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Biomedicine has not provided a complete explanation with fully effective therapies for disorders of pigmentation. Biomedicine emphasizes the role of melanocyte for protection from UV rays and as a determinant of skin colour. These important properties acquired a genetic basis much later than other functions, many relating to cell contact as in the keratinocyte - melano-cyte unit, or as with the synapses of the neurological system. There are other roles, biochemical and mechanical, of melanocyte. Management that is inclusive of a maximally holistic approach justifies the use of diverse herbals, yoga and concern for cultural awareness provided by integrated medicine. Vitiligo provides a model which demonstrates that Ayurveda has a richer view of its presentations, possibly a stronger line on its pathogenesis, and a huge range of herbals, many now backed by studies from ethnobotanical laboratories, awaiting research into the many possible mechanisms by which they may act in the wide and complex field of melanocyte biochemistry.
This paper considers the problem of evaluating multimodal integrative medicine treatments for complex pathologic conditions. The example is given of evaluation of highly successful treatments of lymphedema using Ayurvedic and Yoga medicine practices together with modern medicine. For a framework to evaluate such a complex intervention, we base our proposal on Consolidated Standards of Reporting Trials (CONSORT) guidelines.