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Therapeutic Update on Vitiligo

February 2015 | Volume 14 | Issue 2 | Features | 109 | Copyright © February 2015


Deborah S. Sarnoff MD FAAD FACP

Abstract
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table 1
Vitiligo is a common acquired skin disease of unknown etiology that results in depigmentation. It is clinically characterized by the development of white macules due to selective loss of melanocytes. Lesions typically develop in areas of friction, reflecting koebnerization. Depigmentation, while asymptomatic, may lead to diminished quality of life and severe psychological stress due to cosmetic concerns.1 There is increasing evidence that vitiligo is an autoimmune disorder that shows a genetic predisposition in about 18% of cases.2 It occurs in approximately 1% of the U.S. population with equal frequencies between men and women; half of all patients manifest the disease before 20 years of age.

Medical Treatments

Topical Steroids Calcineurin Inhibitors (tacrolimus = Protopic pimecrolimus = Elidel®) Vitamin D Analogues Systemic Steroids Vitamins
Calcineurin Inhibitors (tacrolimus = Protopic pimecrolimus = Elidel®)
Narrowband UVB (NB UVB) PUVA Laser Therapy Camouflage Depigmentation Therapy
PUVA
Punch Minigrafting Suction Blister Grafting Thin Dermoepidermal Grafts (Split-thickness Skin Grafts) Non Cultured Epidermal Suspensions Cultured Epidermis and Melanocytes
Suction Blister Grafting

References

  1. Alikhan Ali, Felsten Lesley M, et. al. Vitiligo: A Comprehensive Overview, Part I. J Am Acad Dermatol 2011;65:473-91.
  2. Mason CP, Gawkrodger DJ. Vitiligo presentation in adults. Clin Exp Dermatol 2005;30:344–5.