Effects of autologous micrografts on stable bilateral vitiligo: A focus on hand lesions

Menchini, Giovanni; Astarita, Carlo

doi:10.1111/1346-8138.15564

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…In vitiligo, treatment with (excimer) laser in the range of 308 to 311 nm has been used to treat more localized form of disease (56)(57)(58). More so than in psoriasis, phototherapy in vitiligo is used as an adjuvant to other treatements, whether it be pharmacological or surgical (melanocyte transplant, punch biopsies etc) (59)(60)(61)(62)(63). In vitiligo prolonged courses of phototherapy are often prescribed.…”

Section: Vitiligomentioning

confidence: 99%

Low-dose UV-therapy: effectivity and safety aspects

Franken¹

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This thesis investigated the effectivity and safety of low-dose phototherapy in the treatment of skin diseases. The current individualised, “on demand society” creates the need for treatment in the patients’ home at a time point that suits the patient best. But little was known on safety and effectivity of low-dose UV-treatment. This thesis is comprised of three parts: 1. A review of the literature to understand what the hurdles are in prescription of phototherapy, 2. Investigating the effectivity of low-dose home-based phototherapy, 3. Investigating the potential carcinogenic risk of low-dose home based phototherapy. Conclusion and recommendations Low-dose phototherapy is an effective treatment in patients with PLE and mild to moderate psoriasis. PLE patients were more satisfied with the low-dose home based treatment than conventional treatment. Low-dose phototherapy could be given continuously and patients are less limited in planning their activities, which might improve quality of life. For psoriasis patients with mild to moderate complaints low-dose phototherapy might help patients who are tired of the frequent ointment applications or in need of an adjuvant with their corticosteroid therapies. Prolonged treatment up to 18 months appears safe, although further studies are needed to corroborate this and provide more evidence about the effects in even longer time intervals. In these studies it would be relevant to also ascertain the presence of p53 mutations in the epidermis. As skin malignancies can develop after years of chronic UV-exposure it would be wise to advocate for regular skin check-ups for patients undergoing this treatment. An electronic monitoring would be advisable to corroborate the adherence to treatment protocol, although the results of the present study suggest that there is no major reason for concern. This is in line with the results of prior studies. Dermatologists should, however, stay on their toes about development of “tanorexia” which could place a patient at risk for skin cancer. Tanorexia is reported to be caused by the release of β-endorphins by UV light. Not all patients exposed to UV-light develop tanorexia however. There probably are other factors playing a part in the development of this addiction. It is shown in this thesis that low-dose phototherapy is effective in PLE and psoriasis; it is probable that this therapy might be relevant for other inflammatory skin diseases, such as atopic dermatitis, vitiligo or graft versus host disease. Further studies to demonstrate effectiveness and safety of a home-based low-dose phototherapy in other diseases are warranted. Another interesting aspect of the low-dose home-based phototherapy is the rise in vitamin D. If low-dose phototherapy is confirmed to be safe, it would be an interesting option to use this device in patients with or at risk for hypovitaminosis D, such as dialysis patients who also often deal with uremic pruritus. Other patients that could benefit from this are elderly who are at risk for bone fractures, or patients with chronic pain associated with vitamin D deficiency. Prior studies have demonstrated that patients with hypovitaminosis D use more opiates, than patients with normal vitamin D levels. It might be interesting to investigate the effect of low-dose UV in patients with chronic pain requiring opiates with and without hypovitaminosis D. Could low-dose phototherapy lessen their pain use of opioids? And is this effect due to the stimulation of β-endorphins or is it the result of normalisation of vitamin D levels? To recapitulate: if low-dose phototherapy is confirmed to be safe in prolonged treatment, it might provide a valuable tool in the treatment not only dermatological diseases, but also various internal diseases.

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Section: Vitiligomentioning

confidence: 99%

Low-dose UV-therapy: effectivity and safety aspects

Franken¹

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Autologous Cultured Tissue Engineering Epidermal Sheet Transplantation to Treat Vitiligo of the Hands

Lu,

Wang,

Chen

et al. 2024

Dermatol Surg

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BACKGROUND Despite numerous therapeutic modalities for vitiligo, their efficacy varies. Managing vitiligo affecting the hands poses a particularly intricate challenge, with outcomes trailing those in other anatomical regions. OBJECTIVE Assess the determinants influencing the efficacy and safety of autocultured tissue engineering epidermal sheets transplantation in treating hand vitiligo, observed over a 6-month follow-up period. METHODS A retrospective analysis was conducted on 33 patients who underwent treatment for hand vitiligo using autocultured tissue engineering epidermal sheets transplantation. Repigmentation extent was evaluated by 2 dermatologists. RESULTS The cohort comprised 33 patients, including 24 males and 9 females, with an average age of 26.91 ± 9.24 years (range: 10–49 years). The mean duration of the disease was 11.61 ± 7.83 years (range: 1.5–34 years). Vitiligo lesion stability ranged from 6 months to 4 years, with an average duration of stability calculated at 1.715 ± 1 year. After 6 months, 75.8% (25/33) of patients exhibited a favorable response, with 39.4% (13/33) showing complete or near-complete repigmentation. No adverse events, such as infections or scar formation, were recorded. CONCLUSION The authors' investigation suggests that autocultured tissue engineering epidermal sheets transplantation is a highly effective and safe therapeutic approach for hand vitiligo, offering a promising treatment avenue.

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