Reviewing the current treatment approaches for vitiligo – analysis of literature
DOI:
https://doi.org/10.12775/JEHS.2023.49.01.001Keywords
Vitiligo, Therapeutics, Molecular Targeted TherapyAbstract
Introduction:
Vitiligo is a relatively common systemic, idiopathic disease within the spectrum of pigmentary disorders. Clinically, it presents as depigmented patches on the skin, resulting from the loss or dysfunction of melanocytes. Despite not impacting life expectancy, vitiligo should not be perceived merely as a cosmetic defect, given its potential to burden daily life and the frequent experiences of stigmatization by patients.
Aim of the study:
The aim of this study was to summarize the existing knowledge regarding the treatment of vitiligo. The current treatments in practice, alongside potential new methods, were summarized and described.
Materials and methods:
The literature available in the PubMed database was reviewed using the following keywords: “Vitiligo”, “Vitiligo treatment”, “Vitiligo new treatment methods”, “Targeted therapies for vitiligo”.
Conclusions:
Vitiligo is a multifactorial and still inadequately understood disorder, leading to a lack of fully safe and effective treatment. As in the management of other diseases, there should be a push for highly personalized treatments for patients. This approach takes into account the differences among patients and ensures a better chance of a positive clinical response. To achieve this goal, it's necessary to explore new treatment methods and expand ongoing research efforts. Also, raising awareness of vitiligo is key to increasing acceptance, support and understanding for those affected by the disease.
References
Barman S. Switra and its treatment in Veda. Ancient Science of Life. AVP Research Foundation. 1995;15(1):71–74. India.
Singh G, Ansari Z, Dwivedi RN. Letter: Vitiligo in ancient Indian medicine. Arch Dermatol. 1974 Jun;109(6):913.
https://doi.org/10.1001/archderm.1974.01630060081032
Bergqvist C, Ezzedine K. Vitiligo: A Review. Dermatology. S. Karger AG. 2020;236(6):571–92.
https://doi.org/10.1159/000506103
Lai YC, Yew YW, Kennedy C, Schwartz RA. Vitiligo and Depression: A Systematic Review and Meta-Analysis of Observational Studies. Br J Dermatol. 2017;177:708–18.
https://doi.org/10.1111/bjd.15199
Placek W, Czajkowski R, Chabior A. Bielactwo nabyte. Dermatologia Praktyczna. 2009;3:9-18. Poland.
Frisoli ML, Essien K, Harris JE. Vitiligo: Mechanisms of Pathogenesis and Treatment. Annu Rev Immunol. 2020;38.
https://doi.org/10.1146/annurev-immunol-100919-023531
Van Geel N, Speeckaert R, Melsens E, Toelle SP, Speeckaert M, De Schepper S, et al. The distribution pattern of segmental vitiligo: Clues for somatic mosaicism. Br J Dermatol. 2013;168(1):56–64.
https://doi.org/10.1111/bjd.12013
Lerner AB. Part V: Clinical Applications of Psoralens, and Related Materials: Vitiligo From the Section of Dermatology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut. J Invest Dermatol. 1959;32:285–308.
https://doi.org/10.1038/jid.1959.49
Basnet B, Bhushan A, Khan R, Kumar G, Sharma VK, Sharma A, et al. Plasma & urinary catecholamines & urinary vanillylmandelic acid levels in patients with generalized vitiligo. Indian J Med Res. 2018;147(4):384.
https://doi.org/10.4103/ijmr.IJMR_657_16
Nellhaus G. Acquired unilateral vitiligo and poliosis of the head and subacute encephalitis with partial recovery. Neurology (1970) 20(10):965.
https://doi.org/10.1212/wnl.20.10.965
Sharquie KE, Assaf F. Sweating in vitiligo in relation to electrical skin resistance. Clin Exp Dermatol. 1985;10:598–9.
https://doi.org/10.1111/j.1365-2230.1985.tb00632.x
Harris JE. Cellular stress and innate inflammation in organ-specific autoimmunity: Lessons learned from vitiligo. Immunol Rev. 2016;269(1):11–25.
https://doi.org/10.1111/imr.12369
Van den Wijngaard R, Wankowicz-Kalinska A, Le Poole C, Tigges B, Westerhof W, Das P. Local Immune Response in Skin of Generalized Vitiligo Patients. Lab Investig. 2000;80:1299–309.
https://doi.org/10.1038/labinvest.3780138
Chen GY, Nuñez G. Sterile inflammation: Sensing and reacting to damage. Nat Rev Immunol. 2010;10(12):826–837.
https://doi.org/10.1038/nri2873
Wu CS, Yu HS, Chang HR, Yu CL, Yu CL, Wu BN. Cutaneous blood flow and adrenoceptor response increase in segmental-type vitiligo lesions. J Dermatol Sci. 2000; 23(1):53–62.
https://doi.org/10.1016/S0923-1811(99)00090-0
Van Geel N, Mollet I, Brochez L, Dutré M, De Schepper S, Verhaeghe E, et al. New insights in segmental vitiligo: case report and review of theories. Br J Dermatol. 2012;166:240–6.
https://doi.org/10.1111/j.1365-2133.2011.10650.x
Gauthier Y, Cario-Andre M, Lepreux S, Pain C, Taïeb A . Melanocyte detachment after skin friction in non lesional skin of patients with generalized vitiligo. Br J Dermatol. 2003;148(1):95–101.
https://doi.org/10.1046/j.1365-2133.2003.05024.x
Puri N, Mojamdar M, Ramaiah A. In Vitro Growth Characteristics of Melanocytes Obtained From Adult Normal and Vitiligo Subjects. J Invest Dermatol. 1987;88:434–8.
https://doi.org/10.1111/1523-1747.ep12469795
Maresca V, Roccella M, Roccella F, Camera E, Del Porto G, Passi S, et al. Increased sensitivity to peroxidative agents as a possible pathogenic factor of melanocyte damage in vitiligo. J Invest Dermatol. 1997;109(3):310–13.
https://doi.org/10.1111/1523-1747.ep12335801
Czajkowski R, Męcińska-Jundziłł K. Current aspects of vitiligo genetics. Postep Dermatol Alergol. 2014;31:247-255.
https://doi.org/10.5114/pdia.2014.43497
Böhm M, Schunter J, Fritz K et al. S1 Guideline: Diagnosis and therapy of vitiligo.
J Dtsch Dermatol Ges. 2022;20(3):365-378.
https://doi.org/10.1111/ddg.14713
Taieb A, Picardo M. Clinical practice. Vitiligo. N Engl J Med. 2009;360:160-169.
https://doi.org/10.1056/NEJMcp0804388
Ezzedine K, Lim HW, Suzuki T, Katayama I, Hamzavi I, Lan CC, et al. Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference. Pigment Cell Melanoma Res. 2012;25:E1-13.
https://doi.org/10.1111/j.1755-148X.2012.00997.x
Masuria BL, Batra A, Kothiwala RK, Khuller R. Topical mometasone furoate for the treatment of childhood vitiligo. Indian Journal of Dermatology, Venereology, and Leprology. 1999;65(5):219.
Taieb AV, Alomar A, Böhm M, Dell’Anna ML, De Pase A, Eleftheriadou V, Ezzedine K, Gauthier Y, Gawkrodger DJ, Jouary T, Leone G. Guidelines for the management of vitiligo: the European Dermatology Forum consensus. British Journal of Dermatology. 2013;168(1):5-19.
Wazir SM, Paracha MM, Khan SU. Efficacy and safety of topical mometasone furoate 0.01% vs. tacrolimus 0.03% and mometasone furoate 0.01% in vitiligo. Journal of Pakistan Association of Dermatology. 2016;20(2):89-92.
Njoo MD, Spuls P, Bos JT, Westerhof W, Bossuyt PM. Nonsurgical repigmentation therapies in vitiligo: meta-analysis of the literature. Archives of dermatology. 1998;134(12):1532-40.
Felsten LM, Alikhan A, Petronic-Rosic V. Vitiligo: A comprehensive overview: Part II: Treatment options and approach to treatment. Journal of the American Academy of Dermatology. 2011;65(3):493-514.
https://doi.org/10.1016/j.jaad.2010.10.043
Lubaki LJ, Ghanem G, Vereecken P, Fouty E, Benammar L, Vadoud-Seyedi J, Dell’Anna ML, Briganti S, Picardo M, Heenen M. Time-kinetic study of repigmentation in vitiligo patients by tacrolimus or pimecrolimus. Archives of dermatological research. 2010;302(2):131-7.
https://doi.org/10.1007/s00403-009-0973-3
Lepe V, Moncada B, Castanedo-Cazares JP, Torres-Alvarez MB, Ortiz CA, Torres-Rubalcava AB. A double-blind randomized trial of 0.1% tacrolimus vs 0.05% clobetasol for the treatment of childhood vitiligo. Archives of dermatology. 2003;139(5):581-5.
https://doi.org/10.1001/archderm.139.5.581
Karagaiah P, Valle Y, Sigova J, Zerbinati N, Vojvodic P, Parsad D, Schwartz RA, Grabbe S, Goldust M, Lotti T. Emerging drugs for the treatment of vitiligo. Expert Opin Emerg Drugs. 2020;25(1):7-24.
https://doi.org/10.1080/14728214.2020.1712358
Fa Y, Lin Y, Chi XJ, Shi WH, Wang JL, Guo X, Geng JH, Liu HX, Zhang FR. Treatment of vitiligo with 308‐nm excimer laser: our experience from a 2‐year follow‐up of 979 Chinese patients. Journal of the European Academy of Dermatology and Venereology. 2017;31(2):337-40.
https://doi.org/10.1111/jdv.13917
Wu CS, Hu SC, Lan CC, Chen GS, Chuo WH, Yu HS. Low‐energy heliumneon laser therapy induces repigmentation and improves the abnormalities of cutaneous microcirculation in segmental‐type vitiligo lesions. The Kaohsiung journal of medical sciences. 2008;24(4):180-9.
https://doi.org/10.1016/S1607-551X(08)70115-3
Kanwar AJ, Mahajan R, Parsad D. Low-dose oral mini-pulse dexamethasone therapy in progressive unstable vitiligo. Journal of cutaneous medicine and surgery. 2013;17(4):259-68.
https://doi.org/10.2310/7750.2013.1205
Madarkar M, Ankad BS, Manjula R. Comparative study of safety and efficacy of oral betamethasone pulse therapy and azathioprine in vitiligo. Clinical Dermatology Review. 2019;3(2):121.
https://doi.org/10.4103/CDR.CDR_13_18
Fraczek A, Kasprowicz-Furmańczyk M, Placek W, Owczarczyk-Saczonek A. Surgical Treatment of Vitiligo. Int. J. Environ. Res. Public Health 2022;19,4812.
https://doi.org/10.3390/ijerph19084812
Singh A, Kanwar AJ, Parsad D, Mahajan R. Randomized controlled study to evaluate the effectiveness of dexamethasone oral minipulse therapy versus oral minocycline in patients with active vitiligo vulgaris. Indian Journal of Dermatology, Venereology, and Leprology. 2014;80(1):29.
https://doi.org/10.4103/0378-6323.125479
Singh H, Kumaran M, S, Bains A, Parsad D: A Randomized Comparative Study of Oral Corticosteroid Minipulse and Low-Dose Oral Methotrexate in the Treatment of Unstable Vitiligo. Dermatology 2015;231:286-290.
https://doi.org/10.1159/000433424
Taneja A, Kumari A, Vyas K, Khare AK, Gupta LK, Mittal AK. Cyclosporine in treatment of progressive vitiligo: An open-label, single-arm interventional study. Indian J Dermatol Venereol Leprol 2019;85:528-31
https://doi.org/10.4103/ijdvl.IJDVL_656_18
Rothstein B, Joshipura D, Saraiya A, et al. Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib. J Am Acad Dermatol. 2017;76(6):1054-1060.
https://doi.org/10.1016/j.jaad.2017.02.049
Vanderweil SG, Amano S, Ko WC, et al. A double-blind, placebo-controlled, phase-II clinical trial to evaluate oral simvastatin as a treatment for vitiligo. J Am Acad Dermatol. 2017;76(1):150–151.
https://doi.org/10.1016/j.jaad.2016.06.015
Lim HW, Grimes PE, Agbai O, Hamzavi I, Henderson M, Haddican M, et al. Afamelanotide and narrowband UV-B phototherapy for the treatment of vitiligo: a randomized multicenter trial. JAMA Dermatol. 2015;151(1):42–50.
https://doi.org/10.1001/jamadermatol.2014.1875
Taieb AV, Alomar A, Böhm M, Dell’Anna ML, De Pase A, Eleftheriadou V, Ezzedine K, Gauthier Y, Gawkrodger DJ, Jouary T, Leone G. Guidelines for Accepted Manuscript the management of vitiligo: the European Dermatology Forum consensus. British Journal of Dermatology. 2013 Jan;168(1):5-19.
https://doi.org/10.1111/j.1365-2133.2012.11197.x
Grimes PE, Miller MM. Vitiligo: Patient stories, self-esteem, and the psychological burden of disease. International journal of women's dermatology. 2018;4(1):32-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Daniel Ślusarczyk, Bartłomiej Żmuda, Wiktoria Jakubowska, Piotr Pisera, Aleksandra Kiełkowicz, Zuzanna Popińska, Filip Pactwa, Michał Żuberek
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 380
Number of citations: 0