An update on new and emerging options for the treatment of vitiligo

Vitiligo is an acquired leukoderma that results from the loss of epidermal melanocytes, and is characterized by macules and patches of depigmented skin. With a relatively high rate of prevalence, vitiligo occurs in localized, generalized, or segmental patterns; it can run a rapidly progressive course or remain stationary. The pathogenesis of vitiligo is not yet fully understood, but the autoimmune hypothesis is the most commonly accepted one, based on which, many treatment modalities have been described. Although many therapeutic options exist and new modalities are still emerging, treatment challenges persist, as not all patients respond to available therapies. Variables that affect the choice of treatment include the extent, distribution, and progression rate of the lesions. Another challenge is the lack of a standardized scoring system, which hampers the production of level 1a evidence studies for the treatment of this condition.     

Therapeutic options and hot topics in vitiligo with special focus on pediatrics' vitiligo: A comprehensive review study

Vitiligo is a common skin disorder with an estimated worldwide prevalence to 2.28% which is connected with selective melanocytes loss which leads to depigmentation and chalky‐white macules. Vitiligo may be dismissed as a cosmetic problem and may have psychologic impacts on patients. It is occurring in both children and adults and is considered as the most common depigmenting skin disorder in the world. There are still many unknown topics about this disease regarding to its treatment in pediatrics, curable drugs and manifestations. Therefore, we decided to evaluate the recent studies about its therapeutic strategies in pediatrics. Topical therapies should be considered as first line treatment in children, but phototherapy especially NBUVB may be used after topical treatment modalities failure or in extensive or rapidly progressive disease. Our suggestion for the treatment of this disease in children is to use combine treatment modalities with observing safety according to the patient's age.     

Contact vitiligo: etiology and treatment

Fifty patients of contact vitiligo were studied. Etiological agents of contact vitiligo were identified by clinical history, distribution of lesions and patch testing with suspected material. All patients were advised to avoid the suspected agent and treated with PUVASOL and topical steroid. Out of 50 patients (Male 8%, Female 92% age 14-60 years)., etiological agent of contact vitiligo was found to be sticking bindi alone in 24 (48%), while bindi along with other etiological agents were found to be purse, foot wear, plastic watch strap, lipstick and tooth paste in 14 (28%) cases. 14 (28%) patients also had disseminated lesions of vitiligo along with contact vitiligo. Positive reaction with patch testing was observed in 18 (36%) while depigmentation was seen in 4 (8%) cases. We observed that response of treatment was better in patients with shorter duration of disease while poor response was seen in patients with longer duration of disease.     

前列腺素治疗白癜风的研究进展

白癜风是一种常见的色素脱失性疾病,易诊而难治.前列腺素是在紫外线照射下,角质形成细胞产生的脂类旁分泌因子,参与皮肤的免疫调节、细胞生长、分化、凋亡等生理过程.其中前列腺素E2、F2α均可不同程度地作用于黑素细胞,促进黑素细胞树突合成、黑素产生;前列腺素E2还能促进黑素细胞增殖.多项动物和临床试验已证明,局部外用前列腺素E2和前列腺素F2α治疗白癜风安全有效,因而有望成为新的治疗白癜风的药物之一.     

遮盖疗法及其在白癜风治疗中的应用

遮盖疗法是用各种防水、不透明、能提供有效而自然掩盖作用的产品来遮盖皮肤瑕疵.白癜风遮盖剂起效快,能显著提高患者的生活质量.常见遮盖剂可分为物理性遮盖剂和化学性遮盖剂两类,物理性遮盖剂主要为各种含色素颗粒的成分均匀覆盖于白斑上起到掩盖作用,化学性遮盖剂有二羟基丙酮、植物提取液等,主要通过与表皮发生化学反应起效.制剂工业的发展使得白癜风遮盖剂能防水耐磨.     

遮盖疗法及其在白癜风治疗中的应用

遮盖疗法是用各种防水、不透明、能提供有效而自然掩盖作用的产品来遮盖皮肤瑕疵.白癜风遮盖剂起效快,能显著提高患者的生活质量.常见遮盖剂可分为物理性遮盖剂和化学性遮盖剂两类,物理性遮盖剂主要为各种含色素颗粒的成分均匀覆盖于白斑上起到掩盖作用,化学性遮盖剂有二羟基丙酮、植物提取液等,主要通过与表皮发生化学反应起效.制剂工业的发展使得白癜风遮盖剂能防水耐磨.     

遮盖疗法及其在白癜风治疗中的应用

遮盖疗法是用各种防水、不透明、能提供有效而自然掩盖作用的产品来遮盖皮肤瑕疵.白癜风遮盖剂起效快,能显著提高患者的生活质量.常见遮盖剂可分为物理性遮盖剂和化学性遮盖剂两类,物理性遮盖剂主要为各种含色素颗粒的成分均匀覆盖于白斑上起到掩盖作用,化学性遮盖剂有二羟基丙酮、植物提取液等,主要通过与表皮发生化学反应起效.制剂工业的发展使得白癜风遮盖剂能防水耐磨.     

Necrotizing fasciitis: pathophysiology and treatment

Necrotizing fasciitis (NF) is a life-threatening bacterial infection causing necrosis of the fascia, underlying skin, and vasculature. NF spreads rapidly, making immediate diagnosis important for survival. Treatment may involve the administration of several broad-spectrum antibiotics, surgical debridement, and skin grafting. In the following two articles, the pathophysiology, medical management, and nursing care of patients are discussed. An in-depth model care plan illustrates the complexity of the disease and its treatment.     

Topical pimecrolimus in the treatment of vitiligo

Although the treatment of vitiligo has improved during the last decade, therapy is still not satisfactory for many patients. Recently topical calcineurin inhibitors were introduced in the treatment of atopic dermatitis. Considering the autoimmune hypothesis of vitiligo pathogenesis, the use of these topical calcineurin inhibitors seems reasonable. Most clinical vitiligo trials have been performed with tacrolimus and show beneficial effects. Concerning the value of pimecrolimus in the treatment of vitiligo only few data are available. Therefore we performed an open pilot study in 26 patients to evaluate the efficacy and safety of 1% pimecrolimus in the treatment of vitiliginous lesions in the head and neck region. In 13 of 26 (50%) evaluated target lesions, repigmentation was noted after a 6 month treatment period with a median percentage of repigmentation of 72.9% (interquartile range: 30.5-98.3%). Duration of vitiligo and total affected body surface area tended to be inversely correlated with the success rate of treatment. Side effects were mainly limited to a burning sensation at the application site. Despite the promising results of topical immunomodulators in the treatment of vitiligo, prudence is in order, as long-term follow up studies are still lacking.     

alpha-Tocopherol in the combined treatment of vitiligo

Photochemotherapy was combined with alpha-tocopherol in the treatment of 56 patients with vitiligo in order to shorten the treatment. alpha-tocopherol was used as antioxidant to reduce skin erythema and build up single UV doses. Due to 1.5-2-fold increase of UV exposure follicular mechanisms stimulation was enhanced in vitiligo foci, perifollicular pigmentation was achieved approximately 2 times sooner, and the length of treatment necessary to achieve manifest repigmentation (i.e. more than 50% of the maculae surface) was reduced twofold.     

钙调神经磷酸酶抑制剂治疗白癜风的进展

白癜风是一种以黑素细胞破坏为特征的获得性色素脱失性疾病,目前许多学者认为其发病机制主要与免疫异常有关.局部外用钙调神经磷酸酶抑制剂治疗白癜风有较好的疗效.单用钙调神经磷酸酶抑制剂治疗白癜风的疗效与用药方法、用药部位、疾病的病程、分期有关,也与疗程有关系.联合窄谱中波紫外线、308准分子激光及其他方法可以提高其有效率.钙调神经磷酸酶抑制剂治疗白癜风安全有效,长期使用的安全性和稳定性还需要进一步评估.

Abstract：

Vitiligo is an acquired hypopigmented disease characterized by the destruction of melanocytes.Many scholars consider that the pathogenesis of vitiligo is mainly associated with immune abnormalities.Topical calcineurin inhibitors have favorable efficacy in the treatment of vitiligo,and the efficacy is associated with the treatment regimen,course,application sites,duration and stage of vitiligo,etc.The combination with narrow-band ultraviolet B,308-nm excimer laser or other therapies may have synergistic effect on the efficiency of calcineurin inhibitors.Although calcineurin inhibitors are safe and effective in the treatment of vitiligo,further studies are needed to evaluate their long-term safety and stability.     

胎盘制剂治疗白癜风的研究进展

白癜风是最常见的色素减退性皮肤病,临床治疗困难.胎盘制剂含有相对分子质量大于3000的蛋白,肽类和鞘脂,可以通过p38丝裂原活化蛋白激酶通路促进黑素合成.胎盘制剂也可以促进成黑素细胞增殖和分化,其治疗白癜风具有安全、有效、不良反应少的特点,尤其是治疗儿童头皮部白癜风的理想药物.     

白癜风治疗指南文献分析

白癜风是一种常见的色素脱失性疾病,以皮肤或黏膜色素减退为特征,易诊而难治.近年来,国内外对其治疗方案很多,其目的主要是控制白斑的进展,使白斑复色直至正常的皮肤.目前英国、美国、荷兰、沙特阿拉伯、希腊、中国等国家已有针对白癜风的治疗指南.但是白癜风治疗方案的选择受不同文化背景和疾病临床特征的影响.概述国内外有关白癜风的治疗指南及不同国家的治疗指南做一简要比较,为白癜风患者的治疗提供参考方案.     

Acne scarring: current treatment options

Acne vulgaris is one of the most common skin disorders treated in dermatology. Subsequent scarring that may result from acne can lead to devastating consequences. There are currently a wide variety of treatment modalities available for acne scarring. The most widely used options are reviewed.