Comparison between the efficacy of microneedling combined with 5‐fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo

Mina, Mary; Elgarhy, Lamia Hamouda; Al-saeid, Hanan; Ibrahim, Zeinab A

doi:10.1111/jocd.12440

Cited by 53 publications

(102 citation statements)

References 21 publications

(52 reference statements)

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“…12 In our study, flat, non-resistant hairy areas showed more repigmentation (mean 13.8±8.5%) as compared to non-flat, resistant, non-hairy areas (mean 9.8±4.5%). This is contrary to Mina et al, 13 who reported that 40% of acral vitiliginous patches showed good to excellent repigmentation mainly diffuse but the pattern was perifollicular as shown in our study.…”

Section: Discussioncontrasting

confidence: 99%

“…In the study by Anbar et al, 4 the authors reported pain in all their patients, and a higher prevalence of hyperpigmentation in 30%. Interestingly in the study using microneedling with 5-FU, 13 although they reported the procedure to be well tolerated, patients developed hyperpigmentation in 16%, inflammation in 12%, and ulceration in 4% of patients, all more severe side effects than what is reported in our study.…”

Section: Discussioncontrasting

confidence: 68%

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<p>Effect of Topical 5-Fluorouracil Alone versus Its Combination with Erbium:YAG (2940 nm) Laser in Treatment of Vitiligo</p>

Abdelwahab

Salah

Samy

et al. 2020

CCID

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To compare the efficacy of topical 5-FU as monotherapy to combined therapy of topical 5-FU and Er:YAG (2940 nm) laser in the treatment of non-segmental vitiligo (NSV). Methods: This is a prospective randomized comparative study. Thirty patients diagnosed with NSV were recruited from the dermatology outpatient clinics of the Medical Research Centre of Excellence, the National Research Centre and the National Institute of Laser Enhanced Sciences. Our study group was divided into two subgroups, Group 1 was subjected to ablative Er:YAG and 5-FU cream and Group 2 applied topical 5-FU cream. Three treatment sessions were repeated every 4 to 6 weeks and patients were followed up to 9 months. Repigmentation was assessed by digital photography and subsequent computer based image analysis. Results: Repigmentation of Group 1 patients ranged from 0 to 70% (mean 12±7%) whilst in Group 2 this ranged from 0 to 5% (mean 1.4±0.8%). In Group 1 repigmentation was mild in 22/30 (73.3%) and moderate to severe in 3/30 (10%) starting after 3 months and persisted or increased during the period of follow up to 9 months. Groups 1 and 2 were subdivided into A and B, vitiligo involving non-resistant and resistant areas respectively. Group 1A showed more repigmentation (mean 13.8±8.5%) than Group 1B (mean 9.8±4.5%) and Group 2A showed more repigmentation (mean 1.5±1%) than Group 2B (mean 1.3±0.5%). Conclusion: The combination of Er:YAG with 5-FU is safe and effective in treating and improving outcome in vitiligo especially of non-resistant areas. Computer based image analysis of vitiliginous lesions and assessing post-therapy response is an easy, quick, and reliable method.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 68%

<p>Effect of Topical 5-Fluorouracil Alone versus Its Combination with Erbium:YAG (2940 nm) Laser in Treatment of Vitiligo</p>

Abdelwahab

Salah

Samy

et al. 2020

CCID

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“…Microneedling combined with drugs was found to be safe and effective treatment of vitiligo. However, in the case of 5‐fluorouracil a greater percentage of repigmentation was achieved in comparison to tacrolimus (Mina, Elgarhy, Al‐Saeid, & Ibrahim, ).…”

Section: Main Indications For the Application Of Microneedlingmentioning

confidence: 99%

“…Microneedling combined with drugs was found to be safe and effective treatment of vitiligo. However, in the case of 5-fluorouracil a greater percentage of repigmentation was achieved in comparison to tacrolimus (Mina, Elgarhy, Al-Saeid, & Ibrahim, 2018). Korobko I et al performed a pilot comparative study of topical latanoprost and tacrolimus in combination with narrow-band ultraviolet B phototherapy and microneedling for the treatment of nonsegmental vitiligo.…”

Section: Vitiligomentioning

confidence: 99%

Is skin microneedling a good alternative method of various skin defects removal

Zduńska

Kołodziejczak

Rotsztejn

2018

Dermatologic Therapy

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Skin microneedling accelerates the process of skin regeneration through the creation of numerous microinjuries which emerge when skin is deeply punctured with very thin needles. The whole procedure evokes various reactions which can be divided into three major phases: inflammation, proliferation, and remodeling. It activates platelet growth factors which are responsible for the stimulation of fibroblasts to produce collagen and elastin. Moreover, skin breakdown enhances penetration of active ingredients. Treatment can be performed with the use of different devices, all equipped with needles of various lengths. Due to the fact that skin microneedling stimulates the synthesis of significant rebuilding and structural skin elements (collagen, elastin, proteoglycan), it is used in the treatment of many skin defects of different etiologies (e.g., photoaging, wrinkles, loss of elasticity, hypo‐ or hypertrophic scars, pigmentation changes, infraorbital dark circles, teleangiectasia, stretch marks, cellulite, alopecia, and vitiligo). In order to accelerate postsurgical regeneration and/or to enhance effects, microneedling is combined with the application of UV light (photodynamic therapy with ALA), LED light, platelet‐rich plasma, chemical peels, stem cells, retinoids and other pharmaceuticals, and vitamins. High effectiveness, limited number of side effects, and short recovery time, make skin microneedling a popular cosmetic, and medical treatment.

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“…Moreover, a possible mechanical migration of melanocytes from the pigmented borders to the depigmented areas has been postulated. [ 89‐91 ] The wounding action of chemical peels has been reported in patients with vitiligo. Treatment with 88% phenol peeling in stable vitiligo lesions produced a repigmentation of 82.5% of hairy sites and 81.3% of non‐hairy .…”

Section: Proposed Treatmentsmentioning

confidence: 99%

Involvement of non‐melanocytic skin cells in vitiligo

Bastonini

Bellei

Filoni

et al. 2019

Experimental Dermatology

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Despite melanocytes are the key players in vitiligo, a continuous cross‐talk between epidermal and dermal cells may strictly affect their functionality, in both lesional skin and non‐lesional skin. Focusing on this interplay, we have reviewed existing literature supporting evidence on cellular and functional alterations of surrounding epidermal keratinocytes, extracellular matrix (ECM) proteins and fibroblasts in the underlying dermal compartment that may contribute to melanocyte disappearance in vitiligo. We have also examined some clinical and therapeutic aspects of the disease to sustain the non‐exclusive involvement of melanocytes within vitiligo. As a result, a different and more complex scenario has appeared that may enable to provide better understanding about origins and progress of vitiligo and that should be considered in the evaluation of new treatment approaches.

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Comparison between the efficacy of microneedling combined with 5‐fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo

Abstract: Microneedling combined with 5-fluorouracil or tacrolimus is safe and effective treatment of vitiligo. However, 5-fluorouracil achieved a greater percentage of repigmentation than tacrolimus particularly in the acral parts.

Cited by 53 publications

References 21 publications

<p>Effect of Topical 5-Fluorouracil Alone versus Its Combination with Erbium:YAG (2940 nm) Laser in Treatment of Vitiligo</p>

<p>Effect of Topical 5-Fluorouracil Alone versus Its Combination with Erbium:YAG (2940 nm) Laser in Treatment of Vitiligo</p>

Is skin microneedling a good alternative method of various skin defects removal

Involvement of non‐melanocytic skin cells in vitiligo

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