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Dermatol Res Skin Care 2017 | Volume 1 Issue 1
World
Dermatologist Summit and Skin Care Expo
October 30-31, 2017 | Toronto, Canada
New possibilities for prolonging remission with vitiligo
Kassymkhanova Aliya
Department of Dermatovenereology Dispanser of the South-Kazakhstan Region, Kazakhstan
The article discusses the necessity of prophylactic measures
after successful completion of vitiligo treatment aiming to
prevent the recurrence of the disease. Based on the available
scientific data, the complex of measures for prophylactics is
suggested. Observations of 298 vitiligo patients after treatment
are presented, which confirm efficiency of the proposed
measures which allowed for reaching remissions of more than
4 years in 42% of patients, with the maximal remission length
being 9.5 years. NB-UVB phototherapy has been complexed
with balneotherapy and pharmaceuticals for 298 vitiligo
patients with depigmentation of more than 15% of body
surface area. Clinical success (repigmentation 95%-100%) was
observed in 19 (6%) of the patients, significant improvement
(repigmentation from 50% to 95%) was seen in 178 patients
(60%). Improvement (repigmenttaion ranging from 15 to
50%) was observed in 96 patients (32%), and lack of clinical
effect (repigmentation less than 15%) was noted in 5 patients.
The average number of phototherapy sessions was 97±9,
cumulative NB-UVB dosagewas 82.37±4.46 J/cm2. The duration
of phototherapy course was on average 15 months. 22 surgical
transplants were performed: transplantation of a suspension of
uncultivated epidermal cells - keratinocytes and melanocytes
and transplantation of a suspension of uncultivated cells of the
outer root vagina of hair follicles.
Results: repigmentation of 95% -100%was observed in 7 (32%),
repigmentation of 50% -95% was in 10 (45%), repigmentation
of 15% -50% in 3 (14%) and repigmentation to 15% - was in 2
(9%). Currently, the main goal of this treatment is to stop the
disease from progressing and to make it stable while regressing
clinical signs of vitiligo (depigmentation). Besides that, lengthy
treatment, significant spending and anxiety of a patient to
return back to the past condition require to search for novel
prophylactics measures. which, in turn, can lead to vitiligo
recurrence. This further points to the necessity of continuing
treatment. The view of photo-immunology has changed
over the past several years (Ullrich and Byrne, 2012). The
mechanisms involved are much more complex than initially
thought. Low/physiologic doses of UVR inhibit the adaptive
immune system but induce parts of the innate immune system.
This is in line with the fact that ambient solar exposure is crucial
and physiologic. Thus, it is fair to speculate that a certain level
of constant immunosuppression by daily solar exposure may
prevent the induction of such adverse immune responses, but
this must be confirmed by future studies (Schwarz T, Beissert
S, 2013).
Speaker Biography
Kassymkhanova heads the Physiotherapy Department of the Regional
Dermatovenereology Center of South Kazakhstan. She has been actively involved in
vitiligo research since 2004. Dr. Kassymkhanova published over 20 papers and received
two patents for vitiligo treatments. A tireless patient advocate, Aliya chairs the Vitiligo
School - a local patient education and support group she founded in 2005.
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