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

Lommerts, Janny E; Uitentuis, Sanne E.; Bekkenk, Marcel W.; Rie, Menno A. de; Wolkerstorfer, Albert

doi:10.1111/jdv.14950

Cited by 14 publications

(17 citation statements)

References 51 publications

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“…50%, 75% or 90% repigmentation). Studies that provided a form of additional treatment (such as NB‐UVB, PUVASOL, excimer laser) were excluded from the pooled analysis since these could influence the outcomes 18 . Tables 2a, b and c show the number of lesions reaching >50%, >75% and >90% repigmentation, respectively, after NCST per DR expansion ratio used.…”

Section: Resultsmentioning

confidence: 99%

Donor to recipient ratios in the surgical treatment of vitiligo and piebaldism: a systematic review

Narayan¹,

Bol²,

Geel

et al. 2021

Acad Dermatol Venereol

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Stabilized vitiligo resistant to conventional therapy (e.g. segmental vitiligo) and piebaldism lesions can be treated with autologous cellular grafting techniques, such as non-cultured cell suspension transplantation (NCST) and cultured melanocyte transplantation (CMT). These methods are preferred when treating larger surface areas due to the small amount of donor skin needed. However, the donor to recipient expansion ratios and outcomes reported in studies with cellular grafting vary widely, and to date, no overview or guideline exists on the optimal ratio. The aim of our study was to obtain an overview of the various expansion ratios used in cellular grafting and to identify whether expansion ratios affect repigmentation and colour match. We performed a systematic literature search in MEDLINE and EMBASE to review clinical studies that reported the expansion ratio and repigmentation after cellular grafting. We included 31 eligible clinical studies with 1591 patients in total. Our study provides an overview of various expansion ratios used in cellular grafting for vitiligo and piebaldism, which varied from 1:1 up to 1:100. We found expansion ratios between 1:1 and 1:10 for studies investigating NCST and from 1:20 to 1:100 in studies evaluating CMT. Pooled analyses of studies with the same expansion ratio and repigmentation thresholds showed that when using the lowest (1:3) expansion ratio, the proportion of lesions achieving >50% or >75% repigmentation after NCST was significantly better than when using the highest (1:10) expansion ratio (v 2 P = 0.000 and v 2 P = 0.006, respectively). Less than half of our included studies stated the colour match between different expansion ratios, and results were variable. In conclusion, the results of our study indicate that higher expansion ratios lead to lower repigmentation percentages after NCST treatment. This should be taken into consideration while determining which expansion ratio to use for treating a patient.

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Section: Resultsmentioning

confidence: 99%

Donor to recipient ratios in the surgical treatment of vitiligo and piebaldism: a systematic review

Narayan¹,

Bol²,

Geel

et al. 2021

Acad Dermatol Venereol

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“…Phototherapy has been the principal treatment for vitiligo for decades and includes psoralen and ultraviolet A (PUVA) and NBUVB phototherapy. 6,16 Although PUVA is an effective therapy, it has several limitations, including phototoxic effects, nausea and a potential risk of skin cancer. On the contrary, NBUVB phototherapy has gradually taken the place of PUVA phototherapy due to the lack of a photosensitizer, lower cumulative dose and fewer adverse effects, and is now considered the standard therapy for generalized vitiligo.…”

Section: Discussionmentioning

confidence: 99%

“…Although PUVA is an effective therapy, it has several limitations, including phototoxic effects, nausea and a potential risk of skin cancer. On the contrary, NBUVB phototherapy has gradually taken the place of PUVA phototherapy due to the lack of a photosensitizer, lower cumulative dose and fewer adverse effects, and is now considered the standard therapy for generalized vitiligo 6,16 . NBUVB phototherapy was reported to be highly effective in restoring pigmentation in patients affected by vitiligo, showing no side‐effects, 17 and a recent meta‐analysis confirmed that a long duration of phototherapy should be encouraged to enhance the treatment response in vitiligo, mainly for the face and neck where a greater response is commonly observed 16…”

Section: Discussionmentioning

confidence: 99%

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

Menchini¹,

Astarita

2020

The Journal of Dermatology

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Vitiligo is an autoimmune skin disorder characterized by depigmented patches of the skin associated with, among several factors, dysregulation and death of melanocytes. Currently, the treatment of vitiligo is based both on the arrest of the progression of active disease and on the stimulation of the skin repigmentation. The aim of this study was to assess the effects of autologous micrografts and narrowband ultraviolet B (NBUVB) phototherapy for skin repigmentation of patients with bilateral stable vitiligo. Autologous micrografts are derived from mechanical disaggregation of small pieces of the patient's own skin, while phototherapy is a strategy treatment already used. Twenty patients with stable bilateral vitiligo were treated, showing a mean percentage rate of 59.1% at baseline. Combined treatment by autologous micrografts and NBUVB was performed only on the lesions of the hands, and the clinical follow up was performed after 3 and 6 months by photographs taken under Wood's light. After 6 months, we classed 100% of patients as responders. We also reported a mean of repigmentation rate of 36.7% after 3 months and 64.6% after 6 months of treatment. In particular, six of the 20 patients reached a marked repigmentation rate (75-100%), four moderate (51-75%) and 10 mild (26-50%). No adverse effects were observed and no drugs were administrated as co-adjuvant therapy. These results are suggestive of a potential wide use of autologous micrografts associated with NBUVB phototherapy for the treatment of stable vitiligo.

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“…Other unwanted UV effects include sunburn, immunosuppression, eye damage and skin ageing [2]. On the other hand, there are many known positive effects and uses of UV light, including its therapeutic effects (e.g., in treating infants suffering from jaundice [3]; in treating skin, sleep, mood and seasonal affective disorders [4]; in treating vitamin D deficiency [5]; wound healing [6]) and further applications in medicine, such as its use in air ventilation systems in hospitals, in air/water purification, in disinfection in surgery, and much more [7,8].…”

Section: Introductionmentioning

confidence: 99%

Compact UV LED Lamp with Low Heat Emissions for Biological Research Applications

et al. 2019

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Much biomedical research focuses on the effects of UV light on human cells. UV light sources are a prerequisite for such research. This paper presents the design and achieved performance of a UVA (Ultraviolet A: 320–400 nm) and a UVB (Ultraviolet B: 290–320 nm) LED-based lamp suitable for use in bioassays, as well as inside an incubator. Numerical simulations were used to optimise the number, layout and output power of LEDs to achieve good irradiance homogeneity while maintaining low costs. Design was optimised for the efficient transfer of generated heat away from the irradiated samples through the heatsink at the back of the lamps. The average irradiance of the target surface by the UVA lamp was 70.1 W/m2 with a maximum deviation of 4.9%, and the average irradiance by the UVB lamp was 3.1 W/m2 with a maximum deviation of 4.8%. With the UVA and UVB lamps, the temperature of samples undergoing irradiation in the incubator rises from 37 to 42 °C within 40 and 67 min, respectively. This by far exceeds the required UV irradiation time in most cases. Tests on Jurkat and HEK-293 cell cultures confirmed the suitability of our lamps for biomedical research.

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

Cited by 14 publications

References 51 publications

Donor to recipient ratios in the surgical treatment of vitiligo and piebaldism: a systematic review

Donor to recipient ratios in the surgical treatment of vitiligo and piebaldism: a systematic review

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

Compact UV LED Lamp with Low Heat Emissions for Biological Research Applications

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