Mechanisms of phototherapy of vitiligo

Fitzpatrick, Thomas B.

doi:10.1001/archderm.133.12.1591

Cited by 29 publications

(29 citation statements)

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“…[48] It is conceivable that in the future, cytokines may be used to induce melanocyte migration and stimulate repigmentation. [49]…”

Section: The Role Of Proinflammatory Cytokines and Uv Lightmentioning

confidence: 99%

Vitiligo and the melanocyte reservoir

Falabella

2009

Indian J Dermatol

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Repigmentation of vitiligo depends on available melanocytes from three possible sources: from the hair follicle unit which is the main provider of pigment cells, from the border of vitiligo lesions, and from unaffected melanocytes within depigmented areas; pigment cells at these locations originate a perifollicular, border spreading and a diffuse repigmentation pattern. In order for repigmentation to take place under stimulation with diverse therapies, melanocytes should be present in appropriate numbers. Melanocyte tissue stem cells located in the niche at the bulge region of the hair follicle are the most important sources for providing immature pigment cells that undergo terminal differentiation and originate repigmentation, but cytokines, UVR and other molecules acting in melanogenesis with adequate regulation mechanisms contribute to successful recovery in vitiligo. The presence of keratinocyte stem cells in the interfollicular epidermis raises the question on the possibility of melanocyte stem cells in a similar location and the development of future strategies for therapeutic purposes.

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“…[48] It is conceivable that in the future, cytokines may be used to induce melanocyte migration and stimulate repigmentation. [49]…”

Section: The Role Of Proinflammatory Cytokines and Uv Lightmentioning

confidence: 99%

Vitiligo and the melanocyte reservoir

Falabella

2009

Indian J Dermatol

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“…Any theory of therapy must explain not only the action on cytotoxic T lymphocytes, but also the stimulation of melanocyte proliferation and the migration of melanocytes to the epidermis from the hair follicle. [5] In vivo exposure of human epidermis to solar-stimulated UV-irradiation causes changes in the enzymatic antioxidant defence system which, in turn, is accompanied by increased levels of oxidative stress. [6] Photosensitizing agents are also known to generate reactive oxygen species.…”

Section: Introductionmentioning

confidence: 99%

Vitiligo treatment with vitamins, minerals and polyphenol supplementation

Jalel¹,

Soumaya²,

Hamdaoui³

2009

Indian J Dermatol

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Background:Mammalian pigmentation results from the synthesis and accumulation of photo protective epidermal melanin. Melanin was formed from the amino acid precursor L-tyrosine within specialized cells, the melanocytes. Oxidative stress has been suggested to be the initial pathogenetic event in melanocyte degeneration with H2O2 accumulation in the epidermis of patients with active disease. Auto immunity has been also suggested as another hypothesis in the pathogenesis of depigmentation disorders. Topical corticosteroids and phototherapy as common treatment modalities have been prescribed in patients with vitiligo. However, they are often not effective and safe (epidermal atrophy). Therefore, research for alternative therapies continues.Aims:To evaluate the beneficial effects of a supplementation with antioxidant vitamins (A, C, E) and minerals (zinc, selenium) for vitiligo treatment.Methods:Forty experimental autoimmune vitiligo mice C57BL6, aged from 5 to 12 months showing visible signs of induced vitiligo, were sequentially randomized into five parallel groups (8 mice per group). Each group mice was allocated an identical pre coded cage. the first group (SZV) received the ED + 1,4 g zinc (Zn) + 0.04 g selenium (Se) + vitamins (A 118 UI, C 8,5 mg, E 5,4 UI) /kg diet, the second group (PSZV) received the ED + 1,4 g zinc (Zn) + 0.04 g selenium (Se) + vitamins (A 118 UI, C 8.5 mg, E 5,4 UI)/kg diet + Polyphenol orally, the group 3 (PSZ) received the ED + green tea decoction prepared from 100 g/l (polyphenol orally) + 1,4 g Zn + 0.04 g Se, the 4 (P) received the ED + green tea decoction prepared green tea decoction prepared from 100 g/l, the control group 5(C) received the ED + distilled water. Cure was defined as repigmentation of treated sites. Photographic and optical techniques were used both at the baseline and on weekly basis.Results:By the end of the study, mices showed visible repigmentation. Using the investigator's global assessment, therapeutic success in terms of a clear repigmentation documented in 70% of treated mice.Conclusion:Our findings suggest that an antioxidant supplementation is significantly beneficial in contributing superior clinical efficacy to cure vitiligo.

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“…The first step is the stabilization of the depigmenting process and the second is the stimulation of residual follicular melanocytes [12, 13]. The stabilization of the depigmenting process is explained by the immunomodulatory effect of NB-UVB on the local and systemic immune responses [13, 14]. …”

Section: Discussionmentioning

confidence: 99%

Narrow-Band Ultraviolet B versus Oral Minocycline in Treatment of Unstable Vitiligo: A Prospective Comparative Trial

Siadat

Zeinali

Iraji

et al. 2014

Dermatology Research and Practice

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Background. We have compared NB-UVB and oral minocycline in stabilizing vitiligo for the first time. Subjects and Methods. 42 patients were divided equally into two groups: the NB-UVB and minocycline groups. Phototherapy was administered twice a week on nonconsecutive days. In the minocycline group, patients were advised to take minocycline 100 mg once daily. The treatment period was 3 months. Vitiligo disease activity (VIDA) score was noted every 4 weeks for 12 months. Digital photographs were taken at baseline and monthly intervals. Results. Before the therapy, disease activity was present in 100% of the patients, which was reduced to 23.8% and 66.1% by the end of therapy in the NB-UVB and minocycline groups retrospectively (P < 0.05). 16 of the 21 (76/1%) patients with unstable disease in the NB-UVB group achieved stability, whereas this was the case for only 7 of the 21 (33.3%) in the minocycline group (P < 0.001). The diameter changes were statistically significant at the end of treatment in the NB-UVB group compared to the minocycline group (P = 0.031). Side effects in both groups were mild. Conclusion. NB-UVB was statistically more advantageous than oral minocycline in unstable vitiligo in terms of efficacy and the resulting stability.

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Mechanisms of phototherapy of vitiligo

Cited by 29 publications

References 0 publications

Vitiligo and the melanocyte reservoir

Vitiligo and the melanocyte reservoir

Vitiligo treatment with vitamins, minerals and polyphenol supplementation

Narrow-Band Ultraviolet B versus Oral Minocycline in Treatment of Unstable Vitiligo: A Prospective Comparative Trial

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