A Retrospective Study of Methylprednisolone Mini-Pulse Therapy Combined with Narrow-Band UVB in Non-Segmental Vitiligo

Lee, Jungsoo; Chu, Howard; Lee, Hemin; Kim, Miri; Kim, Dae Suk; Oh, Sang Ho

doi:10.1159/000439563

Cited by 22 publications

(18 citation statements)

References 20 publications

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“…The effects of UV radiation are also marked on immune effector cells. Overall, this modality results in the halting of depigmentation and initiation of repigmentation in vitiliginous skin and is one of the most successful treatment options for vitiligo, both as monotherapy and combination therapy [ 80 , 81 , 82 , 83 ].…”

Section: Stabilizing and Repigmenting Treatmentsmentioning

confidence: 99%

Clinical and Molecular Aspects of Vitiligo Treatments

Bishnoi

Parsad

2018

IJMS

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Vitiligo is an asymptomatic but cosmetically disfiguring disorder that results in the formation of depigmented patches on skin and/or mucosae. Vitiligo can be segmental or non-segmental depending upon the morphology of the clinical involvement. It can also be classified as progressing or stable based on the activity of the disease. Further, the extent of involvement can be limited (localized disease) or extensive (generalized disease). The treatment of vitiligo therefore depends on the clinical classification/characteristics of the disease and usually comprises of 2 strategies. The first involves arresting the progression of active disease (to provide stability) in order to limit the area involved by depigmentation. The second strategy aims at repigmentation of the depigmented area. It is also important to maintain the disease in a stable phase and to prevent relapse. Accordingly, a holistic treatment approach for vitiligo should be individualistic and should take care of all these considerations. In this review, we shall discuss the vitiligo treatments and their important clinical and molecular aspects.

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Section: Stabilizing and Repigmenting Treatmentsmentioning

confidence: 99%

Clinical and Molecular Aspects of Vitiligo Treatments

Bishnoi

Parsad

2018

IJMS

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“…24 This was a landmark study for future clinical trials and observational studies. 10,[25][26][27][28] In this study, however, the decision about dosage and its frequency was arbitrarily made. 24 Clinical guidelines regarding the use of OMP therapy for the treatment of vitiligo currently lack sufficient evidence to make a recommendation.…”

Section: Discussionmentioning

confidence: 99%

Oral mini‐pulse therapy in vitiligo: a systematic review

et al. 2021

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Background There is limited evidence supporting the use of alternative treatments for patients with nonstable vitiligo.Objective This study aimed to review the effects of oral mini-pulse (OMP) therapy in the management of nonsegmental vitiligo. MethodsThe following databases were searched between inception and May 2020 for relevant studies: Scopus, Web of Science, MEDLINE, and Embase. All randomized controlled trials that compared OMP therapy with any other active treatment or placebo for nonstable vitiligo were included. The Cochrane's risk of bias tool was used to evaluate the risk of bias (ROB) in selected studies, and the overall quality of evidence of each outcome was assessed using the Grading Recommendations, Assessment, Development, and Evaluations (GRADE) system.Results Four studies met our selection criteria. All of them were conducted in India and included 246 patients. OMP therapy included betamethasone or dexamethasone. The duration of treatment was 6 months in all studies. Up to 32% of patients achieved a repigmentation rate of >75% when OMP therapy was administered as monotherapy. No difference was observed between OMP therapy and other treatments in arresting the disease, and weight gain was the most frequent adverse effect. The overall ROB in all included studies was relatively high because of the randomization process, outcome measurement and informed selection of outcomes. ConclusionBased on the findings of these studies, OMP therapy did not demonstrate additional value compared with other treatments. Hence, there is an urgent need to conduct high-quality clinical trials to evaluate this therapy.

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“…It not only slows disease progression, but it also promotes repigmentation by allowing normal melanocytes to migrate from the lesions' peripheral or the perifollicular region. The time it takes for sickness to stop reoccurring can range from a few weeks to months [63].Patients with vitiligo that is rapidly advancing may benefit from oral mini-pulse (OMP) therapy, as they may have a poor response to other treatments [64]. The administration of cyclical pulsed dosecorticosteroids in substantially lower doses than typical pulsed therapy is referred to as OMP therapy.…”

Section: Oral Mini-pulse Steroidmentioning

confidence: 99%

“…Narrowband ultraviolet B (NB-UVB) therapy for vitiligo is considered an effective and safe treatment option with outstanding results [81].Phototherapy with a peak wavelength of 311 nm has been used to treat vitiligo for decades. In vitiligo patients, NB-UVB phototherapy is performed two to three times per week over several months to years to generate considerable repigmentation [64].The efficacy of NB-therapeutic UVB is due in part to its immunomodulating qualitieswhich prevent melanocyte death andas a result, depigmentation. The main mechanism of action, however, is to induce repigmentation by encouraging melanocyte differentiation, migrationand proliferation, most likely through increased melanocyte growth factors such as basic fibroblast growth factor (bFGF) and endothelin-1 (EN-1) [82].…”

Section: Narrow-band Ultraviolet -Bmentioning

confidence: 99%

Macrophage Migration Inhibitory Factor in Vitiligo: Pathogenesis and Potential Therapeutic Aspects

Ibrahim

Nada

Ali

et al. 2021

AJBGMB

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Vitiligo is an acquired skin disorder that is characterized by a gradual loss of skin pigmentation when melanocytes, the skin's pigment-producing cellsis lost. Pathogenicmechanisms are not well understood. Genetic, abnormal biochemical pathways, autoimmune, melanocyte adhesion deficits and nervous system imbalances are among the pathogenic triggers. Vitiligo lesions have also been shown to have macrophage infiltration.Macrophagemigration inhibitory factor (MIF) is a lymphokine that concentrates macrophages at inflammatory sites and is involved in cell-mediated immunity.MIF enhances chemotaxis and macrophage infiltration and upregulates inflammatory responses by inducing the expression of proinflammatory mediators such as TNF-α, nitric oxide and prostaglandin E2.Therapyfor vitiligo includes corticosteroids, immunomodulatory agents, vitamin D nalogues, antioxidants, phototherapy, laser and surgical therapy.However, no single treatment for vitiligo produces consistently good results and treatment response is variable. Narrow-band ultraviolet (NB-UVB, 311–313nm) phototherapy is viewed as backbone of treatment. Systemic therapies such as systemic corticosteroids and methotrexate were previously used to treat vitiligo which was assumed to be auto-immune nature.Pathogenic mechanisms, role of MIF and various treatment guidelines are discussed in this review

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A Retrospective Study of Methylprednisolone Mini-Pulse Therapy Combined with Narrow-Band UVB in Non-Segmental Vitiligo

Cited by 22 publications

References 20 publications

Clinical and Molecular Aspects of Vitiligo Treatments

Clinical and Molecular Aspects of Vitiligo Treatments

Oral mini‐pulse therapy in vitiligo: a systematic review

Macrophage Migration Inhibitory Factor in Vitiligo: Pathogenesis and Potential Therapeutic Aspects

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