Successful Treatment of Segmental Vitiligo in Children with the Combination of 1-mm Minigrafts and Phototherapy

Tsuchiyama, Kenichiro; Watabe, Akiko; Sadayasu, Anna; Onodera, Nobue; Kimura, Yutaka; Aiba, Setsuya

doi:10.1159/000442666

Cited by 13 publications

(16 citation statements)

References 16 publications

(24 reference statements)

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“…Whitening of hairs (leukotrichia or poliosis) is more commonly observed with SV and can be a marker of poor response to treatment. To date, pathogenesis of SV is not entirely well‐known; however, previous studies showed increased blood flow and vasodilatation in depigmented skin of SV due to impaired sympathetic response results from increased α 2 and β adrenergic receptors and nitric oxide syntheses 7–37 . Other mechanisms such as increased levels of pro‐inflammatory cytokines, cytotoxic effects of neuropeptides on melanocytes, and destruction of melanocytes secondary to oxidative stress, and CD8 cytotoxic T lymphocytes have been proposed in the pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of traditional and surgical treatment modalities in segmental vitiligo: A review article

Khalili

Amiri

Mohammadi

et al. 2022

J of Cosmetic Dermatology

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Background Segmental vitiligo (SV) is a distinctive variant of vitiligo that is usually resistant to traditional treatments. Therefore, surgical therapies are mainstay of treatment in this type of vitiligo. To date, there is no review article or systematic review that evaluates specifically efficacy of treatment modalities on SV. Aim To evaluate current evidence regarding efficacy and safety of traditional and surgical treatment modalities in SV. Methods We conducted a search in PubMed, Embase, Web of science, and Google Scholar for key words of "vitiligo" AND "segmental" AND "treatment" OR "therapy" OR "surgical treatments" OR "medical treatments" OR "laser" OR "phototherapy". Inclusion criteria were English literature that investigated efficacy of different treatments on three or more cases on SV from January 2000 until July 2021. Results A total of thirty‐four articles were selected for detailed assessment. Different treatment modalities include medical treatment [systemic corticosteroid (SCS), topical CS (TCS), and topical calcineurin inhibitors (TCI)], phototherapy [narrow band‐ultraviolet B (NB‐UVB), psoralen and UVA (PUVA) and psoralen+solar exposure (PUVASOL)], laser/lights [helium‐neon and Excimer laser/light (EL)] and surgical treatments [punch graft (PG), follicular graft, suction blister epidermal grafting (SBEG), spilt‐thickness skin graft (STSG), and cultured/non‐cultured‐melanocytes‐keratinocytes transplantation (MKTP)]. Conclusion There were few randomized controlled trials (RCT) evaluating the efficacy of treatments in SV. Therefore, future high quality studies are required for better assessment of various treatment modalities in SV. Results of current evidence indicate resistance of SV to traditional therapies unless in patients with short duration of vitiligo. Therefore, surgical interventions are the first‐line of treatment in refractory cases, long‐standing disease, or presence of leukotrichia in depigmented patches.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of traditional and surgical treatment modalities in segmental vitiligo: A review article

Khalili

Amiri

Mohammadi

et al. 2022

J of Cosmetic Dermatology

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“…Several combination therapies have been introduced to obtain better results and to reduce risks. 2 The prolonged duration of therapy is the main reason for patient noncompliance. 3 Platelet-rich plasma (PRP) is composed of high concentration of platelets with high concentration of growth factors (GFs).…”

Section: Introductionmentioning

confidence: 99%

Platelet-rich plasma versus combined fractional carbon dioxide laser with platelet-rich plasma in the treatment of vitiligo: a comparative study

Kadry

Tawfik

Abdallah

et al. 2018

CCID

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PurposeThe aim of this study was to assess the efficacy of platelet-rich plasma (PRP) vs combined fractional CO2 (Fr: CO2) laser with PRP in the treatment of stable nonsegmental vitiligo (NSV) lesions.Patients and methodsThis prospective, randomized, intrapatient, comparative controlled study was conducted between June 2014 and June 2016 at National Institute of Laser Enhanced Sciences (NILES), Cairo University, Cairo, Egypt. Thirty NSV patients were treated with PRP, Fr: CO2 laser, and combined Fr: CO2 laser with PRP. Intrapatient lesions were divide randomly into four groups. Each group was treated by one modality. The fourth group served as a control.Patients received six treatment sessions with 2-week interval for 3 months and were followed up after 3 months.ResultsA highly significant reduction was demonstrated through vitiligo analysis by computer-assisted grid (VACAG) in the combined Fr: CO2 laser with PRP and in the PRP only groups than other groups. These results were confirmed by mean improvement score by physician (MISP) and by VAS with no statistical difference between them. The combined Fr: CO2 laser with PRP group showed minimal side effects. Regardless of the modalities, better improvement was seen in the trunk than the face, extremities, and acral lesions with significant reduction in all regions. Face showed maximum response with combined Fr: CO2 laser with PRP. Trunk showed higher response with PRP. Upper limbs showed highest response with combined Fr: CO2 laser with PRP. Lower limbs showed the highest improvement with Fr: CO2 laser.ConclusionAccording to our study, combined Fr: CO2 laser with PRP achieved superior repigmentation than intradermal (ID) PRP. However, Fr: CO2 alone showed poor improvement. Combined ablative Fr: CO2 laser and PRP therapy followed by sun exposure could be used effectively and safely to treat refractory NSV.

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“…. From these 39 studies, seven studies compared one phototherapy with another or with no phototherapy as an addition to the surgical treatment in vitiligo; these studies were marked as ‘comparative’ . Furthermore, in the other 32 studies, the results of only one phototherapy were presented; these studies were marked as ‘non‐comparative’ .…”

Section: Resultsmentioning

confidence: 99%

The role of phototherapy in the surgical treatment of vitiligo: a systematic review

Lommerts¹,

Uitentuis²,

Bekkenk³

et al. 2018

Acad Dermatol Venereol

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Vitiligo is frequently treated with the combination of phototherapy and melanocyte transplantation. However, the additional benefit of phototherapy is unclear. Moreover, the optimal type and regimen of phototherapy are unknown. The objective of this systematic review was to identify whether phototherapy improves the outcome of melanocyte transplantation in vitiligo. We searched and screened for eligible studies in the databases of MEDLINE, EMBASE and CENTRAL. We included all clinical studies investigating melanocyte transplantation combined with phototherapy. After screening and selection of abstracts and full-texts, we found 39 eligible clinical studies with 1624 patients. The eligible studies investigated several phototherapy modalities, such as NBUVB (n = 9), PUVA (n = 19), UVA (n = 1), MEL (n = 4) and active sunlight exposure (n = 9). Four studies directly compared phototherapy versus no phototherapy and two studies confirmed the benefit of phototherapy for melanocyte transplantation. We found no significant differences in repigmentation in studies directly comparing phototherapy modalities. The overall quality of the studies was moderate to poor and high heterogeneity between studies was found. We found limited evidence that phototherapy improves the outcome of melanocyte transplantation in vitiligo. There is insufficient evidence to recommend a specific type or regimen of phototherapy. More studies should be performed investigating the additional benefit of different phototherapies and the preferred moment of phototherapy.

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Successful Treatment of Segmental Vitiligo in Children with the Combination of 1-mm Minigrafts and Phototherapy

Cited by 13 publications

References 16 publications

Efficacy and safety of traditional and surgical treatment modalities in segmental vitiligo: A review article

Efficacy and safety of traditional and surgical treatment modalities in segmental vitiligo: A review article

Platelet-rich plasma versus combined fractional carbon dioxide laser with platelet-rich plasma in the treatment of vitiligo: a comparative study

The role of phototherapy in the surgical treatment of vitiligo: a systematic review

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