Treatment of vitiligo

Abstract

Vitiligo, particularly in darker skinned individuals, is a psychosocial disaster. With patient education, proper therapeutic selection and persistence, favorable repigmentation can be achieved in the majority of individuals with vitiligo. Attention to the activity state of the disease, the type, location and extent of the vitiligo must be carefully balanced against the patient's expectations, time commitment and assumption of risks. In this review, Dr Taneja succinctly summarizes the wide range of therapeutic options available today for the vitiligo patient.

Topical Tacrolimus and the 308-nm Excimer Laser

“…1,2 The first line of nonsurgical therapy includes topical corticosteroid therapy and phototherapy (solar exposition, psoralen-UV-A therapy, and narrowband UV-B [NB-UV-B] therapy). [3][4][5] However, to our knowledge, no treatment provides truly satisfactory results.…”

Double-blind Placebo-Controlled Study of Autologous Transplanted Epidermal Cell Suspensions for Repigmenting Vitiligo

“…At 3 observed time points (3,6, and 12 months) there was a significant difference in repigmentation (PϽ.001, P=.002, and P=.002, respectively) between actively treated lesions and placebo-treated lesions (Figures 2, 3, 4, 5, 6, and 7). At 3,6, and 12 months the the median percentages of the repigmented areas at the actively treated site in group 1 were 84%, 88%, and 93%, respectively (means, 60%, 62%, and 71%), and repigmentation in 70% or more of the treated aeras occurred in 55%, 57%, and 77% of actively treated lesions at the same time points.…”

“…Although there are reports of some repigmentation with these treatments, the results have often been unsatisfying. 2,3 UV therapy lasts at least several months and causes physical discomfort, and the cumulative radiation dose limits its total use. Transplantation of autologous melanocytes is an additional option in patients with a stable vitiligo that no longer responds to conventional therapy.…”

Suction Blister Grafting- Still a Useful Modality for Treatment of Resistant and Stable Vitiligo

“…The cause of melanocyte destruction has remained unclear, (15) but several theories have tried to explain the pathogenesis of vitiligo such as autoimmunity, (16) self-destructing mechanisms, (17) neurals, (18) biochemical, (19) an imbalance of epidermal cytokines (20) and genetic factors. (21) Vitiligo is not a life-threatening disease; however, it frequently induces emotional distress.…”