Special site or refractory type of vitiligo treatment

Type:Uv phototherapy   Time:2018-11-20 14:40:32

Vitiligo often involves exposed parts such as the head, hands and feet. The vitiligo of the lips, genital mucosa, eyelids, scalp, elbow and knee is special, and the treatment response is generally poor. According to the characteristics of each part, the clinical needs of different mechanisms, UVB phototherapy, autograft and combination therapy.

 

Prostaglandin gels have been reported to have a good clinical response in the stable lip lesions. Autologous negative pressure suction gown epidermal grafting and drilling transplantation are suitable for lip lesions of larger and smaller lesion areas, respectively.

 

The application of methicillin and pimecrolimus in the orbital area has a good effect. Some researchers conducted a randomized, double-blind trial of 0.1% tacrolimus ointment and 0.05% clobetasol propionate, which achieved good clinical results and had small adverse reactions, which were considered to be useful for young patients and sensitive sites. Patients with vitiligo at the eyelids are safe and effective. Based on the loose structure of the eyelids, vacuum suction and holmium laser are also good choices.

 

For the treatment of epidermis, such as eyelids, perioral, and perineum, which are highly active and lack of support structure, special dressing methods such as wire fixation can be used to improve the survival rate of transplantation. The wound scraping method after autologous melanocyte culture has obvious effects on eye and nose lesions.

 

Genital vitiligo topical prostaglandin gel, pimecrolimus, etc. have a good effect. Hair lesions are effective in combination with prostaglandin gels, melanogenesis generators, and UV treatment. Epidermal transplantation combined with chemical hair removal and hair follicle transplantation, hair follicle scraping injection, cell transplantation and other non-cultured cell transplantation treatments help white complex color.

For the scalp hair area, eyebrows, eyelashes and other parts of the scalp hair can not complete the autologous epidermal transplantation, lesions can be removed, hair transplantation and other methods.

 

Ultraviolet-sensitive areas such as joints and extremities can be treated with 308mm excimer laser. For the lesions at the toe end, micro-drilling transplantation has been reported to be ideal. Autologous non-cultured cell suspension transplantation is also considered to have a good complexing effect.

 

In general, the treatment of refractory vitiligo is still limited. Combination therapy is the option to improve efficacy. Recently, we have combined treatment with dot matrix CO2, laser, external coating of Debaosong solution and NB-UVB, which significantly improved the treatment response rate of vitiligo in the hand, foot and carina.