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2003, Number 3

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Dermatología Cosmética, Médica y Quirúrgica 2003; 1 (3)

Vitiligo: problems and solutions

Lotti TM

Language: Spanish
References: 21
Page: 184-187
PDF size: 147.80 Kb.


ABSTRACT

Vitiligo is a common, chronic and disfiguring skin and hair disorder affecting approximately 1-2% of the world population and the treatment is difficult. In this paper the authors try to answer three major questions: Can the progression of the disease be stopped? Can hyperpigmentation of the non-affected skin be avoided during treatment? Is 100% repigmentation possible? The reply includes the following explanations and proposals.
Vitiligo is progressive in 73.6% of cases and regressive in 1.3%. Koebner phenomenon and mucosal involvement are signs of significant progression. In 89% of the cases we can arrest patch extension in non-segmental vitiligo with oral mini-pulse corticosteroid therapy, and extension of segmental vitiligo can be blocked with PUVA therapy.
Phototherapy and photochemotherapy must be avoided in cases of hyperpigmentation of non-affected skin. This hyperpigmentation can be avoided with application of topical corticosteroids or narrow band focused microphototherapy. Topical corticosteroids should be used in cases of localized vitiligo, but not in segmental vitiligo. Good results have been obtained in generalized vitiligo, but the possible side effects do not recommend this as first choice treatment. Early lesions, especially these localized on the face and neck, respond best and most quickly to topical steroids and this treatment is most effective on vitiligo patches of dark-skinned subjects. Narrow band microphototherapy and melanocyte grafting and transplantation or suction epidermal grafting have been reported to result in 100% repigmentation on limited and stable patches of vitiligo. There is no sure cure and that the outcome of possible treatments is actually unpredictable.


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