Current and emerging therapy for the management of vitiligo
Current and emerging therapy for the management of vitiligo
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当前和新兴的白癜风治疗方法
DOI：
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
N. van Geel
中科院分区：
文献类型：
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作者：
A. Borderé;J. Lambert;N. van Geel
白癜风是一种获得性皮肤色素沉着疾病，全球发病率为0.5%至2%。白癜风的发病机制有三种主要的假说，它们彼此并不排斥：生化/细胞毒性、神经和自身免疫。最近的数据提供了强有力的证据支持自身免疫性发病机制的白癜风。由于白癜风会对生活质量产生重大影响，因此可以考虑治疗，最好在疾病活跃时尽早开始治疗。目前的治疗方式旨在阻止疾病的进展和实现重新着色。治疗方法包括皮质类固醇、局部免疫调节剂、光（化学）疗法、手术、联合疗法和正常色素皮肤的脱色。局部3类皮质类固醇可用于局部白癜风。在白癜风中使用局部免疫调节剂（TIMs）似乎与局部类固醇同样有效，特别是在面部和颈部使用时。在光（化疗）治疗中，窄带紫外线b治疗（NB-UVB）似乎优于补骨脂素紫外线a治疗（PUVA）和宽带紫外线b。在外科技术中，裂厚移植和表皮水疱移植被证明是有效的方法，尽管非培养表皮悬浮技术具有许多优点，似乎是一个有前途的发展。如果白癜风对身体的影响超过60%到80%，可以考虑进行脱色治疗。补充疗法如Polypodium leuotomos与UVB治疗相结合显示出有希望的结果。目前还没有白癜风的病因治疗方法。更多的白癜风治疗的随机对照试验是必要的。
Vitiligo is an acquired cutaneous disorder of pigmentation, with an incidence of 0.5% to 2% worldwide. There are three major hypotheses for the pathogenesis of vitiligo that are not exclusive of each other: biochemical/cytotoxic, neural and autoimmune. Recent data provide strong evidence supporting an autoimmune pathogenesis of vitiligo. As vitiligo can have a major effect on quality of life, treatment can be considered and should preferably begin early when the disease is active. Current treatment modalities are directed towards stopping progression of the disease and achieving repigmentation. Therapies include corticosteroids, topical immunomodulators, photo(chemo)therapy, surgery, combination therapies and depigmentation of normally pigmented skin. Topical class 3 corticosteroids can be used for localized vitiligo. The use of topical immunomodulators (TIMs) in vitiligo seems to be equally effective as topical steroids, especially when used in the face and neck region. In photo(chemo)therapy, narrowband ultraviolet-B therapy (NB-UVB) seems to be superior to psoralen ultraviolet-A therapy (PUVA) and broadband UVB. In surgical techniques, split-thickness grafting and epidermal blister grafting were shown to be effective methods, although the non-cultured epidermal suspension technique has many advantages and seems to be a promising development. Depigmentation therapy can be considered if vitiligo affects more than 60% to 80% of the body. Complementary therapies such as Polypodium leucotomos show promising results in combination with UVB therapy. No causative treatment for vitiligo is currently available. More randomized controlled trials on the treatment of vitiligo are necessary.
DOI：
10.1034/j.1600-0749.2003.00032.x
发表时间：
2003-06-01
期刊：
PIGMENT CELL RESEARCH
影响因子：
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作者：
Alkhateeb, A;Fain, PR;Spritz, RA
通讯作者：
Spritz, RA