Vitiligo medical therapy: Difference between revisions
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(/* Topical corticosteroids Adapted from the 2012 Guidelines for the management of vitiligo: the European Dermatology Forum consensus{{cite journal| author=Taieb A, Alomar A, Böhm M, Dell'anna ML, De Pase A, Eleftheriadou V et al.| title=Guidelines for...) |
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==Medical Therapy== | ==Medical Therapy== | ||
===Topical corticosteroids <small><small><small>Adapted from the 2012 Guidelines for the management of vitiligo: the European Dermatology Forum consensus<ref name="pmid22860621">{{cite journal| author=Taieb A, Alomar A, Böhm M, Dell'anna ML, De Pase A, Eleftheriadou V et al.| title=Guidelines for the management of vitiligo: the European Dermatology Forum consensus. | journal=Br J Dermatol | year= 2013 | volume= 168 | issue= 1 | pages= 5-19 | pmid=22860621 | doi=10.1111/j.1365-2133.2012.11197.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22860621 }} </ref></small></small></small>=== | ===Topical corticosteroids <small><small><small>Adapted from the 2012 Guidelines for the management of vitiligo: the European Dermatology Forum consensus<ref name="pmid22860621">{{cite journal| author=Taieb A, Alomar A, Böhm M, Dell'anna ML, De Pase A, Eleftheriadou V et al.| title=Guidelines for the management of vitiligo: the European Dermatology Forum consensus. | journal=Br J Dermatol | year= 2013 | volume= 168 | issue= 1 | pages= 5-19 | pmid=22860621 | doi=10.1111/j.1365-2133.2012.11197.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22860621 }} </ref></small></small></small>=== | ||
* Topical corticosteroids along, with topical calcineurin inhibitors, are considered the first line treatment for limited | * Topical corticosteroids along, with topical calcineurin inhibitors (such as [[tacrolimus]]), are considered the first line treatment for limited lesions. | ||
* Topical corticosteroids have shown repigmentation rates of up to 75%. | * Topical corticosteroids have shown repigmentation rates of up to 75%. | ||
* Best results have been observed in areas exposed to sunlight (neck and face), dark skin and new lesions. | * Best results have been observed in areas exposed to sunlight ([[neck]] and [[face]]), dark skin and new lesions. | ||
* No difference has been observed between the efficacy of potent (mometasone) versus superpotent (clobetasol) topical corticosteroids, then potent corticosteroids should be the first option. | * No difference has been observed between the efficacy of potent ([[mometasone]]) versus superpotent ([[Clobetasol propionate|clobetasol]]) topical corticosteroids, then potent corticosteroids should be the first option. | ||
* Two schemes are recommended by the European Dermatology Forum consensus for the treatment of facial and extrafacial lesions: | * Two schemes are recommended by the European Dermatology Forum consensus for the treatment of facial and extrafacial lesions: | ||
:* Discontinuous scheme (preferred scheme): Daily application of a potent topical corticosteroid during 15 days a month for a total of 6 months. | :* Discontinuous scheme (preferred scheme): Daily application of a potent topical corticosteroid during 15 days a month for a total of 6 months. | ||
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:* Photographs should be taken to evaluate the response to the treatment. | :* Photographs should be taken to evaluate the response to the treatment. | ||
* Both schemes are recommended for children and adults. | * Both schemes are recommended for children and adults. | ||
* If large areas are affected and risk of systemic absorption is a concern (specially in children), then mometasone furoate or methylprednisolone aceponate are the preferred options as this drugs present less systemic side effects. | * If large areas are affected and risk of systemic absorption is a concern (specially in children), then [[mometasone furoate]] or methylprednisolone aceponate are the preferred options as this drugs present less systemic side effects. | ||
==References== | ==References== | ||
Revision as of 15:00, 25 June 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
Topical corticosteroids Adapted from the 2012 Guidelines for the management of vitiligo: the European Dermatology Forum consensus[1]
- Topical corticosteroids along, with topical calcineurin inhibitors (such as tacrolimus), are considered the first line treatment for limited lesions.
- Topical corticosteroids have shown repigmentation rates of up to 75%.
- Best results have been observed in areas exposed to sunlight (neck and face), dark skin and new lesions.
- No difference has been observed between the efficacy of potent (mometasone) versus superpotent (clobetasol) topical corticosteroids, then potent corticosteroids should be the first option.
- Two schemes are recommended by the European Dermatology Forum consensus for the treatment of facial and extrafacial lesions:
- Discontinuous scheme (preferred scheme): Daily application of a potent topical corticosteroid during 15 days a month for a total of 6 months.
- Continuous scheme: Daily application of a potent topical corticosteroid during 3 months.
- Photographs should be taken to evaluate the response to the treatment.
- Both schemes are recommended for children and adults.
- If large areas are affected and risk of systemic absorption is a concern (specially in children), then mometasone furoate or methylprednisolone aceponate are the preferred options as this drugs present less systemic side effects.
References
- ↑ Taieb A, Alomar A, Böhm M, Dell'anna ML, De Pase A, Eleftheriadou V; et al. (2013). "Guidelines for the management of vitiligo: the European Dermatology Forum consensus". Br J Dermatol. 168 (1): 5–19. doi:10.1111/j.1365-2133.2012.11197.x. PMID 22860621.