. Thank you very much for your cooperation.

Sincerely,

Tony Apuzzo

Questionnaire For Vitiligo Patients

Name (optional) :
1. Age: _________ Date of Birth:
2. Sex:
3. Height:
4. Weight:
5. Ethnic Background (choose one)

6. At what age were you first diagnosed with vitiligo? __________
7. Pick one of the following classifications for the progression of your vitiligo:
8. Is there a history of vitiligo in your family?
9. Is there a history of other autoimmune disorders (i.e. thyroid disease, Crohn's disease, thalassemia, other) in your family? 10. In the past year, have you undergone any treatment for your vitiligo? 11. If so, which of the following methods were tried?(answer yes or no) 12. After this treatment, what was the status of your vitiligo? (please select one) * if you answered #10-12, go on to #17
13. If you answered no to #10, have you undergone any treatment at any time in the past? 14. If so, how many years ago was it? ____________
15. If so, which of the following methods were tried? (answer yes or no) 16. After this treatment, what was the status of your vitiligo? (please select one) 17. Do you take vitamin supplements? 18. If so, how much of each of the following vitamins do you take daily? (please refer to your vitamin containers)
(please include units ex: 20 mg)
19. Are you allergic to any foods? 20. Do you exercise or play sports? 21. For approximately how long do you exercise? ____________
22. Do you smoke? 23. Do you eat red meat (beef, pork, lamb, or other)? 24. Do you eat other meats (chicken, fish, etc.)? 25. Do you eat eggs (either alone or in other foods)? 26. Do you drink milk or eat dairy products? (yogurt, cheese -- including pizza, cottage cheese, other) 27. Please list what you ate for breakfast yesterday: __________________________________ 28. Please list what you ate for lunch yesterday: _____________________________________ 29. Please list what you ate for dinner yesterday: _____________________________________ 30. What snacks did you eat yesterday: __________________________________________ 31. Do you eat vegetables everyday? 32. Please indicate of the following list which vegetables you eat and how often you eat them: use the following choices for each vegetable or group of vegetables:
0 times/week
1-2 /week
3-5 /week
6+ /week
33. Do you eat fruit everyday? 34. Please indicate of the following list which fruits you eat and how often you eat them: use the following choices for each fruit or group of fruits:
0 times/week
1-2 /week
3-5 /week
6+ /week

THE END!!!

Dear Patient,

Thank you very much for answering this questionnaire concerning your eating habits and your vitiligo. The second part of my study involves the actual levels of the vitamins B12, C, and folic acid in the blood of vitiligo patients. In my own case, I found a zero level of vitamin C in my blood. I now take very high levels of vitamin C, and have seen some repigmenting of my vitiligo spots. If you would like to further participate in this study, you can do so by having a vitamin profile of your blood performed looking specifically for the vitamins C, B12, and folic acid, and sending a copy of the results to the following address:

Tony Apuzzo
Vitiligo Study
250 Palmer Ave.
Sleepy Hollow, NY
10591

or, if you have had a vitamin profile performed recently, by sending a copy of the results to the above address. The results from the blood profile can also be beneficial to you, as they were in my case. Also, if you are interested in the results of this study, please write out your mailing address, and the results will be sent to you upon completion. Thank you again for you participation.

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