medigraphic.com
ISSN 0210-5187 (Electronic)

2006, Number 2

<< Back Next >>

Med Cutan Iber Lat Am 2006; 34 (2)

Vitiligo: main therapeutic options

Lázaro TAC, Sánchez SMP

Language: Spanish
References: 43
Page: 81-88
PDF size: 251.98 Kb.


ABSTRACT

Vitiligo is an acquired cutaneous disorder of the pigmentation characterized by the appearance of sharply circumscribed, cosmetically disturbing, white spots, in which some or all of the melanocytes in the epidermis are selectively destroyed. The etiology remains unknown, though it is believed that there should be an important influence of the immune system in its development. Seemingly it represents a banal pathology nevertheless, supposes often a great aesthetic problem in the persons who endure it. Numerous therapeutic options exist but none of them definitive, being the basic steps the photochemotherapy, which aim is to stimulate the melanocytic proliferation and the melanin production; the immunomodulators, effective in the detention of the progression of the disease on having acted like suppressing of the autoimmunity and the different surgical techniques of the vitiligo, based on the transplant of melanocytes. Patients can use cosmetics that will help to camouflage the hipopigmented macules and always sunscreens should be given to minimize risk of sunburn, we must not forget that these patients are unprotected of their natural photoprotector: the melanin.


REFERENCES

  1. Mosher DB, Fitzpatrick TB, Hori Y, Ortonne JP: Trastornos de los melanocitos, En: Dermatología en medicina general, editado por Editorial Médica panamericana, MT de Alvear. Buenos Aires-Argentina, 1997;1: 949-1044.

  2. Hertz KC, Gazze LA, Kirkpatrick CH, Katz SI: Autoinmune vitiligo: Detection of antibodies to melanin-producing cells, New Eng J Med, 1977,297:634-7.

  3. Naughton GK et al: Detection of antibodies to melanocytes in vitiligo by especific inmunoprecipitation, J Invest Dermatol 1983;81:540.

  4. Asthana D, Fujii Y, Huston GE, Lindstrom J: Regulation of antibody production by helper T cell clones in experimental autoimmune myasthenia gravis is mediated by IL-4 and antigen-specific T cell factors, Clin Immunol Immunopathol, 1993;67:240-8.

  5. Nakajim A, Hirose S, Yagitu H, Okumura K: Roles of IL-4 and IL-12 in the development of lupus in NZB/W F1 mice, J Immunol,1977;158:1466-72.

  6. Persot H et al: Vitiligo, thyreopathies et autoimmunisation, Lyon Med 1973;230:325.

  7. Dawber RPR: Clinical association of vitiligo, Postgrad Med J 1970;46:276.

  8. Grunnet I, Hoitz J, Reymann F, Schwartz M: Vitiligo and pernicious anemia, Arch Dermatol 1970;101:821.

  9. Alabi GO, Falope ZF, Lekwauwa UG: Coexisting malignant melanoma and vitiligo in a Nigerian. West Afr J Med 10:443-6.

  10. Yacoub M, Ben Said H et al: Myasthenia in children. A propos of 3 cases. Pediatrie 1991;46:669-72.

  11. Lassus A, Apajalahti A, Blomquist K, Mustakallio M, Kistala U: Vitiligo and neoplasms: Acta Derm Venéreol (Stockh) 1972;52:229-32.

  12. Clayton RS: A double blind trial of 0.05% clobetasol proprionate as the treatment of vitiligo, Br J Dermatol 1997;96:71.

  13. Parsad Davinder MD, Saini Reeti DNB, Junega Archana DVD: Combination of clobetasol and tretinoin in vitiligo, Int J Dermatol 2000;39:639-40.

  14. Handa S, Pandhi R, Kaur I: Vitiligo: A retrospective comparative análisis of treatment modalities in 500 patients, J Dermatol 2001;28:461-6.

  15. Soo Min K, Han-Seung L, Seung-Kyung H: The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patients, Int J Dermatol 1999;38:546-50.

  16. Radakovic S, Fürnsinn-Friedl AM, Hönigsmann H, Tanew A: Oral dexamethasone pulse treatment for vitiligo, J Am Acad Dermatol 2001;44:814-7.

  17. Seiter S, Ugurel S, Tilgen W, Reinhold U: Use of high-dose methylprednisolone pulse therapy in patients with progresive and stable vitiligo, Int J Dermatol 2000;39:624-7.

  18. Njoo MD, Spuls PI, Bos JD, Westerhof W, Bossuyj FM: Nonsurgical repigmentation therapies in vitiligo, Arch Dermatol 1998;134:1532-40.

  19. Peris JB, Stübing G, Vanaclocha B: Lino, en Fitoterapia Aplicada, editado por MICOF. Valencia, 1995;p345-6.

  20. Ortel B, Tanew A, Hönisgsmann H: Treatment of vitiligo with Khellin and ultraviolet A, J Am Acad Dermatol 1988;18:693-70.

  21. Hofer A, Kerl H, Wolf P: Long-term results in the treatment of vitiligo with oral khellin plus UVA, Eur J Dermatol 2001;11:225-9.

  22. Azmi M: Vitiligo repigmentation with anapsos Polypodium Leucotomus. Int J Dermatol 1989;28:479.

  23. Chiaverini C, Passerson T, Ortonne JP: Treatment of vitiligo by topical calcipotriol, JEADV 2002;16:137-8.

  24. Knoell MD, Schreiber MD, Milgraum MD: Treatment of vitiligo with the ultrapulse carbon dioxide laser in patients concomitantly receiving oral psoralen plus UV-A therapy, Arch Dermatol 1997;133:1605-6.

  25. Akyol M, Celik VK, Ozcelik S, Polat M, Marufihah M, Atalay A: The effects of vitamin E on the skin lipid peroxidation and the clinical improvement in vitiligo patients treated with PUVA, Eur J Dermato 2002;12:24-6.

  26. El Mofty M, Zaher H et al: PUVA and PUVB in vitiligo-are they equally effective?, Photodermatol Photoimmunol Photomed 2001;17:159-63.

  27. Lotti MT, Menchini G, Andreassi L: UV-B radiation microphototherapy. An elective treatment for segmental vitiligo, JEADV 1999;13:102-8.

  28. Cormane RH, Siddigini AH, Westerhof W, Schutgens RBH, Hu R, Mohan VI: Treatment of vitiligo with L-phenylalanine and light, Br J Dermatol, 1986;115:587.

  29. Schulpis CH, Antoniou C, Michar T, Stratigos J: Phenylalanine plus ultraviolet light: preliminary report of a promising treatment for childhood vitiligo, Pediatr Dermatol 1989;6:332-5.

  30. Camacho F, Mazuecos J: Treatment of vitiligo with oral and topical phenylalanine: 6 years of experience, Arch Dermatol, 1999;135:216-7.

  31. Nihei Y, Nishibu A, Kaneko F: Suplatast Tosilate (IPD), a new immunoregulator, is effective in vitiligo treatment, J Dermatol 1998;25:250-5.

  32. Nagai K, Ichimiya M, Yokoyama K, Hammamoto Y: Successful treatment of non-segmental vitiligo: systemic therapy with sex hormone-thyroid powder mixture, Horm Res 2000;54:316-7.

  33. Plettenberg H, Assman T, Ruzicka T. Chilhood Vitiligo and tacrolimus. Arch Dermatol 2003;139:651-4.

  34. Tanghetti E. Combination of high- intensity, localized UVB and tacrolimus for the treatment of vitiligo. 61st Annual Meeting of the American Academy of Dermatology 2003,21-26. Abstract P579.

  35. Kawalek A, Spencer J, Phelps R. Combined Excimer laser and topical tacrolimus for the treatment of vitiligo: a pilot study. Dermatol Surgery 2004;30:130-5.

  36. Van Geel N, Ongenae K, Naeyaert JM: Surgical techniques for vitiligo: A review, Dermatology 2001;202:162-6.

  37. Riley PA: Mechanism of pigment cell toxicity produced by hydroxyanisole, J Pathol 1970;101:163-9.

  38. Zouboulis CC: Cryosurgery in dermatology, Eur J Dermatol 1998;8:466-74.

  39. Radmanesh M: Depigmentation of the normally pigmented patches in universal vitiligo patients by cryotherapy, JEADV 2000;14:149-52.

  40. Polla LL, Margolis RJ, Dover JS, et al: Melanosomes are a primary target of Q-switched ruby laser irradiation in guinea pig skin, J Invest Dermatol 1987;89:282-7.

  41. Kim YJ, Chung BS, Choi KC: Depigmentation therapy with Q-switched ruby laser after tanning in vitiligo universalis, Dermatol Surg 2001;27:969-70.

  42. Njoo MD, Vodegel RM, Westerhof W: Depigmentation therapy in vitiligo universalis with topical 4-methoxyphenol and the Q-switched ruby laser, J AM Acad Dermatol 2000;42:760-9.

  43. Fesq H, Brockow K, Strom K, Mempel M, Ring J, Abeck D: Dihydroxyacetone in a New Formulation-A powerful therapeutic option in vitiligo, Dermatology, 2001;203:241-3.




2020     |     www.medigraphic.com