INTRODUCTION: Vitiligo is a skin disorder characterized by a progressive depigmentation, which is caused by the loss of melanocytes at the cutaneous level. A shift of the immune system with a prevalence of T helper (Th)1/Th17 response instead of a Tregs/Th2 one and may be part of etiology of 10 vitiligo. AREAS COVERED: This review describes the major points of vitiligo onset and shows the cutting-edge results in the field of low-dose medicine in the treatment of dermatologic diseases and, in particular. in vitiligo. In this review on advances in vitiligo pharmacotherapy, the most pertinent recent publications are reported. Electronic databases such as PubMed were searched for terms 'low-dose medicine' or 'low dose and vitiligo' or 'low dose and psoriasis.' EXPERT OPINION: The availability of a systemic treatment for vitiligo, based on the oral administration of low-dose activated signaling molecules represents an opportunity for the dermatologists to overcome some specific pitfalls of currently available therapeutic protocols.
- Klíčová slova
- IL-1, IL-10, IL-4, TNF-α, anti-IL-1 antibodies, autoimmunity, basic-fibroblast growth factor, inflammation, low-dose medicine, oxidative stress, sequential kinetic activation, vitiligo,
- MeSH
- cytokiny metabolismus terapeutické užití MeSH
- keratinocyty fyziologie MeSH
- lidé MeSH
- melaniny metabolismus MeSH
- melanocyty fyziologie MeSH
- oxidační stres MeSH
- signální transdukce MeSH
- vitiligo farmakoterapie imunologie patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- cytokiny MeSH
- melaniny MeSH
The classification of vitiligo is mandatory for clinical and research purposes. Although the etiology and pathobiology of vitiligo remain unknown, a working classification of vitiligo is imperative for the scientific community to communicate. The authors delineate herein their efforts for vitiligo classification utilizing clinical, genetic, pathobiological, epidemiological, and molecular characteristics of vitiligo. These different classification approaches may aid clinicians to identify the most suitable treatment for each individual vitiligo subject.
- MeSH
- lidé MeSH
- stupeň závažnosti nemoci * MeSH
- vitiligo klasifikace epidemiologie etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The absence of causal and poor results of conservative treatment of vitiligo in many cases leads to the search for different treatment possibilities such as surgical treatment. All techniques of surgical treatment of vitiligo are based on autologous melanocytes grafting into the achromatic skin lesions. Individual surgical methods for such treatment differ in the preparation of recipient skin site, in harvesting and processing of autologous melanocytes before their grafting. The surgical treatment is useful for patients with stabile achromatic skin lesions up to 30% of total body surface area in cases in which medical treatment has failed. This article is a review of different surgical techniques in surgical treatment of vitiligo.
- MeSH
- lidé MeSH
- melanocyty transplantace MeSH
- transplantace kůže MeSH
- vitiligo chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
A rational approach to hypopigmented disorders needs a clear and widely accepted classification and meta-analysis of the literature to position the medical, physical, surgical, and combined treatments available in terms of safety and effectiveness profiles. Best available scientific evidence must be rationally adapted to the patient's expectations and to the clinical presentation of the hypopigmentary disease, to reach the most valid final results.
- MeSH
- antioxidancia terapeutické užití MeSH
- dermatologické látky aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- fototerapie metody MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- hypopigmentace diagnóza farmakoterapie terapie MeSH
- kosmetické přípravky terapeutické užití MeSH
- laserová terapie MeSH
- lidé MeSH
- přípravky chránící proti slunci terapeutické užití MeSH
- PUVA terapie metody MeSH
- terapie ultrafialovými paprsky metody MeSH
- vitaminy terapeutické užití MeSH
- vitiligo diagnóza farmakoterapie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antioxidancia MeSH
- dermatologické látky MeSH
- hormony kůry nadledvin MeSH
- kosmetické přípravky MeSH
- přípravky chránící proti slunci MeSH
- vitaminy MeSH
Vitiligo is characterized by the loss of skin pigmentation due to the destruction of melanocytes. Its treatment is usually difficult. For stable cases, melanocyte transplantation is the method of choice. A newly developed treatment with recombined human/porcine skin methodology, permitting easy handling of the graft, is described in the present work. In five vitiligo patients, autologous epidermal cells were obtained from pigmented thin skin biopsies. The cells were cultured on a dried cell-free porcine dermis by the 3T3 feeder layer technique. After 10 days melanocytes were regularly dispersed in confluent keratinocyte cultures. Upside-down delivery of epidermal cells was used. The epidermal layer was directly applied onto a dermabraded vitiligo lesion, with porcine dermis covering the lesion. Pigmentation started to be visible 4-6 weeks after grafting. After using the above described methodology, the pigmentation appeared in the range of 65-80% of the grafted area. Additional UVA irradiation enhanced the treatment success up to 100%. The surgical vitiligo treatment appears to be a reasonable method of choice in stable vitiligo cases of a disease lasting for at least two years, which means for approximately 5% of all vitiligo patients.
- MeSH
- autologní transplantace MeSH
- dospělí MeSH
- keratinocyty fyziologie MeSH
- kombinovaná terapie MeSH
- kultivační techniky * metody MeSH
- kůže cytologie MeSH
- lidé MeSH
- melanocyty fyziologie MeSH
- prasata MeSH
- terapie ultrafialovými paprsky MeSH
- transplantace kůže * MeSH
- vitiligo chirurgie terapie MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
By investigating a group of 67 unrelated adult persons suffering from vitiligo it was found that antigens HLA-A2 and HLA-Dw7 differed in their frequencies in comparison to those observed in the healthy population. The antigen HLA-A2 was found in 76.12% of patients compared to 43.95% in the control group (chi 2 = 25.61, P < 0.005, RR = 4.07). The antigen HLA-Dw7 was present in 56.71% of patients compared to 15.8% in the healthy population (chi 2 = 26.55, P < 0.0001, RR = 6.98). No other significant deviations in the frequencies of investigated antigens were observed.
- MeSH
- dítě MeSH
- dospělí MeSH
- HLA-A2 antigen analýza MeSH
- HLA-D antigeny analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- senioři MeSH
- vitiligo imunologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
- Názvy látek
- HLA-A2 antigen MeSH
- HLA-D antigeny MeSH
The patient, a 14-year-old girl, suffered from arthralgias which occurred after tonsillitis. Two months later she developed edema of the left lower extremity, finger flexion contractures and induration of the skin of the left leg, associated with hypergammaglobulinemia, peripheral hypereosinophilia, elevated ESR and a positivity of ANA and anti ds-DNA antibodies. A biopsy of the inguinal lymph node, performed because of left inguinal and retroperitoneal lymphadenopathy, showed only slight inflammatory activation and a granulomatous reaction after lymphography. A few days after the lymphography linear erythema evolving later into hyperpigmentation and corresponding to the superficial lymphatics developed on the left side of the body, very probably as a reaction to the patent-blue dye. Deep en-block skin biopsy confirmed the diagnosis of eosinophilic fasciitis (EF). After two years of therapy with prednisone and d-penicillamine the patient felt well, and her flexion contractures resolved, ANA were positive, while anti ds-DNA were negative. Linear hyperpigmentation persisted, and linear scleroderma-like changes developed on the left lower limb. A vitiligo-like lesion on the right foot which occurred after one year of therapy persisted. The possible risk of developing systemic connective tissue disease necessitates the long term follow up of this patient.
- MeSH
- antinukleární protilátky krev MeSH
- autoprotilátky krev MeSH
- biopsie MeSH
- eozinofilie diagnóza farmakoterapie MeSH
- fasciitida diagnóza farmakoterapie MeSH
- kožní nemoci etiologie patologie MeSH
- kůže patologie MeSH
- lidé MeSH
- lymfatické uzliny patologie MeSH
- mladiství MeSH
- obrovskobuněčný granulom patologie MeSH
- systémová sklerodermie diagnóza MeSH
- vitiligo diagnóza MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- antinukleární protilátky MeSH
- autoprotilátky MeSH
- MeSH
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- metyrapon terapeutické užití MeSH
- mladiství MeSH
- předškolní dítě MeSH
- vitiligo farmakoterapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- metyrapon MeSH
- MeSH
- BCG vakcína aplikace a dávkování MeSH
- dinitrochlorbenzen aplikace a dávkování MeSH
- lidé MeSH
- melanom diagnóza terapie MeSH
- vitiligo etiologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- BCG vakcína MeSH
- dinitrochlorbenzen MeSH
- MeSH
- alkalická fosfatasa krev MeSH
- cholinesterasy krev MeSH
- dítě MeSH
- dospělí MeSH
- fyzioterapie (techniky) * MeSH
- gama-glutamyltransferasa krev MeSH
- helioterapie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- transaminasy krev MeSH
- vitiligo enzymologie terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- alkalická fosfatasa MeSH
- cholinesterasy MeSH
- gama-glutamyltransferasa MeSH
- transaminasy MeSH
