Effectiveness of dermabrasion plus 5‐fluorouracil vs suction blister in treating vitiligo: A comparative study

Abstract

Vitiligo is a prevalent destructive melanocyte skin disease that negatively affects the patients' life in terms of self-esteem. Suction blister and dermabrasion plus 5-fluorouracil are effective treatments for vitiligo. The present study was conducted to compare the outcomes of these two techniques. The present clinical trial was conducted on 36 patients with persistent refractory vitiligo which defined as the lack of any new or progressed lesion during the previous year as well as no responding to conventional therapies of vitiligo including topical treatments and phototherapy. Individuals with two vitiligo patches, with similar baseline Vitiligo Area Severity Index (VASI) scores were randomly allocated to dermabrasion plus 5-fluorouracil or suction blister treatments. VASI and repigmentation scores were measured and compared at the baseline, four, and 12 weeks after performing the procedures. Both of the approaches accompanied with significant improvement in both entities of VASI and repigmentation scores (P value < .05) at the end of the study, besides the trend of VASI and repigmentation scores between the two groups revealed insignificant difference (P > .05). The shortterm follow-up of the patients was the limitation of this study. The present findings suggested that both surgical techniques of dermabrasion plus 5-fluorouracil and suction blister posed acceptable outcomes within 12-week follow-up.

The clinical and pathological effectiveness of microneedling and topical 5‐fluorouracil in vitiligo treatment: An association with matrix metalloproteinase 2 immunohistochemical expression

“…The present results showed a significant reduction of VASI score mean and median values after treatment in comparison with before treatment as evidence of response to therapy. These findings were also seen by others 17 who suggested improvement in the VASI score within 12 weeks after the start of dermabrasion and 5-FU in the treatment of vitiligo.…”

“…10 Application of 5-fluorouracil after therapeutic wounding, as a treatment of vitiligo, was firstly introduced by Tsuji and Hamada in 1983 11 followed by several studies. [12][13][14][15][16][17] This study aimed to investigate the efficacy and safety of flexible microneedling followed by application of 5-FU in vitiligo treatment and to evaluate the immunohistochemical expression of MMP2 in involved skin in vitiligo patients before and after treatment.…”

Pro-pigmentary action of 5-fluorouracil through the stimulated secretion of CXCL12 by dermal fibroblasts

“…[15,16] Several clinical observations support the intriguing speculation that 5-FU potentially possesses a pro-pigmentary activity, conferring beneficial effects on the repigmentation of vitiligo, especially in UVB-resistant depigmented areas. [17,18] 5-FU is a pyrimidine analogue that exerts a potent antimitotic activity and has been widely used in the treatment of actinic keratoses, as well as some basal and squamous cell skin cancers. [19] However, relatively few studies have focused on the extra-genotoxic actions of this chemotherapeutic agent.…”

“…The residual melanocytes in vitiligo lesions are thought to be immature precursors (also referred to as melanoblasts), which might avoid immune attacks due to their lack of expression of immunogens that are exclusively expressed by mature melanocytes [15,16] . Several clinical observations support the intriguing speculation that 5-FU potentially possesses a pro-pigmentary activity, conferring beneficial effects on the repigmentation of vitiligo, especially in UVB-resistant depigmented areas [17,18] . 5-FU is a pyrimidine analogue that exerts a potent antimitotic activity and has been widely used in the treatment of actinic keratoses, as well as some basal and squamous cell skin cancers [19] .…”

Microneedling in Combination with Topical Pimecrolimus 1% versus Topical Pimecrolimus 1% for the Treatment of Refractory Stable Vitiligo: A Randomized Clinical Trial

“…Vitiligo is a common skin disease that affects between 1% and 2% of the world population [ 1 ] that occurs equally in men and women and is most prevalent between the ages of 10 and 30 [ 2 ]. Although various explanations for the mechanism and etiology of vitiligo have been proposed, including genetics, autoimmune mechanisms, psychological factors, biochemical factors, oxidative stress, and viral infections, the exact cause of vitiligo remains unclear [ 3 , 4 ].…”