Phototherapy for Vitiligo

Bae, Jung Min; Jung, Han Mi; Hong, Bo Young; Lee, Joo Hee; Choi, Won Joon; Lee, Ji Hae; Kim, Gyong Moon

doi:10.1001/jamadermatol.2017.0002

Cited by 169 publications

(113 citation statements)

References 46 publications

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“…As opções de tratamento incluem fármacos tópicos, fármacos orais e técnicas de fototerapia para o vitiligo, entretanto, nenhum destes tratamentos ocasiona a cura da doença 6 . Para o vitiligo segmentar, que afeta pequenas áreas do corpo, são recomendados medicamentos tópicos e fototerapia com Excimer Laser.…”

Section: Tratamento Clínicounclassified

“…Para o vitiligo segmentar, que afeta pequenas áreas do corpo, são recomendados medicamentos tópicos e fototerapia com Excimer Laser. Já no vitiligo generalizado é indicada fototerapia com os métodos Psoralen Plus Ultraviolet A (PUVA) e Narrowband Ultraviolet B (NB-UVB) 6 .…”

Section: Tratamento Clínicounclassified

“…Dessa forma, essa técnica vem sendo gradualmente substituída pela Narrowband Ultraviolet B (NB-UVB), que além de apresentar menos efeitos adversos, possui maior eficiência 18 . Em estudo realizado, a resposta global ao tratamento com fototerapia PUVA foi inferior à do NB-UVB, corroborando com dados de outras pesquisas já realizadas 6 . Hoje, o NB-UVB é considerado a primeira linha no tratamento clínico do vitiligo generalizado 20 .…”

Section: Fototerapiaunclassified

“…O tratamento do vitiligo engloba terapias clínicas, estéticas e cirúrgicas que visam limitar a progressão da doença, promover a repigmentação das áreas afetadas e prevenir recidivas 5 . No tratamento clínico dos pacientes encontram-se várias opções terapêuticas, dentre elas, medicamentos tópicos, corticoides orais, imunobiológicos e fototerapia 6 . A escolha da melhor abordagem clinica depende da extensão da lesão e da estabilidade da doença.…”

Section: Introductionunclassified

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Aspectos sobre a etiopatogênese e terapêutica do vitiligo

Mendonça

Aquino

Horbilon

et al. 2020

Rev. Med. (São Paulo)

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O vitiligo é uma doença cutânea crônica caracterizada por despigmentação da pele, sendo associada com desfiguração estética e considerável desconforto psicológico, representando grandes desafios em termos de cuidados dermatológicos. A partir do conhecimento do impacto psicossocial desta doença para o paciente e os desafios do seu tratamento pela medicina, este trabalho teve como objetivos destacar os principais aspectos etiopatogênicos do vitiligo, bem como, apresentar as opções terapêuticas atuais para o manejo da doença. Método: Revisão bibliográfica narrativa, utilizando-se as bases de dados Pubmed (US National Library of Medicine) e Portal Capes. A busca dos trabalhos foi realizada no ano de 2018, utilizando-se os seguintes Descritores em Ciências da Saúde: Vitiligo; Autoimunidade; Repigmentação; Tratamento Farmacológico; Fototerapia; Cosméticos; Cirurgia; Enxerto de tecido. Foram selecionados 26 artigos publicados no período de 2011 a 2018 que apresentaram conteúdos relacionados aos objetivos deste estudo. Resultados: O vitiligo desenvolve-se pela associação da predisposição genética e exposição a fatores ambientais. O tratamento tem o objetivo de limitar a progressão da doença, promover repigmentação das áreas afetadas e prevenir recidivas; podendo ser dividido em clínico, estético e cirúrgico. Os medicamentos tópicos, os sistêmicos, a fototerapia e os recentes imunobiológicos constituem tratamentos clínicos. O tratamento estético é representado pela camuflagem cosmética e o cirúrgico é indicado para aqueles que apresentam doença estável não responsiva a terapia clínica. Conclusão: O tratamento em geral é realizado pela associação de terapias, razão pela qual deve ser individualizado para cada paciente. O início precoce do tratamento está associado a um prognóstico mais favorável. Torna-se de extrema importância não negligenciá-lo além de conhecer inovações terapêuticas, tendo em vista o potencial estigmatizante da doença; melhorando assim a prática clínica e a qualidade de vida dos pacientes.

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Section: Tratamento Clínicounclassified

Section: Fototerapiaunclassified

Section: Introductionunclassified

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Aspectos sobre a etiopatogênese e terapêutica do vitiligo

Mendonça

Aquino

Horbilon

et al. 2020

Rev. Med. (São Paulo)

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“…3 Corticosteroid, calcineurin inhibitors and 308 nm-excimer laser play a role in active and localized disease, inducing immunosuppression; photo-chemotherapy, UVB phototherapy and narrowband UVB phototherapy are also other valid treatments for generalized vitiligo. 4 While surgery techniques are mainly based on autologous transplanting of melanocytes. 1,5 However, despite the presence of several therapeutic options, all these therapeutic modalities show limited responses.…”

Section: Introductionmentioning

confidence: 99%

<p>The Usefulness of Platelet-Rich Plasma (PRP) for the Treatment of Vitiligo: State of the Art and Review</p>

Mercuri

Vollono

Paolino

2020

DDDT

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Introduction: Vitiligo is an acquired, idiopathic disorder clinically characterized by amelanotic lesions on the skin which cause significant impairment of patients' quality of life. A variety of treatments have been proposed, with inconsistent results. In the last decades, the use of platelet-rich plasma (PRP) is receiving increasing interest as a potential effective technique in the treatment of several dermatological diseases, including vitiligo. Objective: We conducted a review with the aim to identify studies that documented the use of PRP for vitiligo. Materials and Methods: Electronic databases of MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 2019 have been searched using different combinations of the following terms: "platelet-rich plasma", "platelet gel", "platelet-rich fibrin", "PRP" and "vitiligo". Results: We identified 6 clinical studies consistent with our research, with a total of 253 patients, listing and discussing the obtained results. In all reports, all treated patients showed a stable vitiligo, and a significantly higher improvement in the PRP groups was always observed compared to control groups. Regarding the side effects, PRP in vitiligo patients is useful and without important side effects. Conclusion: PRP is a promising treatment for stable vitiligo lesions in different body sites. The possible use of PRP in combination with traditional therapeutic options and the standardization of processing protocols represents a very fertile field for future research. Larger clinical trials with longer time of observation would provide solid evidence regarding the effectiveness of PRP for the treatment of vitiligo.

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Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

et al. 2019

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IMPORTANCE Topical calcineurin inhibitors (TCIs), including tacrolimus and pimecrolimus, have been widely used for the treatment of vitiligo; however, the efficacy of TCI monotherapy is often underestimated. OBJECTIVES To estimate the treatment responses to both TCI monotherapy and TCI accompanied by phototherapy for vitiligo, based on relevant prospective studies, and to systematically review the mechanism of action of TCIs for vitiligo treatment. DATA SOURCES A comprehensive search of the MEDLINE, Embase, Web of Science and Cochrane Library databases from the date of database inception to August 6, 2018, was conducted. The main key words used were vitiligo, topical calcineurin inhibitor, tacrolimus, pimecrolimus, and FK506. STUDY SELECTION Of 250 studies initially identified, the full texts of 102 articles were assessed for eligibility. A total of 56 studies were identified: 11 studies on the TCI mechanism, 36 studies on TCI monotherapy, 12 studies on TCI plus phototherapy, and 1 study on TCI maintenance therapy. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data on study design, patients, intervention characteristics, and outcomes. Random-effects meta-analyses using the generic inverse variance weighting were performed for the TCI monotherapy and TCI plus phototherapy groups. MAIN OUTCOMES AND MEASURES The primary outcomes were the rates of at least mild (Ն25%), at least moderate (Ն50%), and marked (Ն75%) repigmentation responses to treatment. These rates were calculated by dividing the number of participants in an individual study who showed the corresponding repigmentation by the total number of participants who completed that study. RESULTS In the 56 studies included in the analysis, 46 (1499 patients) were selected to evaluate treatment response. For TCI monotherapy, an at least mild response was achieved in 55.0% (95% CI, 42.2%-67.8%) of 560 patients in 21 studies, an at least moderate response in 38.5% (95% CI, 28.2%-48.8%) of 619 patients in 23 studies, and a marked response in 18.1% (95% CI, 13.2%-23.1%) of 520 patients in 19 studies after median treatment duration of 3 months (range, 2-7 months). In the subgroup analyses, face and neck lesions showed an at least mild response in 73.1% (95% CI, 32.6-83.5%) of patients, and a marked response in 35.4% (95% CI, 24.9-46.0%) of patients. For TCI plus phototherapy, an at least mild response to TCI plus phototherapy was achieved in 89.5% (95% CI, 81.1-97.9%) of patients, and a marked response was achieved in 47.5% (95% CI, 30.6-64.4%) of patients. CONCLUSIONS AND RELEVANCE The use of TCIs, both as a monotherapy and in combination with phototherapy, should be encouraged in patients with vitiligo.

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Phototherapy for Vitiligo

Cited by 169 publications

References 46 publications

Aspectos sobre a etiopatogênese e terapêutica do vitiligo

Aspectos sobre a etiopatogênese e terapêutica do vitiligo

<p>The Usefulness of Platelet-Rich Plasma (PRP) for the Treatment of Vitiligo: State of the Art and Review</p>

Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

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