Phototherapy is the pillar of vitiligo treatment. One of its main obstacles is noncompliance. It was noticed that patients continue to repigment even after stopping sessions, so the idea of interrupted phototherapy emerged. To evaluate the effectiveness of interrupted versus continuous NB‐UVB in nonsegmental vitiligo treatment. A prospective randomized comparative study of 23 patients with bilateral, nonsegmental vitiligo with no age or sex limits. All patients were treated with NB‐UVB phototherapy for 1 month, after which one side of the body received continuous therapy (Side A) and the other received an interrupted course (Side B) for a total of 6 months. Two more groups of 10 patients were enrolled to exclude the systemic effect of NB‐UVB. One group received continuous NB‐UVB treatment, and the other received interrupted courses for 6 months. Evaluation of the results was performed clinically, by digital photography, planimetry and Vitiligo Area Scoring Index (VASI) prior to and 3 and 6 months after treatment. There was a significant clinical improvement in Group 1 compared to baseline (p < .05). However, there was no significant difference between the sides with regards to the clinical evaluation, point counting, and VASI scores (p > .05). When comparing the other two groups, there was a significant clinical improvement in each group after 6 months of treatment compared to baseline (p < .05), while there was no significant difference between them (p > .05). The current study suggests that interrupted NB‐UVB phototherapy is a good alternative to continuous treatment with improved patient compliance, fewer side effects, and a lower cost of treatment.
Background
The treatment options for vitiligo are either nonsurgical, including medical treatments and phototherapy, or surgical, including autologous transplantation methods. Noncultured epidermal suspension transplantation is indicated for the treatment of stable vitiligo not responding to either medical treatment or phototherapy. Variable results have been reported for the various techniques used for the preparation of this suspension.
Aim
To compare the outcome between suction blister roof grafts and partial‐thickness epidermal cuts for the preparation of noncultured epidermal suspensions for the treatment of stable vitiligo.
Patients and Methods
Forty patients with localized stable vitiligo lesions resistant to conventional therapy were included in the study. They were randomly divided into two groups for treatment with noncultured epidermal suspension grafting. The suspensions in groups I and II were obtained from suction blister roofs and partial‐thickness epidermal cuts, respectively. Repigmentation grade, color match with the surrounding skin, and any side effects were compared between the groups.
Results
In group I, complete repigmentation was achieved in 6 cases while repigmentation was considered excellent in 8 cases; very good, 4 cases; and no response, 2 cases. In group II, complete repigmentation was achieved in 4 cases, and repigmentation was considered excellent in 16 cases. The color of the repigmented area matched the normal surrounding skin in 70% of the cases in group I and 40% of the cases in group II.
Conclusion
Both techniques yielded comparable repigmentation results with advantages and disadvantages of both techniques.
Excision of Sutton's nevus with combined dermabrasion and Thiersch grafting followed by phototherapy is a good aesthetic maneuver in treating halo nevi and helps in avoiding further vitiligo depigmentation.
The foremost target of the current work was to formulate and optimize a novel bergamot essential oil (BEO) loaded nano-phytosomes (NPs) and then combine it with spironolactone (SP) in order to clinically compare the efficiency of both formulations against acne vulgaris. The BEO-loaded NPs formulations were fabricated by the thin-film hydration and optimized by 32 factorial design. NPs’ assessments were conducted by measuring entrapment efficiency percent (EE%), particle size (PS), polydispersity index (PDI), and zeta potential (ZP). In addition, the selected BEO-NPs formulation was further combined with SP and then examined for morphology employing transmission electron microscopy and three months storage stability. Both BEO-loaded NPs selected formula and its combination with SP (BEO-NPs-SP) were investigated clinically for their effect against acne vulgaris after an appropriate in silico study. The optimum BEO-NPs-SP showed PS of 300.40 ± 22.56 nm, PDI of 0.571 ± 0.16, EE% of 87.89 ± 4.14%, and an acceptable ZP value of −29.7 ± 1.54 mV. Molecular modeling simulations showed the beneficial role of BEO constituents as supportive/connecting platforms for favored anchoring of SP on the Phosphatidylcholine (PC) interface. Clinical studies revealed significant improvement in the therapeutic response of BEO-loaded NPs that were combined with SP over BEO-NPs alone. In conclusion, the results proved the ability to utilize NPs as a successful nanovesicle for topical BEO delivery as well as the superior synergistic effect when combined with SP in combating acne vulgaris.
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