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SummaryBackground Vitiligo is a disfiguring disease, characterized frequently by the presence of de-pigmented macules and/or patches. Traditional therapies are essentially medical and are most preferred by dermatologists. Surgical therapies, however, are amongst the most effective interventions for vitiligo but are limited by their invasive nature, as well as the training and expertise needed to perform specific procedures. Objectives To assess the evidence for the effectiveness, safety and applicability of the various surgical methods in the treatment of vitiligo. Methods For this systematic review of vitiligo surgical therapies, our searches included: PubMed, MEDLINE and Cochrane databases. Results We reviewed research studies reporting on split thickness skin grafts (STSG), punch/mini-graft, blister roof grafting, cultured and non-cultured cellular transplantation (MKTP). While all methods vary in their repigmentation outcomes, STSG is found to have the highest repigmentation success rate. Overall, post-operative complications included milia, scarring, cobblestone appearance or hyperpigmentation of treated areas. Conclusion This review highlights the need for more randomized controlled trials in this field, underpinned by a more standardized objective approach to the assessment of repigmentation following surgical interventions.

Background Studies have begun to investigate the complex relationship between host and microorganisms in non‐infectious pathologies such as acne, atopic dermatitis and psoriasis. Though the skin is exposed to environmental stressors such as ultraviolet radiation (UVR), no studies exist examining the effects of both UVA and UVB on the skin microbiome. Objective To test the effect of UVA and UVB on human skin microbiome. Methods To test whether UV will alter the cutaneous microbiome, participants were exposed to doses of UVA (22‐47 J/cm2) or UVB (100‐350 mJ/cm2) and samples were collected. DNA was isolated and sequenced to identify the microbial composition of each sample. Results There was vast intra‐ and inter‐subject variation at all time points, and phylum and species‐level differences were identified. These included an increase in the phylum Cyanobacteria and a decrease in the family Lactobacillaceae and Pseudomonadaceae. The sensitivity of microbes to UVR and their re‐colonization potential following exposure differed in UVA vs UVB samples. Limitations The sample size was small, and the study was limited to males. Conclusion The results demonstrate that UVR has profound qualitative and quantitative influences on the composition of the skin microbiome, possibly effecting skin pathology in which UVR is a factor.

Background Systemic antioxidants, such as oral Polypodium leucotomos extract (PLE), have been found to have photoprotective properties. Objective This study was designed to objectively evaluate the molecular and photobiologic effects of oral administration of PLE. Methods 22 subjects with Fitzpatrick skin phototype I–III were enrolled. On day 1, subjects were irradiated with visible light, ultraviolet A1 (UVA1) and ultraviolet B (UVB; using 308-nm excimer laser). Evaluation was done immediately and 24 hours after irradiation. On days 3 and 4, irradiation and evaluation process was repeated after ingestion of PLE. Results Clinical assessments and colorimetry data showed a decrease in UVB -induced changes in 17 out of 22 subjects post-PLE administration; histology findings demonstrated such a decrease in all 22 subjects. Limitations Only 2 doses of PLE were given. Furthermore, subjects with skin phototypes I–III only were studied. Conclusion This is the first demonstration that PLE has objective measurable suppressive effects on UVB-induced erythema within 2 hours of administration. The results suggest that PLE can potentially be utilized as an adjunctive therapy to lessen the negative photobiologic effects of UVB. In addition, this is the first study to demonstrate the potential correlation between non-invasive colorimetry outcomes and UVB induced molecular damage.

Clinical, spectroscopic and histological similarities of acne-induced and TCA-induced PIH at day 28 suggest that TCA-induced PIH can be a reproducible model for the study of acne-induced PIH.

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Uncommon and even suboptimal responses can occur following the MKTP in SV patients. There is a need for studies to provide better understanding and outcomes for SV patients undergoing the MKTP.

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