Combination therapy of orally administered glycyrrhizin and UVB improved active-stage generalized vitiligo

Glycyrrhizin has been used clinically for several years due to its beneficial effect on immunoglobulin E (IgE)-induced allergic diseases, alopecia areata and psoriasis. In this study, glycyrrhizin, ultraviolet B light (UVB) or a combination of both were used to treat active-stage generalized vitiligo. One hundred and forty-four patients between the ages of 3 and 48 years were divided into three groups: group A received oral compound glycyrrhizin (OCG); group B received UVB applications twice weekly, and group C received OCG+UVB. Follow-ups were performed at 2, 4, and 6 months after the treatment was initiated. The Vitiligo Area Scoring Index (VASI) and the Vitiligo Disease Activity (VIDA) instrument were used to assess the affected body surface, at each follow-up. Results showed that 77.1, 75.0 and 87.5% in groups A, B and C, respectively, presented repigmentation of lesions. Responsiveness to therapy seemed to be associated with lesion location and patient compliance. Adverse events were limited and transient. This study showed that, although the three treatment protocols had positive results, OCG and UVB combination therapy was the most effective and led to improvement in disease stage from active to stable.

Vitiligo - Part 2 - classification, histopathology and treatment

In an unprecedented effort in the field of vitiligo, a global consensus resulted on a suggested new classification protocol for the disease. The main histopathological finding in vitiligo is the total absence of functioning melanocytes in the lesions, while the inflammatory cells most commonly found on the edges of the lesions are CD4+ and CD8+ T lymphocytes. Physical and pharmacological treatment strategies aim to control the autoimmune damage and stimulate melanocyte migration from the unaffected edges of lesions and the outer hair follicle root sheath to the affected skin; moreover, surgical treatments can be combined with topical and physical treatments.

Propuesta de una clasificación pronóstica en vitiligo / Propose of a prognosis classification in vitiligo

El principal interrogante al evaluar un paciente con vitiligo, es la posibilidad de repigmentación que éste pueda tener. En el presente trabajo intentamos usar algunos factores pronósticos que puedan ayudar en la caracterización de subgrupos de pacientes con vitiligo. Los parámetros considerados como factores pronósticos fueron: edad, localización, superficie corporal comprometida, enfermedades asociadas, familiares con vitiligo, presencia de repigmentación con o sin tratamiento, tiempo de evolución. Esta propuesta de clasificación permitirá escoger un diferente tratamiento, tomando en cuenta el potencial del mismo en función de las posibilidades de respuesta del mismo; y además permitiría realizar ensayos terapéuticos más confiables y reproducibles al homogeneizar los pacientes estudiados, haciendo a su vez los datos obtenidos más confiables