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Vitiligo Lesions (vitiligo + lesion)
Selected AbstractsKeratoacanthoma in vitiligo lesion after UVB narrowband phototherapyPHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 4 2006V. Brazzelli The treatment of vitiligo is still a challenge. Among various therapeutic modalities, phototherapy with UVB narrowband (UVB-NB) is presently considered a treatment of choice for this skin disease. The exact skin cancer risk deriving from UVB-NB is a serious concern to be determined. We report a case of keratoacanthoma developed in the vitiligo area during a prolonged course of UVB-NB therapy. [source] Surgical Approaches for Stable VitiligoDERMATOLOGIC SURGERY, Issue 10 2005Rafael Falabella MD Background. Vitiligo therapy is difficult. Depending on its clinical presentation, unilateral or bilateral vitiligo lesions respond well with different repigmentation rates, according to age, affected anatomic area, extension of lesions, time at onset, timing of depigmentation spread, and other associated factors. When stable and refractory to medical treatment, vitiligo lesions may be treated by implanting pigment cells on depigmented areas. Objective. To describe the main events of depigmentation and the fundamentals of surgical techniques for repigmenting vitiligo by implanting noncultured cellular or tissue grafts, in vitro cultured epidermis-bearing pigment cells, or melanocyte suspensions. Methods. A description of the available techniques for repigmentation of vitiligo is done, emphasizing the most important details of each procedure to obtain the best repigmentation and minimize side effects. Results. With most of these techniques, adequate repigmentation is obtained, although there are limitations when applying some methods to clinical practice. Conclusions. Restoration of pigmentation may be accomplished with all available surgical procedures in most anatomic locations, but they are of little value for acral areas. Unilateral vitiligo responds well in a high proportion of patients, and bilateral disease may also respond when stable. Appropriate patient selection is important to achieve the best results. [source] The efficacy of excimer laser (308 nm) for vitiligo at different body sitesJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2006A Hofer Abstract Background, The treatment with XeCl-excimer laser generated 308-nm UVB radiation has shown promising results in patients with vitiligo. Objective, In this controlled, prospective trial we studied the primary efficacy (start and grade of repigmentation) and patient's satisfaction of XeCl-excimer laser for treatment of vitiligo patches at different body sites and re-evaluated the achieved repigmentation 12 months after the end of therapy. Methods, Twenty-five patients with generalized or localized vitiligo with a total of 85 lesions at different body sites were enrolled in this study. Vitiligo patches were treated with 308-nm XeCl-excimer laser 3 times a week for 6 to 10 weeks. The overall repigmentation grade of each treated lesion was evaluated once a week on a 5 point scale rating from 0 (no repigmentation), 1 (1,5%), 2 (6,25%), 3 (26,50%), 4 (51,75%), to 5 (76,100%). Results, Twenty-four patients completed the study. Within 6 to 10 weeks of treatment 67% of the patients (16/24) developed follicular repigmentation of at least one of their vitiligo lesions. Lesion repigmentation started after a mean of 13 treatments in lesions located on the face, trunk, arm, and/or leg (high-responder location), and after a mean of 22 treatments in lesions located on the elbow, wrist, dorsum of the hand, knee, and/or dorsum of the foot (low-responder location). Untreated control lesions and lesions located on the fingers did not achieve any repigmentation. After 10 weeks of treatment repigmentation of more than 75% was found in 25% (7/28) of lesions of the high-responder location group versus 2% (1/43) of lesions of the low-responder location group. In most cases, laser-induced repigmentation was persistent, as determined 12 months after the end of treatment. Conclusions, 308-nm excimer laser is an effective modality for the treatment of vitiligo. However, similar to other non-surgical treatment modalities, the therapeutic effect is mainly dependent on the location of vitiligo lesions. [source] Broadband targeted UVB phototherapy for localized vitiligo: a retrospective studyPHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 3 2009Ahmet Akar Phototherapy with ultraviolet B (UVB) or PUVA has been used in the treatment of vitiligo for many years. The aim of this study was to analyze retrospectively the efficacy and safety of targeted broadband UVB phototherapy in patients with localized vitiligo. Thirty-two patients (14 male, 18 female), aged 18,65 years, were treated with Daavlin T500x High Dose Targeted Phototherapy System. Patients were treated twice or thrice weekly, totaling 20 to 60 sessions. Out of 32 total patients, only four patients (12.5%) showed visible repigmentation. In two patients, repigmentation was more than 75%. Other two patients showed mild repigmentation (less than 25%). All the lesions responsive to treatment were facial lesions. Mild adverse events recorded in 3 of 32 patients. Although safety of targeted broadband UVB phototherapy in the treatment of localized vitiligo is good, its therapeutic effectiveness is limited and depends on the locations of vitiligo lesions. [source] Photo(chemo) therapy for vitiligoPHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 1 2003Rik Roelandts Vitiligo has always been difficult to treat. Several modes of treatment are available, but the therapeutic effect varies greatly, and rarely does one achieve complete repigmentation. One of the most efficient treatment methods is photo(chemo) therapy. Already in ancient Egypt, vitiligo lesions were treated with extracts of the Ammi maius plant followed by exposure to the sun. This principle is at the basis of the photochemotherapy or PUVA therapy, whereby UVA irradiations are given 2 h after administration of 8-methoxypsoralen, a photosensitizer. Another efficient treatment form is UVB phototherapy, particularly narrow-band UVB. This not only gives good therapeutic results but also has the advantage of eliminating the need for a photosensitizer. All these treatments must be applied for many months to be efficient. They can also be combined with various surgical skin-grafting techniques. A newer approach is targeted UVB phototherapy, whereby xenon-chloride lasers or monochromatic excimer light is used. [source] Efficacy and safety of topical tacrolimus for the treatment of face and neck vitiligoTHE JOURNAL OF DERMATOLOGY, Issue 2 2010Yuan-Hsin LO Abstract Vitiligo is a common acquired idiopathic hypomelanotic disorder characterized by circumscribed depigmented maculae. The conventional treatments are limited by their inconsistent and incomplete responses, relapse rate, inconvenience to apply, side-effects and especially long-term effects. The aim of the present study was to determine the efficacy and safety of topical tacrolimus as monotherapy for the treatment of face/neck vitiligo in Taiwan. This was a multicenter, open-label, non-comparative study. Patients were at least 16 years old and had vitiligo lesions with Vitiligo Index of Disease Activity score +1 or more on face or neck. Patients received a monotherapy with 0.1% of tacrolimus ointment twice daily for 12 weeks. The efficacy was measured by the percentage of repigmentation of target lesion, which was graded as minimal (1,25%), mild (26,50%), moderate (51,75%) or excellent (76,100%). Patients who had at least mild repigmentation were defined as responders. A total of 61 patients were enrolled in this investigation. Most of the patients showed repigmentation at week 4. At the end of treatment, all patients showed repigmentation and 45.9% of patients were responders. During the study, 15 adverse events related to the ointment were reported. All the reported adverse events were mild and similar to the well-known adverse effect of tacrolimus in the treatment of atopic dermatitis. Tacrolimus ointment is effective and well tolerated for the treatment of patients with vitiligo in Taiwan. It will be another drug of choice for persons with vitiligo who are unable to receive regular phototherapy and fear the side-effects of topical steroid in long-term use. [source] Randomized controlled trial comparing the effectiveness of 308-nm excimer laser alone or in combination with topical hydrocortisone 17-butyrate cream in the treatment of vitiligo of the face and neckBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2008F. Sassi Summary Background, Vitiligo is a pigmentary disorder which may have disfiguring consequences. Its treatment remains a challenge. Objectives, We designed a parallel-group randomized controlled trial to compare the effectiveness of 308-nm excimer laser alone or in combination with topical hydrocortisone 17-butyrate cream in patients with vitiligo unresponsive to previous treatment with topical steroids or narrow-band ultraviolet (UV) B phototherapy. Methods, Consecutive patients aged 18,75 years with nonsegmental vitiligo localized on the face and/or neck lacking response to previous conventional treatment were eligible. In total, 84 patients (44 women and 40 men, mean age 44 years) were randomized to 308-nm excimer laser phototherapy twice weekly alone or in combination with topical hydrocortisone 17-butyrate cream twice daily for three periods of 3 weeks followed by a 1-week steroid-free interval. The primary outcome was a reduction of at least 75% of the overall lesional areas as judged by automatic image analysis on reflected UV photographs, conducted blind to treatment assignment, at 12 weeks compared with baseline. Secondary outcomes were clearance, and improvements on Physician's Global Assessment (PGA) and Skindex-29 scores. Results, A total of 76 (90%) patients completed the study. In an intention-to-treat analysis, seven [16·6%; 95% confidence interval (CI) 5·3,27·8%] patients in the excimer monotherapy arm and 18 (42·8%; 95% CI 27·8,57·8%) in the combination arm showed , 75% reduction of vitiligo lesions at 12 weeks (,2 test 6·89, P = 0·0087). Clearance was observed in two (4·7%; 95% CI 1·6,11·2%) and nine (21·4%; 95% CI 9·0,33·8%) patients, respectively (Fisher's exact test P = 0·04). A significant difference also emerged for PGA scores, while no difference was documented for Skindex-29. Conclusions, Recalcitrant vitiligo of the face and neck may benefit from the combination of excimer laser phototherapy with topical hydrocortisone 17-butyrate cream. [source] | ||||||||||