Updates and new medical treatments for vitiligo (Review)

Abstract

Vitiligo is a multifactorial disease characterized by the loss of skin pigment, which results in achromic macules and patches. There are currently several medical treatments available, which aim to arrest progression and induce skin repigmentation. These treatments alone or combined have exhibited varying degrees of pigmentation, and the majority are safe and effective. All therapies for vitiligo are limited, and no known treatment can consistently produce repigmentation in all patients. Individualized treatment is appropriate according to the location, clinical presentation and the presence of disease activity. The present review summarizes the medical treatments available for vitiligo: Systemic and topic pharmacological therapies, physical and depigmentation treatments. Several treatments are still underway and have not yet been approved. However, due to the promising preliminary results, these are also mentioned in the present review. Contents 1. Introduction 2. Pharmacological treatment 3. Physical therapy 4. Depigmentation therapies 5. Conclusions

Evaluation of combination use of phenytoin cream 1% and fractionalCO2laser in treatment of stablenonsegmentalvitiligo: A pilot study

“…The potential of phenytoin to suppress oxidative pathway by reducing norepinephrine (NE) and monoamine oxidase (MAO) which are well‐known factors to activate the oxidative stress and induce melanocytes damage, makes it a unique modality in treatment of vitiligo moreover one of the complex effect of phenytoin on immune system is CD + 8 T‐cell suppression. Furthermore, phenytoin has a direct stimulating effect on melanocytes and can preserve the integrity of melanosome membrane 13–16 . On the other hand, CO 2 laser induces inflammation and spongiosis in epidermis leads to increased absorption of topical agents 8,9 …”

Reply to Letter to the Editor re: Dry Eye and Meibomian Glands in Vitiligo

“…In agreement with them, we mentioned "recent use of drugs affecting the lacrimal unit" as an exclusion criterion. It is necessary to explain that topical cyclosporine A is not a conventional medicine in vitiligo treatment 4 , and none of our patients received this drug.…”

Unmet Medical Needs in Chronic, Non-communicable Inflammatory Skin Diseases

“…Currently, there are several drugs available, alone or combination, aiming to arrest progression and induce repigmentation of the skin. The degrees of repigmentation vary ( 172 ). Of note, there is no approved treatment for vitiligo repigmentation and current off-label therapies have limited efficacy.…”