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1.
Dermatol Online J ; 28(1)2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35499421

RESUMO

Vitiligo is an acquired skin depigmentation disorder related to the destruction of melanocytes. There are a limited number of case reports and studies in current literature that show methotrexate (MTX) is effective in the treatment. A 44-year-old man presented to our clinic with a one-year history of psoriasis. On dermatological examination, there were erythematous, scaly papules and plaques on knees, elbows, gluteal area, and scalp compatible with psoriasis. In addition there was total depigmentation over the body. He had a 30-year history of vitiligo, beginning localized but progressed gradually and covered the entire body surface. Subcutaneous methotrexate 10mg weekly was started for psoriasis. On the 6th week of methotrexate treatment, he presented to our clinic with newly developed brown macules on his face. The result of the punch biopsy taken from a macule was reported as normal skin findings. Because his body was fully depigmented, his brown melanocytic macules on his face were considered as repigmentation associated with MTX treatment. His MTX treatment was stopped by patient request. On his 6-month follow-up, hypopigmentation was observed at prior repigmented macules. Methotrexate can be considered an alternative treatment for vitiligo patients when topical therapy and phototherapy are ineffective or not applicable.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Psoríase , Vitiligo , Adulto , Humanos , Masculino , Melanócitos/patologia , Metotrexato/uso terapêutico , Psoríase/complicações , Psoríase/tratamento farmacológico , Vitiligo/terapia
2.
J Dtsch Dermatol Ges ; 20(3): 365-378, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35246935

RESUMO

Vitiligo is a common skin disorder characterized by immune-mediated destruction of melanocytes. Non-segmental vitiligo, the most common clinical subtype, has usually a chronic course and often results in significant psychosocial consequences for the affected patient. Early recognition, awareness of comorbidity, precise assessment of disease extent and activity, evaluation of impairment of quality of life as well as rapid initiation of treatment based on currently available evidence-based therapies are crucial cornerstones in the management of vitiligo. This S1 guideline helps German dermatologists to better diagnose and treat vitiligo.


Assuntos
Guias de Prática Clínica como Assunto , Vitiligo , Humanos , Vitiligo/diagnóstico , Vitiligo/terapia
3.
Dermatol Ther ; 35(5): e15400, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35201673

RESUMO

Leukotrichia is one of the difficulties of vitiligo treatment. Hair follicle transplantation is an efficient method to treat vitiligo-associated leukotrichia. A trichiasis electrolyzer, commonly used for treating trichiasis, can be used to damage and remove the depigmented hair follicles. To evaluate the efficacy of the electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation for the treatment of vitiligo-associated leukotrichia. A total of 15 patients with stable vitiligo-associated eyebrow and eyelash leukotrichia were enrolled from Department of Dermatology, Hangzhou Third People's Hospital between January 2020 and January 2021. All patients were treated using a trichiasis electrolyzer combined with single hair follicle transplantation. The patients were followed up at the first week, the first month, the third month, and the sixth month after surgery. The texture and growth state of the transplanted hair were observed, and the number of surviving transplanted follicles and regenerating depigmented follicles were recorded. The transplanted hair grew as expected with natural shape. No local infection or obvious scar was observed. Most of the depigmented hair in the lesion area re-pigmented and only a few depigmented hairs regenerated. The average survival rate of the transplanted hair follicles was 71.6%, and the average regeneration rate of the depigmented hair was 11.6%. The electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation was an effective and safe method to treat vitiligo-associated leukotrichia.


Assuntos
Doenças do Cabelo , Triquíase , Vitiligo , Eletrólise , Cabelo , Folículo Piloso/transplante , Humanos , Triquíase/complicações , Vitiligo/terapia
4.
Cutis ; 109(1): 49-53, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35180057

RESUMO

Individuals with chronic illnesses turn to online communities to engage in asynchronous peer-to-peer exchanges to better understand and manage their disease. Messages and advice exchanged by online users with vitiligo are not well characterized. We conducted a qualitative study to explore the content exchanged by individuals with vitiligo in online forums. An interpretive research paradigm was utilized to assess public online forum content. A systematic search using the phrases online forum vitiligo support, vitiligo online message board, and vitiligo forums identified 39 relevant forums; 9 of them met inclusion criteria, with 382 total anonymous users. Major themes and subthemes included vitiligo disease management, homeopathy/home remedies, psychosocial impact, public perceptions, and camouflage/concealment.


Assuntos
Hipopigmentação , Vitiligo , Doença Crônica , Humanos , Internet , Pesquisa Qualitativa , Vitiligo/terapia
5.
Stem Cells Dev ; 31(5-6): 111-118, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35044224

RESUMO

Extrinsic injury can evoke intrinsic stimulation and subsequently initiate the physiological repair process. This study aims to investigate whether clinically acceptable micro-injury could be used to create local stimuli to induce hair regeneration and vitiligo repigmentation. A novel device was designed and manufactured to precisely control the micro-injury parameters. Then the most appropriate extent of micro-injury without over-damaging the skin was evaluated. Finally, the effects of micro-injury on hair regeneration and vitiligo repigmentation were examined by macroscopic observation, histological staining, gene and protein expression analysis. We discover that proper micro-injury effectively induces hair regeneration by activating the hair follicle stem cell proliferation and migration downwards to the hair matrix, finally shifting the hair follicle stage from telogen into anagen. On vitiligo model mice, micro-injury also induces the hair follicle melanocyte stem cells to migrate upwards to the interfollicular epidermis, activating and giving rise to melanocytes to repopulate the vitiligo lesion. Mechanistic analysis indicates that the canonical Wnt/ß-catenin pathway plays a key role in the micro-injury-induced repair process. This study demonstrates that micro-injury has great potential in inducing hair regeneration and vitiligo repigmentation, laid a foundation to develop a micro-injury-based treatment method in alopecia and vitiligo.


Assuntos
Vitiligo , Animais , Cabelo , Folículo Piloso , Melanócitos/patologia , Camundongos , Vitiligo/metabolismo , Vitiligo/patologia , Vitiligo/terapia , beta Catenina/genética , beta Catenina/metabolismo
6.
Clin Exp Immunol ; 207(1): 27-43, 2022 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-35020865

RESUMO

Epidermal melanocyte loss in vitiligo, triggered by stresses ranging from trauma to emotional stress, chemical exposure or metabolite imbalance, to the unknown, can stimulate oxidative stress in pigment cells, which secrete damage-associated molecular patterns that then initiate innate immune responses. Antigen presentation to melanocytes leads to stimulation of autoreactive T-cell responses, with further targeting of pigment cells. Studies show a pathogenic basis for cellular stress, innate immune responses and adaptive immunity in vitiligo. Improved understanding of the aetiological mechanisms in vitiligo has already resulted in successful use of the Jak inhibitors in vitiligo. In this review, we outline the current understanding of the pathological mechanisms in vitiligo and locate loci to which therapeutic attack might be directed.


Assuntos
Vitiligo , Imunidade Adaptativa , Humanos , Imunidade Inata , Melanócitos/metabolismo , Melanócitos/patologia , Estresse Oxidativo , Vitiligo/patologia , Vitiligo/terapia
7.
J Eur Acad Dermatol Venereol ; 36(2): 279-285, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34657353

RESUMO

BACKGROUND: Vitiligo management is challenging and requires long-term adherence of patients who often complain of the burden associated with treatment. OBJECTIVE: To develop and validate a patient reported measurement of the burden of treatment in vitiligo. METHODS: The study was nested within the ComPaRe Vitiligo e-cohort, an online e-cohort of vitiligo patients in France. Items were derived from a literature review and from the qualitative analysis of a survey using open-ended questions of 204 patients with Vitiligo. Construct validity of the resulting instrument was assessed by comparing the instrument's score to the Dermatology Life Quality Index (DLQI), Vitiligo Impact Patient score (VIPs) and Treatment Burden Questionnaire (TBQ) scores. Reliability was assessed by test-retest with 15 ± 10 days of interval between both assessments. RESULTS: In total, 343 adult participants participated in the validation of the Vitiligo Treatment Impact score (VITs). The VITs is a 19-item questionnaire assessing the burden of treatment in patients with vitiligo with results suggesting four domains ('Finding a doctor', 'Phototherapy', 'Topical treatment' and 'Impact on outdoor activities and photoprotection'). The VITs total score was well correlated with the DLQI, VIP and TBQ scores. Agreement between test and retest was good (ICC 0.705, 95% CI 0.491-0.818). CONCLUSIONS: We developed a patient reported measurement of the burden of treatment in vitiligo with good psychometric properties.


Assuntos
Vitiligo , Adulto , Estudos de Coortes , Humanos , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários , Vitiligo/terapia
8.
Int J Dermatol ; 61(5): 582-590, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34643271

RESUMO

BACKGROUND: Treatment of vitiligo with intralesional steroid (ILS) injections has shown to be successful in quite a few studies. It is a simple and safe treatment when used with caution with a better response in localized lesions. OBJECTIVES: The aim of the present study is to explore the efficacy and safety of using different concentrations of intralesional corticosteroid combined with NB-UVB phototherapy in the treatment of non-segmental vitiligo (NSV) patients. METHODOLOGY: Twenty patients with non-segmental vitiligo were subjected to different concentrations of ILS injections (triamcinolone acetonide); that was carried out monthly for six sessions. All patients were also subjected to twice-weekly sessions of NB-UVB for 6 months. Punch biopsy was taken from each patch before and at the end of treatment sessions. Each biopsy was stained with hematoxylin and eosin (H&E), Orcein, and Masson's trichrome stains. RESULTS: There was a significant difference between all groups in their repigmentation response (P = 0.017). After treatment, the epidermal thickness (histometry) was decreased (epidermal atrophy), especially with concentrations of 2.5 and 5 mg/ml of intralesional triamcinolone acetonide injection with decreased and disorganized collagen fibers. CONCLUSION: Intralesional corticosteroid injections combined with NB-UVB showed a good and well-tolerated therapeutic option for vitiligo. The concentrations of 0.625 and 1.25 mg/ml of triamcinolone acetonide were the safest with fewer side effects and complications. However, higher concentrations of 2.5 and 5 mg/ml were more effective but with more side effects.


Assuntos
Terapia Ultravioleta , Vitiligo , Corticosteroides , Terapia Combinada , Humanos , Pigmentação da Pele , Resultado do Tratamento , Triancinolona Acetonida , Terapia Ultravioleta/efeitos adversos , Vitiligo/etiologia , Vitiligo/terapia
9.
Autoimmun Rev ; 21(1): 102932, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34506987

RESUMO

Vitiligo is an acquired chronic pigmentary disorder affecting the melanocytes, mainly in the skin and mucosae. It occurs due to the dynamic interaction between genetic and environmental factors leading to autoimmune destruction of melanocytes. Defects in melanocyte adhesion and increased oxidative stress further augment the immune response in vitiligo. It is a cosmetically disfiguring condition with a substantial psychological burden. Its autoimmune nature with resultant chronicity, variable responses to therapeutic modalities, and frequent recurrences have further diminished the quality of life. Hence, treatment should aim to provide more extended remission periods, prevent recurrences, provide good cosmetic outcomes and ensure patient satisfaction. These treatment goals seem plausible with the recent progress in our understanding of the complex pathogenic mechanisms underlying vitiligo at a molecular and genetic level. We provide a literature review of the pathogenic mechanisms and the therapies targeting these mechanisms.


Assuntos
Vitiligo , Autoimunidade , Humanos , Melanócitos , Qualidade de Vida , Pele , Vitiligo/genética , Vitiligo/terapia
10.
Dermatol Ther ; 35(1): e15198, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34750933

RESUMO

Combination therapy shows superior outcomes over monotherapy in treating vitiligo. Topical bimatoprost is a melanogenic agent effectively used to induce repigmentation. However, topical bimatoprost 0.01% has never been explored in non-facial vitiligo, and triple therapy of phototherapy, fractional laser and topical bimatoprost has never been examined. This study aims to investigate the efficacy and safety of triple-modality treatment, combining narrowband ultraviolet B (NB-UVB), fractional carbon dioxide (CO2 ) laser and topical bimatoprost 0.01% for stable non-segmental vitiligo on non-facial areas. Fifteen vitiligo patients with at least two symmetrical, comparable-sized lesions on non-facial regions were included. The paired lesions were randomized to receive a treatment regimen of twice-daily application of either bimatoprost 0.01% solution or placebo in combination with once-monthly fractional CO2 laser and twice-weekly NB-UVB therapy for 12 weeks. There were no statistically significant differences in the vitiligo surface area (VSA) and melanin concentration (MC) at baseline between treatment sides. After 12 weeks of treatment, the percentage change from baseline of MC on the triple-therapy side was significantly higher than that on the dual-therapy side, 27.17 ± 13.62% versus 22.82 ± 10.10% (p = 0.028). The change from baseline of VSA was also greater on the triple-therapy side; however, a statistically significant difference was not reached. Improvement grades of repigmentation and adverse events were similar on both sides. Triple therapy with NB-UVB, fractional CO2 laser and topical bimatoprost 0.01% tends to be safe and more effective as compared to dual therapy of NB-UVB and fractional CO2 laser in non-facial vitiligo.


Assuntos
Lasers de Gás , Terapia Ultravioleta , Vitiligo , Bimatoprost , Terapia Combinada , Humanos , Lasers de Gás/uso terapêutico , Estudos Prospectivos , Resultado do Tratamento , Vitiligo/diagnóstico , Vitiligo/terapia
11.
Dermatol Ther ; 35(2): e15219, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34812544

RESUMO

In spite of multiple therapeutic regimens for vitiligo, disease relapse remains a challenge. Most guidelines consider systemic treatments only in rapidly progressive disease with wider surface areas. This delay in halting the immune attack, may give the chance for further disease progression as well as establishment of resident memory T-cell population predisposing to future relapses. To assess the ability of early systemic therapy of localized (<2% BSA), recent onset (<6 months) vitiligo to control disease activity and minimize the possibility of recurrence. Twenty-five patients with recent onset (<6 months), localized (<2% BSA) vitiligo were included. Patients received pulse dexamethasone therapy for 6 months plus topical treatments and NB-UVB sessions. Patients were followed monthly as regards percent of repigmentation and VIDA score. To detect recurrence, biannual assessment was done for 4 years. Eighty-four percent of patients had acrofacial lesions and 44% had facial lesions. Arrest of activity was achieved after 3.65 ± 2.19 months. Complete repigmentation was achieved in a mean duration of 6.88 ± 0.2 months. At the end of the 4-year follow up, recurrence occurred in 32% of patients. In spite of recurrence, localized disease (<2% BSA) was secured. A significantly higher incidence of recurrence was associated with cases with bilateral distribution of lesions. Early systemic immunomodulation for recent localized vitiligo is a successful approach to achieve early control of disease activity and minimize the incidence of recurrence. Such cases should not be overlooked but managed as early as possible; it is a race against time.


Assuntos
Terapia Ultravioleta , Vitiligo , Progressão da Doença , Seguimentos , Humanos , Resultado do Tratamento , Vitiligo/tratamento farmacológico , Vitiligo/terapia
12.
Arch Dermatol Res ; 314(3): 275-284, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33866437

RESUMO

Vitiligo is an acquired pigmentary skin disorder that currently lacks standardized treatment and validated biomarkers to objectively evaluate disease state or therapeutic response. Although prior studies have linked vitiligo autoimmunity with CXCL10/CXCL9-mediated recruitment of leukocytes to the skin, only limited clinical data are available regarding CXCL10 as vitiligo biomarker. To evaluate the utility of systemic CXCL10 as a predictor of disease progression and treatment response on a large cohort of vitiligo patients. CXCL10 levels in lesional, perilesional, and unaffected skin of vitiligo patient (n = 30) and in the serum (n = 51) were measured by quantitative ELISA. CXCL10 expression, recruitment of leukocytes, and inflammatory infiltrates were evaluated by histochemical (n = 32) and immunofluorescence (n = 10) staining. Rigorous cross-sectional and longitudinal biostatistical analysis were employed to correlate CXCL10 levels with disease variables, treatment response, and outcome. We demonstrated that elevated CXCL10 level (2 pg/mm2 and higher) in lesional skin correlates with increased leukocytic infiltrate, disease duration (< 2 year), and its higher level in the serum (50 pg/ml and higher). Changes in CXCL10 serum levels in patients treated with psoralen plus UVA (PUVA) phototherapy, narrowband UVB (NB-UVB) phototherapy, and systemic steroids (SS) correlated with changes in the intralesional CXCL10 levels in repigmented skin. NB-UVB and SS regimens provided most consistent CXCL10 mean change, suggesting that these regimens are most effective in harnessing CXCR3-mediated inflammatory response. Serum CXCL10 is a useful vitiligo biomarker, which predicts lesional skin leukocytic infiltration, and vitiligo treatment response and outcome.


Assuntos
Quimiocina CXCL10/metabolismo , Vitiligo/terapia , Adolescente , Corticosteroides/uso terapêutico , Adulto , Biomarcadores/sangue , Biomarcadores/metabolismo , Quimiocina CXCL10/sangue , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia PUVA , Valor Preditivo dos Testes , Terapia Ultravioleta , Vitiligo/metabolismo , Vitiligo/patologia , Adulto Jovem
14.
J Cosmet Dermatol ; 21(4): 1574-1581, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34133823

RESUMO

BACKGROUND: Recipient site preparation is a crucial step in non-cultured epidermal cell suspension (NCES) as it facilitates proper uptake of the grafted melanocytes. OBJECTIVES: To compare the repigmentation rate of recipient sites prepared with manual dermabrasion (MD) versus electrofulguration-assisted dermabrasion (EF) in patients undergoing NCES for treatment of stable vitiligo. METHODS: This was a prospective randomized study including 26 patients of stable vitiligo (VIDA 0 or -1), each having two patches of size greater than 3 × 3 cm located symmetrically or at the same site or a single patch of 6 × 6 cm or larger. After randomization of patches in the given patient, MD and EF were performed on recipient areas followed by NCES. The patients were followed up at 4 weekly intervals up to 24 weeks and assessed for extent of repigmentation and adverse effects if any. RESULTS: Greater than 75% repigmentation was observed in 69.3% of the patches prepared by MD as compared to 73.1% patches prepared by EF at the end of 24 weeks (p = 0.791). The mean improvement in target VASI was 64.0% in the MD group as compared to 68.8% in the EF group (p = 0.21). Patches prepared by EF achieved successful repigmentation earlier as compared to patches prepared by MD (9.4 weeks vs 11.4 weeks, p = 0.12). CONCLUSION: Both MD and EF have comparable outcomes with respect to all parameters.


Assuntos
Vitiligo , Dermabrasão , Células Epidérmicas , Humanos , Estudos Prospectivos , Pigmentação da Pele , Transplante Autólogo/métodos , Resultado do Tratamento , Vitiligo/terapia
16.
Mol Med Rep ; 25(1)2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34751412

RESUMO

Vitiligo is a depigmentation disease commonly seen in clinical practice, mainly involving loss of functional epidermal pigment cells and hair follicle melanocytes. Narrow­band ultraviolet B (NB­UVB) has emerged as the first choice of treatment for vitiligo, but long­term exposure may have serious consequences. Recently, it was reported that adipose­derived stem cells (ADSCs) improve melanocyte growth and the efficacy of melanocyte transplantation. The present study aimed to examine the efficacy of NB­UVB/ADSC­transplantation combined therapy on a mouse vitiligo model and explore the underlying mechanisms by focusing on endoplasmic reticulum stress and cellular calcium (Ca2+) homeostasis. Vitiligo mice models were established by applying 40% monobenzone (MBZ) cream twice daily and treated with NB­UVB/ADSC combination therapy. Some treated mice were also given ML385, a nuclear factor erythroid 2 like 2 (Nr2) inhibitor. Histopathological changes were evaluated using a depigmentation evaluation score and observed with hematoxylin and eosin staining on skin tissues. ELISA was used to measure diagnostic markers in plasma. Flow cytometric assay was performed to quantify CD3+, CD4+ and CD8+ levels. Expression levels of associated proteins were detected with western blot and immunofluorescence. Treatment of mice with MBZ­induced depigmentation patches on the skin was accompanied with loss of redox balance and disruption of cellular Ca2+ homeostasis. Oxidative stress and Ca2+ unbalancing were improved after the mice were treated by NB­UVB/ADSCs transplantation combination therapy. ML385, strongly negated the protective effect of NB­UVB/ADSC transplantation combination therapy, indicating the critical role of Nr2 signaling. The findings improved the understanding of the pathogenesis of vitiligo and will guide future development of therapeutic strategies against it.


Assuntos
Transplante de Células-Tronco Mesenquimais/métodos , Pigmentação da Pele/fisiologia , Vitiligo/terapia , Animais , Cálcio/metabolismo , China , Estresse do Retículo Endoplasmático/fisiologia , Epiderme/metabolismo , Feminino , Folículo Piloso/metabolismo , Homeostase , Hidroquinonas/efeitos adversos , Hidroquinonas/farmacologia , Melanócitos/metabolismo , Células-Tronco Mesenquimais/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Fator 2 Relacionado a NF-E2/metabolismo , Fator 2 Relacionado a NF-E2/fisiologia , Estresse Oxidativo , Pele/patologia , Pigmentação da Pele/genética , Raios Ultravioleta , Terapia Ultravioleta/métodos , Vitiligo/metabolismo , Vitiligo/fisiopatologia
17.
Dermatol Ther ; 35(3): e15294, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34964230

RESUMO

Treatment of vitiligo represents a highly therapeutic challenge in spite of the continuous development of new modalities. Combination therapies of vitiligo can help improve treatment response, and reduce recurrence potential. To compare the efficacy and adverse effects of microneedling combined with-fluorouracil, pimecrolimus, and trichloroacetic acid (TCA) in the treatment of localized, stable vitiligo. The study included 75 patients with non-segmental, stable vitiligo who were randomly assigned to three equal groups: group received a combination of microneedling and -FU, group 2 received microneedling and pimecrolimus, and group 3 received microneedling and TCA. The procedure was done every 2 weeks for a maximum of six sessions. Combined microneedling and TCA was associated with the highest + 5-fluorouracil, and lastly combined microneedling + pimecrolimus. The difference between the three groups was statistically significant in favor of the combined microneedling and TCA. Pain, erythema, post-inflammatory hyperpigmentation, infection, and scarring were variably reported adverse effects in the three groups. Combination therapy seems to be a promising modality for the treatment of vitiligo. Combined microneedling and TCA is superior to combined microneedling with either-fluorouracil or pimecrolimus.


Assuntos
Ácido Tricloroacético , Vitiligo , Terapia Combinada , Fluoruracila , Humanos , Tacrolimo/análogos & derivados , Resultado do Tratamento , Ácido Tricloroacético/efeitos adversos , Vitiligo/induzido quimicamente , Vitiligo/diagnóstico , Vitiligo/terapia
20.
Dermatol Ther ; 34(6): e15159, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34657363

RESUMO

Microneedling can accelerate skin repair through numerous complex processes triggered by micro-injuries it produces on the skin surface with very thin needles. The current growth in the application of microneedling in the treatment of cutaneous diseases can be explained by its numerous effects on the skin as reported in the literature. Despite the numerous studies conducted on the application of microneedling in the treatment of skin lesions, its effects on pigmented skin lesions have remained relatively unexplored. The present review comprises an examination of the evidence for the application of microneedling in skin diseases in general and a comprehensive review of the applications of microneedling in pigmentation disorders. The review involved a search of all clinical studies, including trials, case reports, and case series, in the databases MEDLINE/PubMed and Google Scholar using the following keywords: "microneedling," "dermal needling," "percutaneous collagen induction," "skin needling," "dermaroller," and "dermatology disorder." Pertinent data were extracted from all relevant articles published from 1990 to April 2021, and focused on the application of microneedling in the treatment of pigmented skin lesions. Despite the limited number of available studies, evidence suggests the effectiveness and safety of microneedling in treating vitiligo, melasma, and periorbital hypermelanosis. It is noteworthy that the combination of any type of non-aggressive needing technique with other effective therapies (especially topical agents and mesotherapy) yields more promising therapeutic results than single therapy for melasma, dark cycles, and vitiligo as the prototype of pigmentary disorders. However, single needling therapy is significantly effective, too.


Assuntos
Melanose , Transtornos da Pigmentação , Vitiligo , Colágeno , Humanos , Melanose/terapia , Agulhas , Transtornos da Pigmentação/terapia , Vitiligo/diagnóstico , Vitiligo/terapia
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