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Alshiyab D, Ba-Shammakh SA, Al-Fakih A, Tashman O, Sarakbi D, Al-Qarqaz F, Muhaidat J, Atwan A, Cork MJ. Efficacy and safety of 308-nm Excimer lamp combined with Tacrolimus 0.1% ointment vs Tacrolimus 0.1% ointment as monotherapy in treating children with limited vitiligo: a randomized controlled trial. J DERMATOL TREAT 2024; 35:2296851. [PMID: 38124534 DOI: 10.1080/09546634.2023.2296851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study aims to assess the efficacy and safety of combining the 308-nm Excimer lamp with Tacrolimus 0.1% ointment, compared to Tacrolimus 0.1% ointment monotherapy, for treating pediatric vitiligo involving less than 10% of the body surface area. METHODS Fifty pediatric patients with vitiligo were randomly assigned to two groups. Group A received Tacrolimus 0.1% ointment twice daily and Excimer light at 308-nm twice weekly, while Group B received Tacrolimus 0.1% ointment alone, administered twice daily. Repigmentation percentages were evaluated after 30, 90, and 180 days using the rule of nine. RESULTS Group A exhibited a significant improvement in repigmentation, increasing from 10% after one month to 65% after six months. In contrast, Group B observed an increase from 10% to 30% over the same timeframe. The efficacy of the treatment was significantly higher in Group A at both the 3-month and 6-month follow-up points (p-value < .001). Moreover, Group A achieved notably higher repigmentation rates in the face, trunk, and lower limbs. CONCLUSION The combination of Tacrolimus and the 308-nm excimer lamp yielded superior repigmentation results compared to Tacrolimus monotherapy in pediatric vitiligo patients. This combined approach may offer an effective new treatment protocol for pediatric vitiligo.
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Affiliation(s)
- Diala Alshiyab
- Department of Dermatology, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Saleh A Ba-Shammakh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdulqudos Al-Fakih
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Osama Tashman
- Department of Dermatology, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Danyah Sarakbi
- Department of Dermatology, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Firas Al-Qarqaz
- Department of Dermatology, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Jihan Muhaidat
- Department of Dermatology, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Michael J Cork
- Sheffield Dermatology Research, IICD, University of Sheffield, UK
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Mukhatayev Z, Le Poole IC. Vitiligo: advances in pathophysiology research and treatment development. Trends Mol Med 2024:S1471-4914(24)00097-2. [PMID: 38705825 DOI: 10.1016/j.molmed.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 05/07/2024]
Abstract
The autoimmune condition vitiligo, characterized by skin depigmentation, presents challenges for effective treatment design, with Janus kinase (JAK) inhibitors and other repurposed drugs offering a promising strategy for symptom management. This review explores advantages and shortcomings of current therapies, while presenting the urgent need for further innovative approaches. We emphasize the growing understanding of autoimmune involvement in vitiligo, highlighting several novel treatment avenues including relieving melanocyte stress, preventing dendritic cell activation, halting T cell migration, and suppressing inflammation and autoimmunity. Integrating psychodrama therapy to remediate stress alongside medical interventions marks a holistic approach to enhance patient well-being. The molecular underpinnings of vitiligo care are covered, emphasizing exciting advances revolutionizing vitiligo treatment and improving the quality of life for affected individuals.
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Affiliation(s)
| | - I Caroline Le Poole
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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Ju HJ, Kim SH, Lee SG, Bae JM. Eyelash Dyeing for Poliosis of Eyelashes in Patients With Vitiligo. Ann Dermatol 2024; 36:56-57. [PMID: 38325435 PMCID: PMC10861308 DOI: 10.5021/ad.22.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/06/2023] [Accepted: 04/17/2023] [Indexed: 02/09/2024] Open
Affiliation(s)
- Hyun Jeong Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo Hyung Kim
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seo Gyeong Lee
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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van Geel N, Speeckaert R, Taïeb A, Ezzedine K, Lim HW, Pandya AG, Passeron T, Wolkerstorfer A, Abdallah M, Alomar A, Bae JM, Bekkenk M, Benzekri L, Böhm M, Eleftheriadou V, Esmat S, Ghia D, Goh BK, Grimes P, Gupta S, Hamzavi IH, Harris JE, Oh SH, Huggins R, Katayama I, Lan E, Lee AY, Leone G, Le Poole C, Lui H, Maquignon N, Meurant JM, Monteiro P, Oiso N, Parsad D, Pliszewski G, Raboobee N, Rodrigues M, Rosmarin D, Suzuki T, Tanemura A, Thng S, Xiang F, Zhou Y, Picardo M, Seneschal J. Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm. J Eur Acad Dermatol Venereol 2023; 37:2173-2184. [PMID: 37746876 DOI: 10.1111/jdv.19451] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/04/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND The treatment of vitiligo can be challenging and depends on several factors such as the subtype, disease activity, vitiligo extent, and treatment goals. Vitiligo usually requires a long-term approach. To improve the management of vitiligo worldwide, a clear and up-to-date guide based on international consensus with uniform stepwise recommendations is needed. OBJECTIVES To reach an international consensus on the nomenclature and to develop a management algorithm for the diagnosis, assessment, and treatment of vitiligo. METHODS In this consensus statement, a consortium of 42 international vitiligo experts and four patient representatives participated in online and live meetings to develop a consensus management strategy for vitiligo. At least two vitiligo experts summarized the evidence of topics included in the algorithms. A survey was utilized to resolve remaining issues among a core group of eight experts. Subsequently, the unanimous recommendations were finalized and validated based on further input from the entire group during two live meetings. RESULTS The algorithms highlight the importance of shared decision-making. Dermatologists are encouraged to provide patients with detailed explanations of the prognosis and expected therapeutic outcomes based on clinical examination. The treatment goal should be discussed and clearly emphasized to patients given the different approaches for disease stabilization and repigmentation. The evaluation of disease activity remains a cornerstone in the tailor-made approach to vitiligo patients. CONCLUSIONS These new treatment algorithms are intended to guide clinical decision-making in clinical practice. Promising novel therapies for vitiligo are on the horizon, further highlighting the need for reliable outcome measurement instruments and greater emphasis on shared decision-making.
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Affiliation(s)
- Nanja van Geel
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - Alain Taïeb
- Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, BRIC, UMR 1312, Inserm, University Bordeaux, Bordeaux, France
| | - Khaled Ezzedine
- Department of Dermatology, University Hospital Henri Mondor, EpiDermE EA 7379, Université Paris-Est Créteil Val de Marne, Créteil, France
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Amit G Pandya
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Thierry Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - Albert Wolkerstorfer
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
- Department of Dermatology, Netherlands Institute for Pigment Disorders, Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Marwa Abdallah
- Dermatology, Andrology, and Venereology Department, Ain Shams University, Cairo, Egypt
| | - Augustin Alomar
- Department of Dermatology, Clinica Dermatologica Moragas, Barcelona, Spain
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Marcel Bekkenk
- Department of Dermatology, Netherlands Institute for Pigment Disorders, Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity, VU University, Amsterdam, The Netherlands
| | - Laila Benzekri
- Department of Dermatology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Markus Böhm
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | | | - Samia Esmat
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Deepti Ghia
- Department of Dermatology, Jaslok Hospital and Research Hospital and South Mumbai Dermatology Clinic, Mumbai, India
| | - Boon Kee Goh
- Skin Physicians Pte Ltd, Mount Elizabeth Medical Centre, Singapore City, Singapore
| | - Pearl Grimes
- Vitiligo & Pigmentation Institute of Southern California, Los Angeles, California, USA
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Iltefat H Hamzavi
- Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - John E Harris
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sang Ho Oh
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Richard Huggins
- Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Ichiro Katayama
- Pigmentation Research and Therapeutics, Osaka Metropolitan University, Osaka, Japan
| | - Eric Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ai-Young Lee
- Department of Dermatology, College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Giovanni Leone
- Photodermatology and Vitiligo Treatment Unit, Israelite Hospital, Roma, Italy
| | - Caroline Le Poole
- Departments of Dermatology, Microbiology and Immunology, Robert H. Lurie Comprehensive Cancer Center Northwestern University, Chicago, Illinois, USA
| | - Harvey Lui
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | - Naoki Oiso
- Department of Dermatology, Kindai University Nara Hospital, Ikoma, Japan
| | - Davinder Parsad
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Noufal Raboobee
- Department of Dermatology, Westville Hospital, Durban, South Africa
| | - Michelle Rodrigues
- Chroma Dermatology, Pigment and Skin of Colour Centre, Parkville, Victoria, Australia
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - David Rosmarin
- Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Tamio Suzuki
- Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Atsushi Tanemura
- Department of Dermatology Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Steven Thng
- Skin Research Institute of Singapore, ASTAR, Singapore City, Singapore
| | - Flora Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Youwen Zhou
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Julien Seneschal
- Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin disorders, Hospital Saint-André, University of Bordeaux, CNRS UMR 5164, ImmunoConcept, Bordeaux, France
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5
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Seneschal J, Speeckaert R, Taïeb A, Wolkerstorfer A, Passeron T, Pandya AG, Lim HW, Ezzedine K, Zhou Y, Xiang F, Thng S, Tanemura A, Suzuki T, Rosmarin D, Rodrigues M, Raboobee N, Pliszewski G, Parsad D, Oiso N, Monteiro P, Meurant JM, Maquignon N, Lui H, Le Poole C, Leone G, Lee AY, Lan E, Katayama I, Huggins R, Oh SH, Harris JE, Hamzavi IH, Gupta S, Grimes P, Goh BK, Ghia D, Esmat S, Eleftheriadou V, Böhm M, Benzekri L, Bekkenk M, Bae JM, Alomar A, Abdallah M, Picardo M, van Geel N. Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the international Vitiligo Task Force-Part 2: Specific treatment recommendations. J Eur Acad Dermatol Venereol 2023; 37:2185-2195. [PMID: 37715487 DOI: 10.1111/jdv.19450] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/04/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND The treatment of vitiligo can be challenging. Up-to-date agreed consensus recommendations on the use of topical and systemic therapies to facilitate the clinical management of vitiligo are currently lacking. OBJECTIVES To develop internationally agreed-upon expert-based recommendations for the treatment of vitiligo. METHODS In this consensus statement, a consortium of 42 international vitiligo experts and four patient representatives participated in different online and live meetings to develop a consensus management strategy for vitiligo. At least two vitiligo experts summarized the evidence for different topics included in the algorithms. A survey was then given to a core group of eight experts to resolve the remaining issues. Subsequently, the recommendations were finalized and validated based on further input from the entire group during two live meetings. RESULTS The recommendations provided summarize the latest evidence regarding the use of topical therapies (steroids, calcineurin inhibitors and Jak-inhibitors) and systemic therapies, including steroids and other systemic immunomodulating or antioxidant agents. The different modalities of phototherapies (NB-UVB, photochemotherapy, excimer devices and home phototherapy), which are often combined with other therapies, are also summarized. Interventional approaches as well as depigmentation strategies are presented for specific indications. Finally, the status of innovative and targeted therapies under development is discussed. CONCLUSIONS This international consensus statement culminated in expert-based clinical practice recommendations for the treatment of vitiligo. The development of new therapies is ongoing in vitiligo, and this will likely improve the future management of vitiligo, a disease that still has many unmet needs.
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Affiliation(s)
- Julien Seneschal
- Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, ImmunoConcept, CNRS UMR 5164, Bordeaux University, Bordeaux, France
| | | | - Alain Taïeb
- Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, BRIC, UMR 1312, Inserm, University Bordeaux, Bordeaux, France
| | - Albert Wolkerstorfer
- Department of Dermatology, Netherlands Institute for Pigment Disorders, Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Thierry Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - Amit G Pandya
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Khaled Ezzedine
- Department of Dermatology, University Hospital Henri Mondor, EpiDermE EA 7379, Université Paris-Est Créteil Val de Marne, Créteil, France
| | - Youwen Zhou
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Flora Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Steven Thng
- Skin Research Institute of Singapore, ASTAR, Singapore, Singapore
| | - Atsushi Tanemura
- Department of Dermatology Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tamio Suzuki
- Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - David Rosmarin
- Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Michelle Rodrigues
- Chroma Dermatology, Pigment and Skin of Colour Centre, Wheelers Hill, Victoria, Australia
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Noufal Raboobee
- Department of Dermatology, Westville Hospital, Durban, South Africa
| | | | - Davinder Parsad
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naoki Oiso
- Department of Dermatology, Kindai University Nara Hospital, Ikoma, Japan
| | | | | | | | - Harvey Lui
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline Le Poole
- Department of Dermatology, Microbiology and Immunology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA
| | - Giovanni Leone
- Photodermatology and Vitiligo Treatment Unit, Israelite Hospital, Roma
| | - Ai-Young Lee
- Department of Dermatology, College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Eric Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ichiro Katayama
- Pigmentation Research and Therapeutics, Osaka Metropolitan University, Osaka, Japan
| | - Richard Huggins
- Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Sang Ho Oh
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - John E Harris
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Iltefat H Hamzavi
- Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Pearl Grimes
- Vitiligo & Pigmentation Institute of Southern California, Los Angeles, California, USA
| | | | - Deepti Ghia
- Department of Dermatology, Jaslok Hospital and Research Hospital and South Mumbai Dermatology Clinic, Mumbai, India
| | - Samia Esmat
- Department of Dermatology, Faculty of Medicine Cairo University, Cairo, Egypt
| | | | - Markus Böhm
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Laila Benzekri
- Department of Dermatology, Mohammed V University, Ibn Sina University Hospital, Rabat, Morocco
| | - Marcel Bekkenk
- Department of Dermatology, Netherlands Institute for Pigment Disorders, Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity, VU University, Amsterdam, The Netherlands
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Augustin Alomar
- Department of Dermatology, Clinica Dermatologica Moragas, Barcelona, Spain
| | - Marwa Abdallah
- Dermatology, Andrology, and Venereology Department, Ain Shams University, Cairo, Egypt
| | | | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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Ring J. Global recommendations for vitiligo management. J Eur Acad Dermatol Venereol 2023; 37:2157-2158. [PMID: 37877761 DOI: 10.1111/jdv.19490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Johannes Ring
- Department Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
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Xie B, Zhu Y, Shen Y, Xu W, Song X. Treatment update for vitiligo based on autoimmune inhibition and melanocyte protection. Expert Opin Ther Targets 2023; 27:189-206. [PMID: 36947026 DOI: 10.1080/14728222.2023.2193329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
INTRODUCTION The treatment of vitiligo remains challenging due to the complexity of its pathogenesis, influenced by genetic factors, oxidative stress and abnormal cell adhesion that collectively impact melanocyte survival and trigger immune system attacks, resulting in melanocyte death. Melanocytes in vitiligo are believed to exhibit genetic susceptibility and defects in cellular mechanisms, such as defects in autophagy, that reduce their ability to resist oxidative stress, leading to increased expression of the pro-inflammatory protein HSP70. The low expression of adhesion molecules, such as DDR1 and E-cadherin, accelerates melanocyte damage and antigen exposure. Consequently, autoimmune attacks centered on IFN-γ-CXCR9/10-CXCR3-CD8+ T cells are initiated, causing vitiligo. AREAS COVERED This review discusses the latest knowledge on the pathogenesis of vitiligo and potential therapeutic targets from the perspective of suppressing autoimmune attacks and activating melanocytes functions. EXPERT OPINION Vitiligo is one of the most challenging dermatological diseases due to its complex pathogenesis with diverse therapeutic targets. Immune suppression, such as corticosteroids and emerging JAK inhibitors, has proven effective in disease progression. However, during the early stages of the disease, it is also important to optimize therapeutic strategies to activate melanocytes for alleviating oxidative stress and improving treatment outcomes.
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Affiliation(s)
- Bo Xie
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine; West Lake Ave 38, Hangzhou, 310009, People's Republic of China
| | - Yuqi Zhu
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine; West Lake Ave 38, Hangzhou, 310009, People's Republic of China
- Zhejiang Chinese Medical University; Binwen Rd 548, Hangzhou, 310053, People's Republic of China
| | - Yuqing Shen
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine; West Lake Ave 38, Hangzhou, 310009, People's Republic of China
- Zhejiang Chinese Medical University; Binwen Rd 548, Hangzhou, 310053, People's Republic of China
| | - Wen Xu
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine; West Lake Ave 38, Hangzhou, 310009, People's Republic of China
- Zhejiang University School of Medicine; Yuhangtang Rd 866, Hangzhou, 310058, People's Republic of China
| | - Xiuzu Song
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine; West Lake Ave 38, Hangzhou, 310009, People's Republic of China
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8
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Yousefian F, Yadlapati S, Browning JC. The use of Janus kinase inhibitors and narrowband ultraviolet B combination therapy in non-segmental vitiligo. J Cosmet Dermatol 2023; 22:1105-1107. [PMID: 36440703 DOI: 10.1111/jocd.15537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022]
Abstract
Vitiligo is a depigmentation disorder of the skin that occurs secondary to the destruction of melanocytes by an immune-mediated process. Vitiligo clinically presents with depigmented macules and patches, most commonly on the face, acral sites, and genitalia. It can be characterized as generalized or localized based on distribution. The localized form can be further divided into segmental (linear, band-like, or Blaschkoid) and non-segmental vitiligo. The classical treatment of vitiligo includes topical steroids, pulsed oral steroids in unstable vitiligo, phototherapy, a combination of steroid therapy and phototherapy, surgical grafting, as well as intentional depigmentation therapy in severe cases. However, recent advances in understanding the immune mechanisms implicated in the pathogenesis of vitiligo have led to the use of an FDA-approved topical Janus kinase (JAK) inhibitors for vitiligo. Despite this novel therapy advancement, we recommend the addition of narrowband ultraviolet B (NB-UVB) to JAK inhibitors in patients with extensive and progressive lesions, or those not fully responsive to JAK inhibitor monotherapy.
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Affiliation(s)
- Faraz Yousefian
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Sujitha Yadlapati
- HCA Corpus Christi Medical Center- Bay Area Dermatology Residency Program, McAllen, Texas, USA
| | - John C Browning
- Adjunct Associate Professor, UT Health San Antonio Medical Director, Texas Dermatology and Laser Specialists, San Antonio, Texas, USA
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Hu W, Lin F, Lei J, Xu AE. Impacts of exposure to topical calcineurin inhibitors on metabolism in vitiligo infants. Pediatr Res 2023; 93:661-665. [PMID: 35681095 DOI: 10.1038/s41390-022-02133-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tacrolimus ointment is a recently developed topical immunomodulator that has been approved for use in patients with vitiligo older than 2 years. Concern regarding potential systemic toxic effects has limited treatment options for children younger than 2 years. We wanted to determine whether topical tacrolimus therapy is safe and effective in patients with vitiligo younger than 2 years. METHODS The present 6-month clinical trial was conducted to evaluate the efficacy and safety of 0.03% tacrolimus in the treatment of vitiligo in children under 2 years of age. Meanwhile, serum and urine samples were collected, and liquid chromatography-mass spectrometry was performed to generate the serum and urine metabolic profile data of patients and healthy controls. RESULTS The overall response rate at the sixth month, which was defined by the degree of re-pigmentation, was 100%. As revealed by blood monitoring and metabolite detection 6 months later, there was no difference between the treatment group and the control group. There is no evidence that long-term topical application of 0.03% tacrolimus ointment will cause metabolite or other physical changes in the body. CONCLUSIONS Tacrolimus ointment appears to be effective and safe in the treatment of vitiligo in children younger than 2 year. TRIAL REGISTRATION http://www.chictr.org.cn identifier: ChiCTR 2100045920. IMPACT We first reported the efficacy and safety of topical application of 0.03% tacrolimus ointment in infants with vitiligo characterized by the metabolites. There is no evidence that long-term topical application of 0.03% tacrolimus ointment will cause metabolite or other physical changes in the body. This study provide evidence for the TCI treatment of infants with vitiligo.
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Affiliation(s)
- Wenting Hu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Fuquan Lin
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jiehao Lei
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ai-E Xu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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10
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Böhm M, Schunter JA, Fritz K, Salavastru C, Dargatz S, Augustin M, Tanew A. S1-Leitlinie: Diagnostik und Therapie der Vitiligo. J Dtsch Dermatol Ges 2022; 20:365-379. [PMID: 35304960 DOI: 10.1111/ddg.14713_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Markus Böhm
- Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Deutschland
| | - Jo Ana Schunter
- Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Deutschland
| | - Klaus Fritz
- Hautarztpraxis und Laserzentrum Landau, Landau, Deutschland
| | - Carmen Salavastru
- Universität Carol Davila, Pädiatrische Dermatologie, Bukarest, Rumänien
| | | | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Adrian Tanew
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
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11
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Khalili M, Amiri R, Mohammadi S, Iranmanesh B, Aflatoonian M. Efficacy and safety of traditional and surgical treatment modalities in segmental vitiligo: A review article. J Cosmet Dermatol 2022; 21:2360-2373. [DOI: 10.1111/jocd.14899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/27/2022] [Accepted: 03/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Maryam Khalili
- Department of Dermatology Kerman University of Medical Sciences Iran
| | - Rezvan Amiri
- Department of Dermatology Afzalipour Hospital Afzalipour faculty of Medicine Kerman University of Medical Sciences Kerman Iran
| | - Saman Mohammadi
- Department of Dermatology Afzalipour Hospital Afzalipour faculty of Medicine Kerman University of Medical Sciences Kerman Iran
| | - Behzad Iranmanesh
- Department of Dermatology Afzalipour Hospital Afzalipour faculty of Medicine Kerman University of Medical Sciences Kerman Iran
| | - Mahin Aflatoonian
- Department of Dermatology Afzalipour Hospital Afzalipour faculty of Medicine Kerman University of Medical Sciences Kerman Iran
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12
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Böhm M, Schunter JA, Fritz K, Salavastru C, Dargatz S, Augustin M, Tanew A. S1 Guideline: Diagnosis and therapy of vitiligo. J Dtsch Dermatol Ges 2022; 20:365-378. [PMID: 35246935 DOI: 10.1111/ddg.14713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 01/01/2023]
Abstract
Vitiligo is a common skin disorder characterized by immune-mediated destruction of melanocytes. Non-segmental vitiligo, the most common clinical subtype, has usually a chronic course and often results in significant psychosocial consequences for the affected patient. Early recognition, awareness of comorbidity, precise assessment of disease extent and activity, evaluation of impairment of quality of life as well as rapid initiation of treatment based on currently available evidence-based therapies are crucial cornerstones in the management of vitiligo. This S1 guideline helps German dermatologists to better diagnose and treat vitiligo.
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Affiliation(s)
- Markus Böhm
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Jo Ana Schunter
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Klaus Fritz
- Dermatology Office and Laser Center Landau, Landau, Germany
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adrian Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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13
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Kumar S, Vinay K, Choudhary R, Thakur V, Bishnoi A, Kumaran MS, Parsad D. Clinicodemographic features of mixed vitiligo: a case–control study. Int J Dermatol 2022; 61:982-987. [DOI: 10.1111/ijd.16090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/16/2021] [Accepted: 01/05/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Rajat Choudhary
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Vishal Thakur
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
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14
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Xu X, Jiang M, Zhang C, Qiao Z, Liu W, Le Y, Wu J, Ma W, Xiang LF. New insights into segmental vitiligo: A clinical and immunological comparison with nonsegmental vitiligo. Pigment Cell Melanoma Res 2021; 35:220-228. [PMID: 34780118 DOI: 10.1111/pcmr.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/07/2021] [Accepted: 11/04/2021] [Indexed: 11/30/2022]
Abstract
The overlaps between segmental vitiligo (SV) and nonsegmental vitiligo (NSV) suggest the underlying features of SV, which may be helpful for treating SV. In this study, 379 vitiligo patients were recruited and divided into SV (33.2%), mild-to-moderate NSV (M-NSV, affected body affected area [BSA] ≤10%, 34.0%), and severe NSV (S-NSV, affected BSA >10%, 32.7%) groups. Demographics and clinical data were collected through in-person interviews. The disease activity, progression, and prognosis were assessed through 6 months' follow-up. Serum cytokines profile and tissue-infiltrating immune cells were measured by ELISA assay and immunofluorescence, respectively. The SV exhibited lower rates of autoimmune comorbidities and recurrence than the S-NSV, but performed similar to the M-NSV. Moreover, the disease activity, progression, serum cytokines profile, and tissue-infiltrating Th/c1 cells in the active SV and M-NSV were comparable, but differed significantly from those of the active S-NSV. The clinical and immunological similarities between SV and M-NSV presented a deeper autoimmune understanding of SV. Additionally, a classification of active vitiligo according to disease extent may be more clinically meaningful than subtypes for guiding immunomodulatory treatment.
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Affiliation(s)
- Xinya Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Min Jiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhuhui Qiao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenjie Liu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Le
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiaqiang Wu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenjuan Ma
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Leihong Flora Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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15
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Mohammadi S, Amiri R, Khalili M, Iranmanesh B, Aflatoonian M. Treatment protocols and efficacy of combined laser with medical treatment modalities in vitiligo. J Cosmet Dermatol 2021; 21:3272-3291. [PMID: 34766697 DOI: 10.1111/jocd.14602] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUNDS Nowadays, lasers are used for treatment of vitiligo in difficult-to-treat areas and refractory lesions. Combination of lasers with other medical modalities can provide higher efficacy, faster response rate, and higher compliance of patients to treatment. AIM In this article, we reviewed articles regarding safety, efficacy, and treatment protocols of combined laser with other medical modalities. METHODS We searched articles with relevant key words in Google scholar and PubMed. Inclusion criteria were articles in English language since January 2000 until March 2021that evaluate combination of laser with other topical or systemic medical treatments. RESULTS A total of 42 articles evaluated efficacy of lasers [excimer, carbon dioxide (CO2 ), erbium-doped yttrium-aluminum-garnet (Er:YAG), and non-ablative resurfacing laser] combined with topical or systemic medical treatment modalities. Effective response rate (more than 50% improvement) varied between 7.7% and 92%. Initial repigmentation observed between 4 and 13 weeks after beginning of treatment. CONCLUSION Combination of laser with medical modalities leads to more rapid repigmentation, superior efficacy, and better compliance of patients with localized non-segmental type of vitiligo compared to monotherapy. Combination of excimer laser with topical therapy might be suggested for recalcitrant vitiligo lesions in face and neck. Combination of fractional ablative resurfacing lasers with topical therapy, especially 5-flurouracil, can be recommended particularly in recalcitrant acral and bony prominent areas. Further studies are required to achieve conclusive evidence in order to define the best stage of vitiligo for laser therapy and most effective combined treatment regimen.
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Affiliation(s)
- Saman Mohammadi
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Rezvan Amiri
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Khalili
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Behzad Iranmanesh
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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16
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Hu W, Zhang L, Lin F, Lei J, Zhou M, Xu A. Topical epigallocatechin-3-gallate in the treatment of vitiligo. Australas J Dermatol 2021; 62:e404-e407. [PMID: 34046892 DOI: 10.1111/ajd.13612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To preliminarily assess the efficacy and safety of the topical application of Epigallocatechin-3-gallate (EGCG) in treating vitiligo, a 6-month clinical trial was carried out. METHOD Patients were randomly given topical application of EGCG on the assigned lesions, with pimecrolimus being used as the control for twice a day over a 6-month treatment period. Responses to treatment were assessed based on the changes in VASI score for percentage reduction in body surface area and the PGA scores. RESULTS According to our results, both drugs were discovered to be markedly effective on repigmentation. The VASI of lesion had diminished from 1.19 ± 0.42 to 0.63 ± 0.38, in the EGCG-treated lesions, while from 1.18 ± 0.43 to 0.61 ± 0.36 in the pimecrolimus-treated lesions, and there was no statistically significant difference in VASI score between the EGCG-treated lesions and pimecrolimus-treated lesions (P = 0.755). Meanwhile, the mean PGA score on the EGCG applied side was 4.39 ± 2.23, while that was 4.43 ± 2.02 on the pimecrolimus applied side (P = 0.886). Furthermore, difference in the improvement degree between pimecrolimus side and EGCG side was not statistically significant (P = 0.845). Notably, no serious side effects were observed throughout the study. CONCLUSION Findings of the study indicate that topical EGCG can be effective on treating vitiligo.
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Affiliation(s)
- Wenting Hu
- Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, China
| | - Lingling Zhang
- Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, China
| | - Fuquan Lin
- Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, China
| | - Jiehao Lei
- Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, China
| | - Miaoni Zhou
- Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, China
| | - AiE Xu
- Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, China
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17
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Bergqvist C, Ezzedine K. Vitiligo: A focus on pathogenesis and its therapeutic implications. J Dermatol 2021; 48:252-270. [DOI: 10.1111/1346-8138.15743] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Christina Bergqvist
- Department of Dermatology AP‐HP Henri Mondor University Hospital UPEC Créteil France
| | - Khaled Ezzedine
- Department of Dermatology AP‐HP Henri Mondor University Hospital UPEC Créteil France
- EA 7379 EpidermE Université Paris‐Est Créteil, UPEC Créteil France
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18
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Phan K, Phan S, Shumack S, Gupta M. Repigmentation in vitiligo using janus kinase (JAK) inhibitors with phototherapy: systematic review and Meta-analysis. J DERMATOL TREAT 2020; 33:173-177. [PMID: 32096671 DOI: 10.1080/09546634.2020.1735615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: Vitiligo is an autoimmune disorder characterized by progressive loss of melanocytes, leading to cutaneous depigmentation. Vitiligo has significant psychosocial impacts on patients and is challenging to manage with limited treatment options. Recent studies have suggested promising results for JAK1/3 inhibitors including tofacitinib and ruxolitinib.Objective: To determine the expected response of vitiligo to JAK inhibitor therapy and factors which influence response rates.Methods: A systematic review and meta-analysis was performed according to PRISMA guidelines. Good response was defined as repigmentation >50% or a 'good' or 'excellent' outcome as described by authors. Partial response was defined as some repigmentation <50%.Results: From the 9 eligible studies, individual patient data from 45 cases were pooled. Good response was achieved in 57.8%, partial response in 22.2%, and none or minimal response in 20% of cases. When subgrouped according to site, facial vitiligo had the highest good response rate (70%), compared to extremities (27.3%) and torso/non-sun exposed areas (13.6%). Concurrent phototherapy was significant associated with higher rates of good overall response (p < .001) and good facial response (p < .001).Conclusions: There is promising low-quality evidence regarding the effectiveness of JAK inhibitors in vitiligo. Concurrent UVB phototherapy appears to improve efficacy of JAK inhibitors for vitiligo.
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Affiliation(s)
- Kevin Phan
- Department of Dermatology, Liverpool Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia.,St George Dermatology and Skin Cancer Centre, Sydney, Australia
| | - Steven Phan
- Department of Dermatology, Liverpool Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stephen Shumack
- St George Dermatology and Skin Cancer Centre, Sydney, Australia
| | - Monisha Gupta
- Department of Dermatology, Liverpool Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
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19
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Huang C, Li P, Wang B, Deng Y, Li J, Mao M, Jian D. Multi‐Factors Associated With Efficacy and Adverse Events of Fractional Erbium:YAG Laser‐Assisted Delivery of Topical Betamethasone for Stable Vitiligo: A Retrospective Analysis. Lasers Surg Med 2019; 52:590-596. [PMID: 31820470 DOI: 10.1002/lsm.23198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Chuchu Huang
- Department of Dermatology, National Clinical Research Center for Geriatric DisordersXiangya Hospital, Central South University87 Xiangya Road Changsha Hunan 410008 China
| | - Peiyao Li
- Department of Dermatology, National Clinical Research Center for Geriatric DisordersXiangya Hospital, Central South University87 Xiangya Road Changsha Hunan 410008 China
| | - Ben Wang
- Department of Dermatology, National Clinical Research Center for Geriatric DisordersXiangya Hospital, Central South University87 Xiangya Road Changsha Hunan 410008 China
| | - Yuxuan Deng
- Department of Dermatology, National Clinical Research Center for Geriatric DisordersXiangya Hospital, Central South University87 Xiangya Road Changsha Hunan 410008 China
| | - Ji Li
- Department of Dermatology, National Clinical Research Center for Geriatric DisordersXiangya Hospital, Central South University87 Xiangya Road Changsha Hunan 410008 China
| | - Mengping Mao
- Department of Dermatology, National Clinical Research Center for Geriatric DisordersXiangya Hospital, Central South University87 Xiangya Road Changsha Hunan 410008 China
| | - Dan Jian
- Department of Dermatology, National Clinical Research Center for Geriatric DisordersXiangya Hospital, Central South University87 Xiangya Road Changsha Hunan 410008 China
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20
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Hu W, Xu Y, Ma Y, Lei J, Lin F, Xu AE. Efficacy of the Topical Calcineurin Inhibitors Tacrolimus and Pimecrolimus in the Treatment of Vitiligo in Infants Under 2 Years of Age: A Randomized, Open-Label Pilot Study. Clin Drug Investig 2019; 39:1233-1238. [DOI: 10.1007/s40261-019-00845-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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21
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Bae JM, Eun SH, Kim YH, Park JH, Hann SK. Excimer stamp test distinguishing between nevus depigmentosus and segmental vitiligo. Pigment Cell Melanoma Res 2019; 32:864-865. [PMID: 31365787 DOI: 10.1111/pcmr.12814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/02/2019] [Accepted: 07/29/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Jung Min Bae
- Department of Dermatology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sung Hye Eun
- Department of Dermatology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yeong Ho Kim
- Department of Dermatology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ji Hun Park
- Korea Institute of Vitiligo Research, Seoul, Korea.,Drs Woo and Hann's Skin Center, Seoul, Korea
| | - Seung-Kyung Hann
- Korea Institute of Vitiligo Research, Seoul, Korea.,Drs Woo and Hann's Skin Center, Seoul, Korea
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22
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Bae JM, Oh SH, Kang HY, Ryoo YW, Lan CE, Xiang L, Kim K, Suzuki T, Katayama I, Lee S. Development and validation of the Vitiligo Extent Score for a Target Area (
VESTA
) to assess the treatment response of a target lesion. Pigment Cell Melanoma Res 2018; 32:315-319. [DOI: 10.1111/pcmr.12730] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/09/2018] [Accepted: 07/24/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Jung Min Bae
- Department of DermatologyCollege of MedicineThe Catholic University of Korea Seoul Korea
| | - Sang Ho Oh
- Department of DermatologyYonsei University College of Medicine Seoul Korea
| | - Hee Young Kang
- Department of DermatologyAjou University Hospital School of Medicine Suwon Korea
| | - Young Wook Ryoo
- Department of DermatologySchool of MedicineKeimyung University Daegu Korea
| | - Cheng‐Che E. Lan
- Department of DermatologyKaohsiung Medical University Hospital, and College of MedicineKaohsiung Medical University Kaohsiung Taiwan
| | - Lei‐Hong Xiang
- Department of DermatologyHuashan HospitalFudan University Shanghai China
| | - Ki‐Ho Kim
- Department of DermatologyDong‐A University School of Medicine Busan Korea
| | - Tamio Suzuki
- Department of DermatologyFaculty of MedicineYamagata University Yamagata Japan
| | - Ichiro Katayama
- Department of Pigmentation Research and Therapeutics Graduate School of MedicineOsaka City UniversityOsakaJapan
| | - Seung‐Chul Lee
- Department of DermatologyChonnam National University School of Medicine Gwangju Korea
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23
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Li L, Hong J, Lan L, Xie Z, Liang Y, Chen H, Pan N. The effectiveness of combination therapy with 308-nm excimer laser in vitiligo in Han Chinese People. Australas J Dermatol 2018; 60:e85-e86. [PMID: 29974452 DOI: 10.1111/ajd.12883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Lili Li
- Department of Dermatology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiqiong Hong
- Department of Dermatology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lizhen Lan
- Department of Dermatology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhi Xie
- Department of Dermatology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yanping Liang
- Department of Dermatology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Huiyuan Chen
- Department of Dermatology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Nannan Pan
- Department of Dermatology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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24
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Wang LM, Zhang B, Li JJ, Zhou YC, Wang DX. The expression change of RORγt, BATF, and IL-17 in Chinese vitiligo patients with 308 nanometers excimer laser treatment. Dermatol Ther 2018; 31:e12598. [PMID: 29642271 DOI: 10.1111/dth.12598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 12/21/2017] [Accepted: 03/18/2018] [Indexed: 11/29/2022]
Abstract
This study aims to explore the expression of RORγt, BATF, and IL-17 in Chinese vitiligo patients with 308 nm excimer laser treatment. One hundred and sixty-four vitiligo patients treated with 308 nm excimer laser were enrolled as Case group and 137 health examiners as Control group. Quantitative real-time polymerase chain reaction and immunohistochemistry were conducted to detect the expressions of RORγt, BATF, and IL-17. Expression of RORγt, BATF, IL-17A, and IL-17F were higher in Case group than Control group, with the diagnostic accuracy of 88.04, 87.38, 97.34, and 89.04%, respectively. Pearson correlation analysis showed a positive correlation in RORγt, BATF, IL-17A, and IL-17F mRNAs in vitiligo patients. Moreover, their expressions were higher in active vitiligo patients than stable ones. Besides, the expressions of RORγt, BATF, IL-17A, and IL-17F in vitiligo skin were significantly higher than those in non lesional skin and normal controls. After treatment, their expressions were significantly decreased. Active vitiligo and the high expressions of RORγt, BATF, and IL-17F were the independent risk factors for the ineffectiveness of 308 nm excimer laser treatment. The expressions of RORγt, BATF, IL-17 were significantly enhanced in vitiligo patients, which were correlated with the activity of vitiligo and 308 nm excimer laser therapeutic effects.
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Affiliation(s)
- Lu-Mei Wang
- Department of Dermatology, Dong Guan People's Hospital, Guangdong Province, Dongguan 523018, People's Republic of China
| | - Bin Zhang
- Department of Gynaecology and Obstetrics, Dong Guan People's Hospital, Guangdong Province, Dongguan 523018, People's Republic of China
| | - Jun-Jie Li
- Department of Dermatology, Dong Guan People's Hospital, Guangdong Province, Dongguan 523018, People's Republic of China
| | - Yun-Cong Zhou
- Department of Dermatology, Dong Guan People's Hospital, Guangdong Province, Dongguan 523018, People's Republic of China
| | - Dong-Xia Wang
- Department of Interventional Therapy, Dong Guan People's Hospital, Guangdong Province, Dongguan 523018, People's Republic of China
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25
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Watabe A, Yamasaki K, Asano M, Kanbayashi Y, Nasu-Tamabuchi M, Terui H, Furudate S, Kakizaki A, Tsuchiyama K, Kimura Y, Ito Y, Kikuchi K, Aiba S. Efficacy of oral cholecalciferol on rhododendrol-induced vitiligo: A blinded randomized clinical trial. J Dermatol 2018; 45:456-462. [DOI: 10.1111/1346-8138.14244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Akiko Watabe
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kenshi Yamasaki
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Masayuki Asano
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yumi Kanbayashi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Mei Nasu-Tamabuchi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Hitoshi Terui
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Sadanori Furudate
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Aya Kakizaki
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kenichiro Tsuchiyama
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yutaka Kimura
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yumiko Ito
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Katsuko Kikuchi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Setsuya Aiba
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
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Recent Advances in Pathogenesis and Medical Management of Vitiligo. PIGMENTARY SKIN DISORDERS 2018. [DOI: 10.1007/978-3-319-70419-7_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Abstract
Segmental vitiligo is characterized by its early onset, rapid stabilization, and unilateral distribution. Recent evidence suggests that segmental and nonsegmental vitiligo could represent variants of the same disease spectrum. Observational studies with respect to its distribution pattern point to a possible role of cutaneous mosaicism, whereas the original stated dermatomal distribution seems to be a misnomer. Although the exact pathogenic mechanism behind the melanocyte destruction is still unknown, increasing evidence has been published on the autoimmune/inflammatory theory of segmental vitiligo.
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Affiliation(s)
- Nanja van Geel
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium.
| | - Reinhart Speeckaert
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium
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Liu LY, Strassner JP, Refat MA, Harris JE, King BA. Repigmentation in vitiligo using the Janus kinase inhibitor tofacitinib may require concomitant light exposure. J Am Acad Dermatol 2017; 77:675-682.e1. [PMID: 28823882 DOI: 10.1016/j.jaad.2017.05.043] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 05/19/2017] [Accepted: 05/21/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Vitiligo is an autoimmune disease in which cutaneous depigmentation occurs. Existing therapies are often inadequate. Prior reports have shown benefit of the Janus kinase (JAK) inhibitors. OBJECTIVE To evaluate the efficacy of the JAK 1/3 inhibitor tofacitinib in the treatment of vitiligo. METHOD This is a retrospective case series of 10 consecutive patients with vitiligo treated with tofacitinib. Severity of disease was assessed by body surface area of depigmentation. RESULTS Ten consecutive patients were treated with tofacitinib. Five patients achieved some repigmentation at sites of either sunlight exposure or low-dose narrowband ultraviolet B phototherapy. Suction blister sampling revealed that the autoimmune response was inhibited during treatment in both responding and nonresponding lesions, suggesting that light rather than immunosuppression was primarily required for melanocyte regeneration. LIMITATIONS Limitations include the small size of the study population, retrospective nature of the study, and lack of a control group. CONCLUSION Treatment of vitiligo with JAK inhibitors appears to require light exposure. In contrast to treatment with phototherapy alone, repigmentation during treatment with JAK inhibitors may require only low-level light. Maintenance of repigmentation may be achieved with JAK inhibitor monotherapy. These results support a model wherein JAK inhibitors suppress T cell mediators of vitiligo and light exposure is necessary for stimulation of melanocyte regeneration.
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Affiliation(s)
- Lucy Y Liu
- Yale University School of Medicine, New Haven, Connecticut
| | - James P Strassner
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Maggi A Refat
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - John E Harris
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts.
| | - Brett A King
- Department of Dermatology, New Haven, Connecticut.
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Yan R, Yuan J, Chen H, Li YH, Wu Y, Gao XH, Chen HD. Fractional Er:YAG laser assisting topical betamethasone solution in combination with NB-UVB for resistant non-segmental vitiligo. Lasers Med Sci 2017; 32:1571-1577. [DOI: 10.1007/s10103-017-2282-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/05/2017] [Indexed: 12/26/2022]
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30
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Rodrigues M, Ezzedine K, Hamzavi I, Pandya AG, Harris JE. Current and emerging treatments for vitiligo. J Am Acad Dermatol 2017; 77:17-29. [DOI: 10.1016/j.jaad.2016.11.010] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/03/2016] [Accepted: 11/06/2016] [Indexed: 01/28/2023]
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31
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Zhang C, Zhou L, Huang J, Shi W. A combination of Yiqiqubai granule and 308-nm excimer laser in treatment of segmental vitiligo: a prospective study of 233 patients. J DERMATOL TREAT 2017; 28:668-671. [PMID: 28320220 DOI: 10.1080/09546634.2017.1303570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To study the effect of Yiqiqubai granule combined with 308-nm excimer laser treatment for segmental vitiligo (SV). METHODS A prospective research was performed in 233 patients with SV treated in Shanghai General Hospital from 11 February 2015 to 25 August 2016, they were divided into group A (n = 75), group B (n = 78) and group C (n = 80) according to the random number table. Group A was treated with Yiqiqubai granule, group B treated with 308-nm excimer laser and group C treated with combined treatments. The treatment time lasts for 6 months. The clinical efficacy, color-reverse rate and quality of life of the three groups were assessed. RESULTS After treatment, the effective rate and markedly effective rate of group C (87.5%, 51.3%) were significantly higher than group A (74.7%, 42.7%) and group B (80.8%, 47.4%) (p < .05). Color-reverse rate of group C (66.5 ± 17.6%) was much higher than group A (47.2 ± 16.4%) and group B (49.9 ± 24.2%) (p < .05). Significant differences were found among three groups after treatment in terms of embarrassment, social and work (p < .05). CONCLUSIONS The combination of 308-nm excimer laser and Yiqiqubai granule in the treatment of SV has good clinical effect.
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Affiliation(s)
- Chengzhong Zhang
- a Department of Dermatology , Shanghai General Hospital, Shanghai Jiaotong University, School of Medicine , Shanghai , China
| | - Le Zhou
- a Department of Dermatology , Shanghai General Hospital, Shanghai Jiaotong University, School of Medicine , Shanghai , China
| | - Jie Huang
- a Department of Dermatology , Shanghai General Hospital, Shanghai Jiaotong University, School of Medicine , Shanghai , China
| | - Weimin Shi
- a Department of Dermatology , Shanghai General Hospital, Shanghai Jiaotong University, School of Medicine , Shanghai , China
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32
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Repigmentation of poliosis in a patient with segmental vitiligo. J Am Acad Dermatol 2016; 75:e23-4. [DOI: 10.1016/j.jaad.2016.01.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 11/21/2022]
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33
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Crall CS, Rork JF, Delano S, Huang JT. Phototherapy in children: Considerations and indications. Clin Dermatol 2016; 34:633-9. [PMID: 27638444 DOI: 10.1016/j.clindermatol.2016.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Phototherapy can be a safe and effective treatment for various skin diseases in children. Special considerations governing the use of this treatment modality in pediatric populations include patient, family, and facility-based factors that are oriented around heightened concerns with regard to safety and tolerability of treatment. Although phototherapy has been found to be effective in a wide range of dermatologic conditions affecting pediatric populations, including psoriasis, atopic dermatitis, pityriasis lichenoides, cutaneous T-cell lymphoma, and vitiligo, there is need for additional research on other conditions in which phototherapy has shown promise.
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Affiliation(s)
- Cary S Crall
- Harvard Medical School, Dermatology Program, Division of Allergy and Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA
| | - Jillian F Rork
- Department of Dermatology, University of Massachusetts School of Medicine, Worcester, MA
| | - Sophia Delano
- Harvard Medical School, Dermatology Program, Division of Allergy and Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA
| | - Jennifer T Huang
- Harvard Medical School, Dermatology Program, Division of Allergy and Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA.
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