Tacalcitol: a useful adjunct to narrow-band ultraviolet-B phototherapy in vitiligo

Using a Topical Formulation of Vitamin D for the Treatment of Vitiligo: A Systematic Review

Vitamin D is one significant prohormone substance in human organ systems. It is a steroidal hormone produced in the skin upon exposure to UVB rays. This paper presents a systematic review of the utilization of topical vitamin D, specifically cholecalciferol, calcipotriol, and tacalcitol, in the treatment of vitiligo. It considers the role of vitamin D in stimulating the synthesis of melanin and melanogenesis, which can help with the process of repigmentation. The inclusion of calcipotriol or tacalcitol in Narrowband Ultraviolet Phototherapy (NB-UVB) has shown the potential to enhance therapeutic outcomes for vitiligo. However, their effectiveness in combination with Psoralens Long Wave Ultraviolet Radiation (PUVA) and Monochromatic Excimer Light (MEL) treatment for vitiligo is limited. In contrast, combining topical corticosteroids with vitamin D analogues has demonstrated superior efficacy in treating vitiligo compared to using vitamin D analogues alone, while also providing the added benefit of reducing corticosteroid-related adverse effects. In addition, treating stable vitiligo with topical cholecalciferol and microneedling has shown success. Future studies are needed to ascertain an efficient method of administering vitamin D topically as an anti-vitiligo agent.

Systematic Evaluation and Meta-Analysis of Randomized Controlled Trials of Fire Needle Combined Phototherapy for the Treatment of Vitiligo

This study investigated the fire needle and phototherapy combination for treating vitiligo through a meta-analysis of the published literature. Indeed, vitiligo is a common chronic skin condition characterized by the appearance of white patches. It is the most prevalent disorder, affecting approximately 1% of the global population. There is no known cure or clinical recommendation for treating vitiligo. The majority of medical guidelines suggest vitiligo treatment with the use of fire needles. Here, vitiligo was treated with a novel mechanism combining a fire needle with phototherapy. The handheld phototherapy devices include a fire needle option for disease treatment. Miniature lesions that could be used to detect and treat vitiligo at an early stage could be managed by hybrid-capable devices. The real-time study included more than 3,435 patients. The dosages were altered to control the adverse effects. Following treatment, granulation tissues developed on the injured skin, diminishing the shallow area and wound surface. The case studies demonstrate that combining phototherapy and fire needle therapy is more practical than the other methods.

Vitamin deficiencies/hypervitaminosis and the skin

Vitamins are an indispensable food source and important owing to the enzyme cofactor and catalytic roles they play in the body. Fat-soluble vitamins A, D, E, K, and B12, are stored in the body and can cause problems with their excessive accumulation. Other vitamins rarely accumulate in the body because they dissolve in water and are excreted through the kidneys. Alcoholism, strict diets, insufficient parental nutrition, and gastrointestinal absorption problems may be included in the causes of vitamin deficiencies. Although clinical findings of vitamin deficiencies display different characteristics depending on the vitamins, the signs that generally occur are cutaneous pigmentation, pigmentation on mucous membranes, palmoplantar keratoderma characterized by fissures, palmar streaking, yellow streaking on the nails, nail layering, and intranail hemorrhage.

Nuclear factor erythroid 2-related factor 2 (Nrf2) as a potential therapeutic target for vitiligo

Vitiligo is an autoimmune disease of the skin which causes loss of melanocytes from the epidermis. Recently, it is demonstrated that oxidative stress (OS) plays a significant role in the immuno-pathogenesis of vitiligo. A major mechanism in the cellular defense against OS is activation of the nuclear factor erythroid2-related factor (Nrf2)-Kelch-like ECH-associated protein 1(Keap1)-antioxidant responsive element (ARE) signaling pathway. Recently it has been shown that vitiligo melanocytes have impaired Nrf2-ARE signaling. A number of drugs including those known as Nrf2 activators and those known to possess effects to activate Nrf2, have been used in treating vitiligo with certain therapeutic effects. Also, studies have shown that a number of compounds can protect melanocytes against OS via activating Nrf2. These compounds may be considered as candidates for developing new drugs for vitiligo in the future. Nrf2 can be considered as a potential therapeutic target for vitiligo.