Atopic Dermatitis: a Short Summary
Dr Christophe HSU – dermatologist. Geneva, Switzerland
- Medical Repigmentation treatments consist of:
- medical: topical (tacrolimus, pimecrolimus, topical corticosteroids…(calcipotriène, pseudocatalase, piperine)), systemic (pulse steroids…)
-UV (Ultraviolet)-based therapy: Narrow Band UVB (NBUVB) is the mainstay of treatment. PUVA (Psoralen + UVA is also used but is more complicated (and less effective).
Let us consider the following combination treatment: Combination of afamelanotide* with NBUVB:
- -it has been shown to be more effective than with NBUVB alone for non segmental vitiligo patients (study following patients for a duration of one year). So far (presentation in Manila) the results compare 5 patients treated with the combination vs the NBUVB group.
- It takes 2 times fewer phototherapy treatments
- the VASI (Vitligo Analog Severity index) goes from 24 to 18 in the combination group, but only 26 to 25 in the NBUVB group only.
- no mole changes in the afamelanotide treated group were observed. Unfortunately, in the end (presentation in Verona) ,half of the 12 patients in the combination treatment dropped out of the study.
* It is an alpha- MSH Melanocyte Stimulating Hormone) agonist used in photodermatoses: solar urticaria (injection og 16mg s.c.once) and erythropoietic propoporphyria ( 2 injection of 20mg s.c. spaced by 60 days)
Other combination treatments have been tried with: topical calcipotriol and tacrolimus, oral P.Leucotomus.
Contributors:
Dr Christophe HSU – dermatologist. Geneva, Switzerland
Source of information:
Lim H. White Patches: What’s New in Vitiligo ? 2012 (02) – 20th Regional Conference of Dermatology (RCD) – Manila, Phillipines
SY 22. Lim H.W. Therapeutic challenges in vitiligo. 2012 (06) – 9th Spring Symposium of the EADV (European Academy of Dermatology and Venerology) – Verona, Italiy (Italia)
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