A new treatment option for Vitiligo ?

Reagents inducing epidermal proliferation also induce pigmentation: induction of keratinocyte proliferation as a novel strategy for the treatment of vitiligo.

Wu CS, Komine M, Fujimoto S, Ohmatsu H, Kikuchi K, Tada Y, Yu HS, Ohtsuki M, Tamaki K.

J Dermatol Sci. 2013 Oct;72(1):66-8. doi: 10.1016/j.jdermsci.2013.05.005. Epub 2013 Jun 18. No abstract available.

• Vitiligo affects 1% of the population and is a challenge to treat. Topical treatment s (tacroimus, steroids), phototherapy often achieve partial results although being used for a long duration…often to recur after the treatment is stopped. Cellular transplants are another option but are notoriously ineffective in segmental vitiligo as well as on joints and acral areas.
• The study suggests that epidermal keratinocytes could be the target of vitiligo treatment, and that reagents that induce keratinocyte proliferation may induce repigmentation.

• After 28 days of application in guinea pigs:

1. Tretinoin tocoferil-treated skin showed marked pigmentation and epidermal acanthosis with slight infiltration of lymphoid cells
2. This substance was applied in addition to phototherapy (NBUVB) or steroid treatment in 15 volunteers with vitiligo

• In humans:

1. In 10 patients, repigmentation was seen in 25-50% of lesions
2. In three patients repigmentation was very effective and needed no further treatment

This ointment exists commercially as 0.25% tretinoin-tocoferil ointment (Pola Pharma Inc. Tokyo, Japan).

The study was supported by a grant from the Japanese Ministry of Health, Labour and Welfare.

Contributors Dr Christophe Hsu – dermatologist. Geneva, Switzerland