Take 5: Promising Developments in Vitiligo Research

1. Cyclic Approach Aids Children with Vitiligo.
Given that half of all vitiligo vulgaris patients have onset of disease during childhood—causing increased psychological stress during the formative years—it is important to understand how the condition manifest in children and how to treat it. A new review suggests that in light of the amount of treatment options available, younger patients might benefit from a cyclic approach to therapy, wherein topical agents are altered every six to eight months. Moreover, the researchers suggest that technologies such as the excimer laser can be used as alternatives after maximal topical response has been achieved. (Curr Opin Pediatr; 22(4): 445-52.)

2. IPL and Vitiligo Linked?
Though vitiligo is not known to result from laser treatment, a new report of a rare case of vitiligo apparently induced by IPL laser treatment is worth noting. Investigators presented a 41- year-old woman who developed multiple round, hypopigmented macules on both the cheek and mandibular area following treatment with IPL for lentigines and dyspigmentation. Vitiligo was successfully treated with a 308nm excimer laser. Researchers advise dermatologists to be aware of unsighted vitiligo lesions before commencing with IPL treatment. (J Dermatol; 37(7): 674-6.)

3. Oral Minocycline Shown Effective.
A new study suggests that oral minocycline may be an effective treatment for vitiligo. Recent data indicate that minocycline can rescue melanocytes from oxidative stress in vitro. Researchers enrolled 32 patients with gradually progressive vitiligo to take minocycline 100mg once daily. In 29 patients, disease progression was arrested. Only three patients showed development of new lesions and/or enlargement of existing lesions. Researchers concluded that minocycline may offer a unique and potentially powerful approach to arresting the activity of vitiligo and recommended larger studies. (Dermatol Ther; 23(3): 305-7.)

4. Autologous Melanocyte Transplants Show Promise.
Transplantation of cultured autologous pure melanocytes may be an effective approach for children and adults with vitiligo. Investigators isolated melanocytes from the roof of suction blister, cultured and expanded them with Hu16 medium in vitro, and transplanted to laser-denuded host areas. Twelve children (eight-12 years), 20 adolescents (13-17 years), and 70 adults with vitiligo were treated. In all, 83.3 percent of children achieved repigmentation of 50 percent or more, as compared to 95 percent of adolescents, and 84 percent of adults. (J Eur Acad Dermatol Venereol. 2010 July Epub.)

5. Lower Glutathione Levels a Feature of Vitiligo.
New research appears to confirm the link between erythrocytic or systemic glutathione (GSH) levels and vitiligo presentation. Researchers examined blood samples of 53 vitiligo patients and 65 phototype-, age-, and sex-matched healthy controls, all of whom answered a questionnaire as well. Researchers observed significantly lower levels of GSH in vitiligo patients. They concluded that reduced erythrocytic or systemic GSH levels constitute a distinctive feature in vitiligo patients regardless of disease activity. (Ann Dermatol. 22(3): 279-83.)