祛白酊治疗白癜风的临床研究

为观察祛白酊治疗白癜风的临床疗效和安全性,治疗组用祛白酊外涂,对照组用白癜风溶液外涂,并采用统一的疗效评定标准进行疗效评价。治疗组有效率为56.98%,明显优于对照组的33.96%(χ2=6.9564,P<0.01),同时祛白酊治疗白癜风局限型疗效明显优于治疗散发型(χ2=4.8795,P<0.05),且不良反应发生率低而轻。祛白酊治疗稳定期白癜风安全、有效,尤其适用于局限型白癜风的治疗。     

祛白酊治疗寻常型白癜风89例疗效观察

目的观察祛白酊治疗寻常型白癜风的临床疗效。方法治疗组用祛白酊外涂,对照组用卤米松三氯生乳膏外涂,4个月后进行疗效评价。结果治疗组有效率为57.30%,明显优于对照组的33.93%(P<0.01),同时祛白酊治疗局限性疗效明显优于散发性(P<0.05)。结论祛白酊治疗稳定期寻常型白癜风有效,尤其适用于局限性。     

转录因子T-bet/GATA3与白癜风相关性研究

目的分析白癜风患者Th1、Th2两类细胞因子和转录因子T-bet与GATA3的相关性,探讨祛白丸对本病的治疗作用.方法32例活动期白癜风患者用祛白丸治疗前后用ELISA和RT-PCR技术分别检测血清γ干扰素(IFN-γ)、白介素4(IL-4)水平和外周血单个核细胞转录因子T-bet与GATA3的表达状况,并以10例正常人为对照.结果活动期血清IFN-γ水平较正常人降低,IL-4水平升高;T-bet下降,GATA3升高.治疗后皮疹静止或消退,血清IFN-y、IL-4、T-bet和GATA3水平与正常人相同.结论活动期白癜风患者Th1/Th2失衡,分别与T-bet表达下降,GATA3表达升高相关;祛白丸可以降低Th2类细胞因子和GATA3的表达,提高Th1类细胞因子和T-bet的表达和治疗白癜风的作用.     

自制祛白酊对白癜风动物模型的实验研究

目的 :考察祛白酊对白癜风动物模型的药物疗效。方法 :用化学脱色法制备白癜风动物模型 ,用祛白酊对白癜风动物模型进行治疗 ,并与新适确得进行比较实验。结果 :祛白酊对白癜风动物模型有良好的治疗作用 ,对白癜风动物模型皮肤黑色素的影响和对胆碱脂酶的影响与模型组比较有极显著差异 (P <0 0 1) ,与新适确得组比较有显著性差异 (P <0 0 5 )。结论 :实验研究证实了祛白酊对白癜风的治疗作用 ,为临床应用提供了理论依据。     

白癜风丸加祛白药水治疗白癜风疗效观察

白癜风由于病因不明，临床上治疗较为困难。笔者采用自行研制的白癜风丸口服加祛白药水外用治疗白癜风，获得较好疗效，现将结果报告如下。     

自配祛白酊治疗白癜风34例报告

自配祛白酊治疗白癜风３４例报告雷鹏程，翟云霞北京医科大学第三临床医学院皮肤科（邮政编码１０００８３）药物配制菟丝子、补骨脂、白芷、独活各１００ｇ，红花５０ｇ，研磨后，以７０％乙醇浸泡７天，过滤为１０００ｍｌ酊剂，分装备用。病例均为门诊病人，共３４例。...     

芪归祛白胶囊治疗小鼠白癜风的实验研究

目的:确定芪归祛白胶囊治疗白癜风的药效学机制。方法:组织病理学观察黑素的变化;应用蘑菇酪氨酸酶多巴速率氧化法体外测定酪氨酸酶活性;通过碳粒廓清功能的变化明确其对单核巨噬细胞吞噬功能的影响。结果:白癜风动物模型经芪归祛白胶囊治疗后皮肤棘层及表皮基底细胞黑素分布及有黑素毛囊数均明显增加;酪氨酸酶活性明显增高;单核巨噬细胞对血清中异物的吞噬功能明显降低。结论:芪归祛白胶囊对白癜风小鼠模型有治疗作用。     

白癜风丸配合白癜净治疗白癜风74例疗效观察

近年来我科应用白癜风丸配合白癜净治疗白癜风，取得良好效果，现报道如下。     

激光治疗局限型白癜风28例疗效观察

病例选择：非瘢痕体质者;稳定期的局限型白癜风经其它治疗无效者;病灶部位皮肤平整,主要分布于面颈、四肢、躯干。单个皮损面积,最小２４ｃｍ２,最大１４８ｃｍ２。治疗方法：（１）白斑部位常规消毒,２％利多卡因皮内浸润麻醉;（２）ＣＯ２激光气化掉白斑表皮...     

适确得软膏治疗面部局限型白癜风30例的疗效观察

适确得软膏治疗面部局限型白癜风３０例的疗效观察北京医院皮肤科仝建坤金祖余谢志宏用０．５％适确得软膏每日１次、连续１～４个月治疗面部局限型白癜风３０例。结果：痊愈１７例（５６．７％），显效５例（１６．７％），有效４例（１３．３％），总有效率为８６．７％...     

308nm准分子激光治疗儿童白癜风疗效观察

目的评价308nm准分子激光治疗儿童白癜风的疗效及安全性。方法采用自身对照的方法,用Xt-rac颠峰准分子激光系统治疗85例稳定期儿童白癜风患者(年龄≤12岁)的自身对称或相邻皮损,每周治疗1～3次,共30次,每隔10天及治疗结束3天后评价疗效。结果治疗的皮损痊愈12例,显效45例,好转21例,无效7例,显效率为67.1%,有效率为91.8%;未治疗的皮损仍为色素脱失斑。面颈部疗效优于躯干四肢,躯干四肢优于肢端,面颈部非节段型优于节段型。结论308nm准分子激光治疗稳定期儿童白癜风疗效高、副作用少,其疗效与皮损部位有关。     

A survey of vitiligo management among dermatologists in Saudi Arabia

Background  There are concerns that there is no uniform approach towards the management of vitiligo.
Objectives  To explore attitudes and strategies for the management of vitiligo among dermatologists.
Methods  A self-administered questionnaire containing 22 questions was distributed to 160 dermatologists attending a national dermatology conference in 2007.
Results  One hundred and twelve dermatologists responded to the questionnaire (70% response rate). We had 105 completed questionnaires (seven were excluded due to incompleteness). Active treatment of vitiligo was recommended by 96% in more than half of patients, while 79% recommended treatment at non-visible sites. Repigmentation was regarded as main treatment goal by 54%. Mid-potent topical steroids were widely prescribed for focal vitiligo (72% in children and 65% in adults). Use of tacrolimus and pimecrolimus was limited. The most common used phototherapy was 'narrowband ultraviolet B' (NBUVB; 36% and 40% for generaliased vitiligo in children and adults, respectively). The use of oral psoralen plus UVA (PUVA) was limited (8% for generalized vitiligo in adults). Few respondents (1–8% for different types of vitiligo) prescribed outdoor topical PUVA. Vitiligo surgery was advised mainly for segmental type (18% in adults and 5% in children). Depigmentation was the first option for universal vitiligo by 50% and 30% in adults and children, respectively.
Conclusions  Most dermatologists are enthusiastic about active treatment of vitiligo even in hidden sites. Overall, the most two common treatment modalities were topical steroids and NBUVB. Vitiligo surgery is underutilized. Development of national practice guidelines is needed.     

分段毛囊移植治疗毛发部位白癜风

【摘要】 目的 探讨分段毛囊移植治疗特殊部位白癜风的疗效。方法 2016年12月至2018年12月在杭州市第三人民医院皮肤科纳入10例19 ~ 28岁稳定期白癜风患者（男4例，女6例），共26处白斑合并白发，其中18处为头皮，8处为眉部。采用毛囊单位提取法从枕部或耳后区域获取毛囊，并均分为上下两部分。患者每处白斑合并白发皮损分为2部分，上下两部分毛囊分别移植于白斑的不同区域。术后每4周随访1次，观察复色及毛发生长情况。结果 12周时，移植毛囊上部26处白斑中痊愈3处，显效5处，好转12处，无效6处，有效率30.8%（8/26），且均未见毛发生长；移植毛囊下部的26处皮损中痊愈5例，显效7例，好转11例，无效3例，有效率46.2%（12/26），8处皮损出现毛发生长。移植毛囊上部组与移植毛囊下部组有效率差异无统计学意义（χ2 = 1.30，P = 0.25）。结论 分段毛囊移植术适用于头皮和眉部白癜风合并白发的治疗。     

细胞自体体外再生技术治疗稳定期白癜风患者15例疗效观察

目的: 评价细胞自体体外再生(ReCell?)技术治疗稳定期白癜风的临床疗效。方法: 利用ReCell?技术治疗稳定期白癜风患者,观察患者的复色程度。结果: 共15例患者接收治疗,男8例,女7例;年龄8 -46岁,平均23.3岁。随访9个月,有13例患者皮损色素恢复为显效,有效率为86.67%。所有患者手术区域术后随访未出现感染与疤痕形成。结论: ReCell?技术对稳定期白癜风患者有较好的疗效。     

Topical tacrolimus for treatment of childhood vitiligo in Asians

Childhood vitiligo is a common disorder of pigmentation in India. Considering the lack of uniformly effective and safe treatment modalities for children with vitiligo, search for newer therapeutic agents continues. This study was designed to evaluate the role of topical tacrolimus in the treatment of childhood vitiligo. Twenty-five children with vitiligo were treated with topical 0.03% tacrolimus ointment applied twice daily for 12 weeks. Response was noted as marked to complete (> 75% repigmentation), moderate (50-75% repigmentation) and mild (< 50% repigmentation). Twenty-two children (9 boys and 13 girls) of mean age 7.2 +/- 1.4 years completed the study. Twelve (54.5%) children had vitiligo vulgaris, nine (40.9%) had focal vitiligo and one (4.5%) had segmental vitiligo. The mean duration of disease was 8 +/- 3 months. Nineteen (86.4%) children showed some repigmentation at the end of 3 months and other three had no response. Of these 19 children, repigmentation was marked to complete in 11 (57.9%), moderate in five (26.3%) and mild in three (15.7%) children. Side effects were minimal, such as the pruritus and burning noted in only three patients. Topical tacrolimus is an effective and well-tolerated treatment modality in Asian children with vitiligo.     

Effectiveness of 0.1% topical tacrolimus in adult and children patients with vitiligo

Topical corticosteroids and phototherapy are the conventional treatments of vitiligo. However, the acrofacial and segmental types are often unresponsive to these treatments. Nowadays, a few studies have been conducted on efficacy of topical tacrolimus in treatment of vitiligo including vulgaris and segmental types. Nevertheless, the acrofacial type has never been investigated with this topical therapy. The aim of our study is to evaluate the effectiveness of 0.1% tacrolimus ointment in patients including all types of vitiligo. Forty-two patients with vitiligo (22 adults, 20 children) were enrolled in this study. They were treated with 0.1% tacrolimus ointment twice daily for 6 months. Of these 42 patients, 38 of them completed the treatment process. The mean age of the patients was 27.8 years. The response rate was 76.09%. The vulgaris and focalis had a maximum response rate of 94.12%. The response rates for segmentalis and acrofacialis were 76.92% and 56.25% respectively. Concerning the response, age groups, types and location of vitiligo, there was significant difference in all variables (P = 0.001, P = 0.001, P = 0.025, respectively). Children had approximately nine times higher odds (95% CI = 1.09, 81.88) of having better response to the treatment than adults. The disease duration of 5 years or less also showed a better response. In conclusion, topical tacrolimus can be used for the treatment of patients with vitiligo. We recommend that, other than in the vulgaris type, topical tacrolimus may be considered as a treatment for two difficult to treat types of vitiligo, acrofacialis and segmentalis, before considering other modalities.     

Evaluation of the effects of NB-UVB in both segmental and non-segmental vitiligo affecting different body sites

BACKGROUND: Narrow band (NB)-UVB has been used in the treatment of vitiligo for years but statistical evaluation of the clinical response in both segmental and non-segmental vitiligo patients has yet to be assessed. OBJECTIVES: Statistical evaluation of the clinical response of vitiligo patients to NB-UVB in both segmental and non-segmental types affecting different body sites. METHODS: This study included 150 patients with vitiligo either segmental (10%) or non-segmental (90%). NB-UVB therapy was given twice weekly till reaching our end point of 100% re-pigmentation or a cut point in unresponsive cases. Evaluation of the percentage of re-pigmentation was performed by total body photography and planimetry every 8 weeks. RESULTS: The overall response to therapy in the non-segmental vitiligo group demonstrated that 48% of the patients showed marked response, 27% showed moderate response and 25% showed mild response after UVB therapy. The patients showed marked response in 76.3% in face lesions, 41.9% in trunk lesions and 37.6% in limbs lesions. None of the patients in the acral areas achieved marked response. The mean duration of therapy was 7.8 months. Moreover, the results demonstrated that the earlier the patient was treated, the better the response was especially for lesions on the face, trunk and limbs. On the other hand, in the segmental vitiligo group, patients showed no more than mild response to NB-UVB whatever the site of the lesion was. No side effects were encountered with NB-UVB therapy except for aggravation of the disease in two cases and erythema in one patient who was an outdoor worker and was skin type II. CONCLUSION: The type of vitiligo, the affected anatomical area and the disease duration are important factors that influence potential re-pigmentation.     

Correlation between vitiligo occurrence and clinical benefit in advanced melanoma patients treated with nivolumab: A multi‐institutional retrospective study

Vitiligo is occasionally seen in melanoma patients. Although several studies indicate a correlation between vitiligo occurrence and clinical response in melanoma patients receiving immunotherapy, most studies have included heterogeneous patient and treatment settings. The aim of this study is to investigate the correlation between the occurrence of vitiligo and clinical benefit of nivolumab treatment in advanced melanoma patients. We retrospectively reviewed unresectable stage III or IV melanoma patients treated with nivolumab. Of 35 melanoma patients treated with nivolumab, 25.7% (9/35) developed vitiligo during treatment. The time from the start of nivolumab treatment to occurrence of vitiligo ranged 2–9 months (mean, 5.2). Of nine patients who developed vitiligo, two (22.2%) had a complete response to nivolumab and two (22.2%) had a partial response. The objective response rate was significantly higher in patients with vitiligo than in patients without vitiligo (4/9 [44.4%] vs 2/26 [7.7%]; P = 0.027). The mean time to vitiligo occurrence in patients achieving an objective response was significantly less than that in patients who showed no response (3.1 vs 6.8 months, P = 0.004). Vitiligo occurrence was significantly associated with prolonged progression‐free and overall survival (hazard ratio, 0.24 and 0.16; 95% confidence interval, 0.11–0.55 and 0.03–0.79; P = 0.005, and 0.047, respectively). At the 20‐week landmark analysis, however, vitiligo was not associated with a statistically significant overall survival benefit (P = 0.28). The occurrence of vitiligo during nivolumab treatment may be correlated with favorable clinical outcome.     

Chemical leucoderma: a clinico-aetiological study of 864 cases in the perspective of a developing country

Background  Chemical leucoderma, often clinically mimicking idiopathic vitiligo and other congenital and acquired hypopigmentation, has been increasing rapidly in incidence in developing countries such as India.
Objectives  This study attempts to detect clinical and epidemiological patterns of chemical leucoderma.
Methods  Detailed history-taking, especially of exposure to contributory chemicals, clinical examination, relevant investigations, data recording and analysis were done.
Results  In a total of 864 cases of chemical leucoderma, 65·6% cases started de novo and vitiligo patches were pre-existing in the remaining cases. Patches were limited to the contact area in 73·7% but had spread to remote areas in 26·3% cases. The face (41·1%) and scalp (5·9%) were the commonest and least involved sites. Confetti macules were seen in 89% and pruritus was complained of in 21·8%. Aetiological agents identified were hair dye 27·4% (21% self-use; 6·4% not self-use), deodorant and spray perfume 21·6%, detergent and cleansers 15·4%, adhesive bindi 12%, rubber chappal 9·4%, black socks and shoes 9·1%, eyeliner 8·2%, lipliner 4·8%, rubber condoms 3·5%, lipstick 3·3%, fur toys 3·1%, toothpaste 1·9%, insecticides 1·7%, 'alta' 1·2%, amulet string colour 0·9%. Therapeutic response was much better in 'pure' chemical leucoderma (73·4%) than in those with co-existing vitiligo (20·9%).
Conclusions  Chemical leucoderma, a disease of mostly industrial origin in developed countries, may be induced by common domestic products in developing countries. Diagnosis and differentiation from other causes of hypopigmentation can be done confidently by following the clinical criteria as proposed. The therapeutic response of chemical leucoderma is better than that of vitiligo.     

Narrow-band UVB treatment of vitiligo in Chinese

Narrow-band ultraviolet B (NBUVB) phototherapy has recently been reported to be an effective and safe treatment modality for vitiligo. In the present report, we evaluated the efficacy and safety of NBUVB therapy for vitiligo in Chinese patients. Seventy-two vitiligo patients treated from 2000 to 2003, were included retrospectively (male: female=33:39, mean age: 38.5). Among them, 61 were non-segmental type and 11 the segmental type. Treatments were given two to three times a week for a maximum period of one year with an initial dose of 0.2 J/cm2 and a 0-20% increment each session (mean accumulation dose: 155.3 J/cm2). Computer image analysis by Supervise classification was used to estimate the area of vitiligo involvement before and after treatment. An excellent response (75-100% area of repigmentation) was obtained in 9 patients (12.5%) and a good response (50-75%) in 24 (33.3%), a moderate response (25-50%) in 20 (27.8%), and a poor response (0-25%) in 19 (26.4%). In summary, 45.8% of our patients had more than 50% repigmentation. Burns were a side effect in 5 patients (7%) and transient erythema with itching or xerosis was noted in 5 patients (7%). These results indicate that NBUVB phototherapy is an effective and safe treatment choice for generalized vitiligo.