Evaluation of needling/microneedling as an adjunct to phototherapy in the treatment of stable acral vitiligo: a comparative clinical and immunohistochemical study

Esmat, Samia; Assaf, Magda; Eldeen, Riham Mohye; Gawdat, Heba I.; Saadi, Dina G

doi:10.1080/09546634.2022.2062279

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…22 Complications of micro-needling such as pain, erythema, itching, and most importantly, the koebnerization made us apply tacrolimus monotherapy and compare it with the effect of the combination of micro-needling and 5-FU solution. 26,30 In the present study, no side effect was observed in the group receiving topical tacrolimus. However, in the micro-needling and 5-FU treated group, different degrees of redness and mild burning were reported.…”

Section: Discussionsupporting

confidence: 38%

“…In their study, more than 75% improvement was seen in 48% of patches receiving micro‐needling plus 5‐FU, compared with only 16% for tacrolimus and needling 22 . Complications of micro‐needling such as pain, erythema, itching, and most importantly, the koebnerization made us apply tacrolimus monotherapy and compare it with the effect of the combination of micro‐needling and 5‐FU solution 26,30 . In the present study, no side effect was observed in the group receiving topical tacrolimus.…”

Section: Discussionmentioning

confidence: 43%

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The efficacy of adding topical 5‐fluorouracil to micro‐needling in the treatment of vitiligo: A randomized controlled trial

Pazyar

Hatami

Yaghoobi

et al. 2023

J of Cosmetic Dermatology

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Background and Aim Vitiligo is an autoimmune skin disorder characterized by circumscribed depigmented macules and patches caused by the loss of functional melanocytes. Although there is no definitive treatment for vitiligo, several treatment options have been associated with relative satisfactory outcomes. The purpose of this study was to compare the efficacy of micro‐needling in conjunction with topical 5‐fluorouracil (5‐FU) versus topical tacrolimus ointment in treating vitiligo patches. Patients and Methods This study included nineteen participants, each of whom received both treatments on two randomly selected vitiligo patches of approximately the same size and location. On one patch, a combination of weekly micro‐needling and topical application of 5‐FU solution was used every other day, while on the other, 0.1% tacrolimus topical ointment was applied twice daily. The G‐score was used to compare treatment outcomes after 3 months. Results The median duration of the disease in our population was 7 years. Six patients (32%) in the micro‐needling plus topical 5‐FU treated group showed a moderate to excellent response, indicating a significant improvement between both treatments (p‐value = 0.019). In contrast, all other patches treated with topical tacrolimus showed poor improvement. Lower extremity and trunk responded more to treatment with micro‐needling plus topical 5‐FU than upper extremity and acral areas. Moreover, none of those who have had the disease for more than ten years have responded to treatment. Mild erythema, pinpoint bleeding, and irritation were detected only in the micro‐needling treated group. Conclusion The current study showed that using micro‐needling in conjunction with 5‐FU could treat vitiligo patients more efficiently than tacrolimus monotherapy. Despite showing moderate to excellent improvement in patches treated with micro‐needling and 5‐FU, this well‐tolerated office‐based modality still requires additional research.

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Section: Discussionsupporting

confidence: 38%

Section: Discussionmentioning

confidence: 43%

The efficacy of adding topical 5‐fluorouracil to micro‐needling in the treatment of vitiligo: A randomized controlled trial

Pazyar

Hatami

Yaghoobi

et al. 2023

J of Cosmetic Dermatology

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“…After browsing the full texts of the included articles, 136 studies were excluded for the following reasons: improper intervention or comparator ( n = 88), not RCT ( n = 43), no relevant outcomes ( n = 10), full‐text unavailable ( n = 5). Only 28 articles 19,25–51 were eligible for inclusion and progressed to the stage of data extraction. Finally, only 22 studies were included in the data analysis since the others had insufficient data.…”

Section: Resultsmentioning

confidence: 99%

Comparison of NB‐UVB combination therapy regimens for vitiligo: A systematic review and network meta‐analysis

Zhu

Liu

Zhang

et al. 2022

J of Cosmetic Dermatology

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Background: Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation. Objectives:To compare the effectiveness of current NB-UVB combination regimen at the improvement in repigmentation through a systematic review and network meta-analysis. Methods:We searched the electronic databases for randomized controlled trials related to NB-UVB combination therapy for vitiligo till October 2022. STATA15.0 software was applied to carrying out data analysis.Results: A total of 28 eligible studies involving 1194 participants were enrolled in the analysis. The NMA results revealed that compared with NB-UVB, carboxytherapy

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“…However, acral lesions as well as lesions overlying joints as elbows and knees are resistant even to surgical treatment 3,26–28 . In addition to scarce pilosebaceous follicles and lower melanocyte densities, it was found that melanocyte growth and migration in acral vitiligo is hindered by several factors such low MMP2, MMP9, SCF, c‐kit, MHCII expression, together with higher expression of antimelanogenic factors as DKK1 and tenascin 3,29 . This, in turn, urges us to optimise our surgical technique to provide our patients with better chances of repigmentation.…”

Section: Discussionmentioning

confidence: 99%

The value of adding platelet‐rich plasma (PRP) to noncultured epidermal cell suspension (NCECS) in surgical treatment of stable resistant vitiligo: A self‐controlled randomised double‐blinded study

Halim

Fekry²,

Mogawer

2023

Aust J Dermatology

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BackgroundNoncultured epidermal cell suspension (NCECS) is a commonly used surgical treatment for resistant stable acral vitiligo and vitiligo overlying joints. Platelet‐rich plasma (PRP) has been reported to enhance the repigmentation response of different therapeutic modalities for vitiligo, including vitiligo surgery.ObjectiveTo assess the value of adding of PRP to NCECS in the surgical treatment of acral vitiligo and vitiligo overlying joints.Patients and MethodsThis self‐controlled randomised trial included 15 patients with 30 lesions in which NCECS suspended in PRP was performed for one lesion and NCECS in ringer's lactate for another comparable lesion. Following NCECS, patients underwent thrice weekly excimer light sessions for 3 months. After 8 weeks, patients underwent preliminary assessment. By the end of the 3 months, both lesions were compared as regards improvement in surface area and pigmentation. Additionally, physician global assessment was made by a blinded investigator.ResultsSignificant improvement was reported in both lesional extent and pigmentation (after PRP and lactated ringer NCECS) with no statistical difference between them.ConclusionDespite previous promising results, suspending NCECS in PRP offered no privilege in surgical treatment of acral vitiligo and vitiligo overlying joints, which are quite resistant to treat.Pan African Clinical Trial registry IDPACTR202108873035929, Date: 16 August 2021.

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Evaluation of needling/microneedling as an adjunct to phototherapy in the treatment of stable acral vitiligo: a comparative clinical and immunohistochemical study

Cited by 5 publications

References 21 publications

The efficacy of adding topical 5‐fluorouracil to micro‐needling in the treatment of vitiligo: A randomized controlled trial

The efficacy of adding topical 5‐fluorouracil to micro‐needling in the treatment of vitiligo: A randomized controlled trial

Comparison of NB‐UVB combination therapy regimens for vitiligo: A systematic review and network meta‐analysis

The value of adding platelet‐rich plasma (PRP) to noncultured epidermal cell suspension (NCECS) in surgical treatment of stable resistant vitiligo: A self‐controlled randomised double‐blinded study

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