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Differences in treatment principles between progressive vitiligo and stable vitiligo

02/21/2019

Differences in treatment principles between progressive vitiligo and stable vitiligo

(1) Advanced vitiligo:

  1. The undetermined type of vitiligo (formerly known as localized type): external use of glucocorticoids (hormones) or calcineurin inhibitors (tacrolimus ointment, pimecrolimus cream), etc. Low concentration photosensitizers such as 8-methoxysaline (8-MOP) and vitamin D3 derivatives can also be used for external use. Narrow-band ultraviolet B (NB-UVB), 308 nm excimer laser and excimer light can be selected for local phototherapy. For rapid progression, hormones can be used systematically.

2.Non-segmental and mixed types of vitiligo: VIDA integral > 3 points considered                 systemic hormones, traditional Chinese medicine, NB-UVB, 308 nm excimer light                 and excimer laser. In the rapid progression stage, hormones or antioxidants can be               used in combination with phototherapy system to avoid the oxidative stress caused               by phototherapy leading to skin enlargement. The reference progression of topical                  medication is undetermined.

  1. Segmental type: refer to advanced indeterminate type of treatment.

 

(2) Stable vitiligo:

  1. Uncertain types (formerly known as limited types): external photosensitizers (such as furanocoumarins 8-MOP), hormones, nitrogen mustard, calcineurin inhibitors, vitamin D3 derivatives, etc.); autologous epidermal transplantation and melanocyte transplantation; local phototherapy reference advanced undetermined types.
  2. Non-segmental and mixed types: phototherapy (such as NB-UVB, 308 nm excimer light and excimer laser, etc.), traditional Chinese medicine, autologous epidermal transplantation or melanocyte transplantation (exposed or required parts of patients). The reference stable period of topical medication is undetermined.
  1. Segmental type of vitiligo: autologous epidermal transplantation or melanocyte transplantation (stable for more than 6 months), including autologous epidermal graft, mini-skin graft, razor-thick skin graft, autologous non-cultured epidermal cell suspension transplantation, autologous cultured melanocyte transplantation, etc. Reference to indeterminate treatment in stable phase.

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