Heterologous Type I Collagen as an Add-on Therapy to Narrowband Ultraviolet B for the Treatment of Vitiligo: A Pilot Study.

BACKGROUND: There is still an unsatisfied need for new treatments for vitiligo with more rapid onset and long-term sustainability of repigmentation. OBJECTIVE: We sought to evaluate the possible efficacy of heterologous type I collagen as an add-on therapy to narrowband ultraviolet B (NB-UVB) for the treatment of vitiligo. METHODS: Five patients with non-segmental vitiligo older than 18 years with bilateral and approximately symmetrical vitiligo lesions that did not evolve in size for at least six months were included. All vitiligo lesions were treated with NB-UVB therapy according to the Vitiligo Working Group recommendations. Two selected nonfacial lesions of each patient were also treated with intradermal injections of heterologous type I collagen (HTIC) every two weeks. Repigmentation of HTIC plus NB-UVB-treated lesions and their symmetrical counterparts treated just with NB-UVB was evaluated at baseline and Week 12. RESULTS: Repigmentation of the HTIC-injected lesions started after the first treatment session in three cases and after the second session in two cases. After six sessions (Week 12), the mean repigmentation rate was 70.5 percent (95% confidence interval:0.569-0.841) in the NB-UVB plus HTIC treatment group versus 16.5 percent (95% confidence interval: 0.137-0.192) in NB-UVB treatment group (p=0.0006, paired t-test). CONCLUSION: Although the number of patients treated with the combination treatment was limited in our study, our results suggest that the addition of HTIC to NB-UVB therapy might offer a more rapid onset of repigmentation in patients with vitiligo.

Time-Dependent Effects in Chronic Urticaria: A Time-Series Perspective of Omalizumab Treatment.

BACKGROUND: Chronic spontaneous urticaria (CSU, or CU) is a disease that significantly affects the quality of life of patients. It is a chronic disease and requires a specialized approach to diagnosis and treatment. In recent years, the disease has been of great interest due to the existence of new targeted therapeutic approaches. AIM: The present study aims at analyzing CU score concerning time, as a time-series. The authors have attempted to model the investigated time-series to unravel possible causative relationships. METHODS: 108 patients (25Males/83Females) admitted to our department were diagnosed with CU. CU was estimated on a score basis, which was used to define disease severity. Urticaria score was assessed on the basis of Urticaria Activity Score 7 (UAS7). The mean CU score, the mean CU score rate concerning the first month at diagnosis as well as the monthly CU score rate were calculated. RESULTS: Gender is a factor that influences CU score with time. In addition, there was a significant finding that time-series differ with the administration of monotherapy or complementary therapy. CONCLUSION: We have found that females are more prone to CU, while omalizumab monotherapy has more beneficial results as compared to the application of concurrent and maintenance therapies. Further, patients with co-morbidities were more likely to interrupt treatment. Finally, and most significantly, it was shown that monthly CU score rate manifested an oscillatory pattern, which was modelled with the sum of sines functions, highlighting a relative immunological pattern.

Childhood Vitiligo.

Vitiligo is a common acquired depigmenting skin disease characterized by a progressive loss of functional melanocytes. It may appear from the first years of life to late adulthood. Childhood vitiligo (CV), defined as vitiligo that begins before the age of 12 years, is common and may differ from post-CV in terms of epidemiology, clinical presentation, comorbidities, and treatment options. Taking into consideration the potential significant psychosocial impact of the disease on both children and their parents, all available therapeutic options must be offered to patients who desire treatment. According to the most recent guidelines, topical corticosteroids, topical calcineurin inhibitors, and narrowband ultraviolet B phototherapy are the most commonly used treatment modalities for vitiligo in children. This review presents recent data regarding the whole spectrum of CV. Differences between CV and post-CV are also discussed.

Narrowband ultraviolet B phototherapy and 308-nm excimer laser in the treatment of vitiligo: a review.

Vitiligo is a common and chronic disease with a great impact on patients' quality of life. Phototherapy with narrowband ultraviolet B radiation and excimer laser are two treatment modalities that are used increasingly for the management of the disease with variable results. In this article, we review the efficacy, adverse effects, and possible mechanisms of action of narrowband ultraviolet B and excimer laser in the management of vitiligo. Available data concerning the follow-up of treated patients and some criteria for the selection of patients with a greater chance to respond satisfactorily to treatment are also presented.

Efficacy, predictors of response, and long-term follow-up in patients with vitiligo treated with narrowband UVB phototherapy.

BACKGROUND: Narrowband UVB (NB-UVB) phototherapy is considered an accepted therapy for vitiligo. OBJECTIVE: We sought to estimate the effectiveness of NB-UVB in patients with vitiligo, identify predictive factors of response, and assess the stability of NB-UVB-induced repigmentation. METHODS: In all, 70 patients with vitiligo were treated twice weekly with NB-UVB. RESULTS: Cosmetically acceptable (>75%) repigmentation was achieved in 34.4% of patients with lesions on the face and in 7.4% of patients with lesions on the body. Patients with phototypes III to V had a greater chance to achieve greater than 75% repigmentation on the face. Patients who responded in the first month of treatment were more likely to achieve better repigmentation rates. Repigmentation was stable in 14.3% of patients 4 years after cessation of treatment. LIMITATIONS: The study was uncontrolled. Treatment frequency was twice weekly. These results may not be representative of different treatment regimens. CONCLUSION: Patients with vitiligo who have lesions on the face, darker phototypes, and early response to treatment have a greater chance to achieve satisfactory repigmentation after NB-UVB phototherapy.