Updates and new medical treatments for vitiligo (Review).

Vitiligo is a multifactorial disease characterized by the loss of skin pigment, which results in achromic macules and patches. There are currently several medical treatments available, which aim to arrest progression and induce skin repigmentation. These treatments alone or combined have exhibited varying degrees of pigmentation, and the majority are safe and effective. All therapies for vitiligo are limited, and no known treatment can consistently produce repigmentation in all patients. Individualized treatment is appropriate according to the location, clinical presentation and the presence of disease activity. The present review summarizes the medical treatments available for vitiligo: Systemic and topic pharmacological therapies, physical and depigmentation treatments. Several treatments are still underway and have not yet been approved. However, due to the promising preliminary results, these are also mentioned in the present review.

Novel immunological and genetic factors associated with vitiligo: A review.

Vitiligo is a skin disorder characterized by depigmentation of the skin due to a lack of melanin. This condition affects men and woman of all ages and its incidence is not restricted by ethnicity or region. Vitiligo is a multifactorial disease, in which melanocytes, which serve important functions in skin pigmentation and immune processes, are impaired. There is sufficient evidence that immunological and genetic factors are primarily responsible for the destruction and dysfunction of melanocytes. Therefore, genetic DNA sequence variants that participate in skin homeostasis, pigmentation and immune response regulation, as well as altered expression patterns, may contribute to the risk of developing vitiligo. The current review presented an overview of the mechanism of pigmentation and of currently known factors involved in depigmentation, as well as the classification, epidemiology, associated comorbidities, risk factors, immunopathogenesis and several genetic and molecular changes associated with vitiligo.

[Mohs micrographic surgery: 27 year experience in the Northeast of Mexico]. / Cirugía micrográfica de Mohs: 27 años de experiencia en el Noreste de México.

INTRODUCTION: Skin cancer treatment includes surgical and non-surgical techniques. Among surgical techniques, Mohs micrographic surgery permits a complete evaluation of surgical margins with maximal tissue sparing. MATERIAL AND METHODS: Retrospective review of dermatology database of skin cancer cases treated with Mohs surgery at University Hospital Dr. José Eleuterio González from 1988 to 2015. RESULTS: A total of 546 cases were included, of these 289 (52.93%) corresponded to women and 257 (47.07%) to men. Mean age at presentation was 64.3. Most tumors (63.2%) corresponded to infiltrative basal cell carcinoma and the majority were located on the nose and cheek; 9.7% of cases corresponded to recurrent tumors. A mean of 1 Mohs stages was used in 56%, with a mean of 2 sections in 23.6%. Cutaneous flaps were used in 47.7%, representing the predominant reconstruction technique. CONCLUSION: Mohs surgery has emerged in one of the dermatology reference centres in the North of the country as one of the surgical techniques for the treatment of aggressive carcinomas with high risk of recurrence.

Treatment of vitiligo with a melanocyte-keratinocyte cell suspension versus dermabrasion only: a pilot study with a 12-month follow up.

BACKGROUND: Dermabrasion is a surgical procedure that has been used for repigmentation; however, autologous transplantation of uncultured melanocytes in a suspension combined with the use of adjunct treatment provides better results. PURPOSE: To evaluate the clinical effectiveness of dermoabrasion (DA) and melanocyte-keratinocyte cell suspension transplantation (DA+MKT) vs. dermabrasion with no adjunct treatment. MATERIALS AND METHODS: We selected 11 patients (six women and five men) with stable vitiligo. From these, two achromic maculae of similar size were selected. One macule was treated with DA+MKT and the other with DA only. The main parameter of treatment efficacy was the percentage of repigmentation in the area treated, three and 12 months after implantation. RESULTS: In seven of the 11 patients, slightly better pigmentation occurred with DA+MKT. Two of these patients had a repigmentation greater than 50 percent and in two other patients, the result was similar for both techniques, although slightly better with MKT. Two more patients showed less than 20 percent repigmentation, but only in the area treated with DA+MKT. One patient showed pigmentation initially after DA+MKT only, and subsequent depigmentation. CONCLUSION: DA+MKT produced slightly better repigmentation than DA only when given without adjunct treatment in a 12-month follow-up period.

Paraffinomas of the facial area: treatment with systemic and intralesional steroids.

We present a case of a 32-year-old male patient with a history HIV infection, who administered vitamin E and almond oil into the malar region and chin. On histology the main pathological finding was a foreign body granulomatous reaction. The patient was treated with 20-mg prednisone and intralesional triamcinalone. After three more treatments the erythema and edema decreased with resolving post-inflammatory hyperpigmentation. We conclude that the use of oral and intralesional steroids are effective treatments in foreign body reactions.