Depigmentation therapies in vitiligo.

Depigmentation therapy in vitiligo is an option in those with extensive vitiligo who have failed to respond to medical therapy and have obvious cosmetic disfigurement due to intervening patchy pigmented areas. Various aspects of this therapy such as the cost, treatment time, course, permanency of depigmentation, side effects, and the possibility of repigmentation should first be discussed with the patient. At present, there is no ideal depigmenting therapy available, but many agents in the market have been in use for many years. Monobenzyl ether of hydroquinone (MBEH) is the mainstay and Food and Drug Administration (FDA) approved in USA but takes many months to depigment and is associated with local side effects and risk of repigmentation. Other agents which are also used are 4-methoxy phenol and 88% phenol. Physical therapies for depigmentation include Q-switched ruby and alexandrite lasers and cryotherapy. Second-line agents which can be explored for depigmentation include imatinib mesylate, imiquimod, and diphencyprone. Many possible experimental agents are being explored like various phenol derivatives, melanoma vaccines, interferon gamma, busulfan, etc. A major lacuna still exists in this area and a lot more research is desirable to give satisfactory cosmesis to these patients with extensive vitiligo.

Vitiligo Universalis Associated with Chronic Hepatitis B / 대한피부과학회지

Vitiligo universalis is an uncommon variant that is rarely seen. Interestingly, vitiligo universalis often accompanies systemic diseases such as endocrinopathies. A 43-year-old man presented with whole body depigmentation and poliosis affecting most of his scalp and body hair. He had undergone a liver transplant 2 years ago due to liver cirrhosis from a chronic hepatitis B infection and has been treated for diabetes mellitus for several years. Histopathology showed no melanocytes and an absence of epidermal pigmentation on the skin. We herein report a rare case of vitiligo universalis associated with chronic viral hepatitis B.

Depigmentation Therapy with Monobenzyl Ether of Hydroquinone in a Patient with Vitiligo Universalis / 대한피부과학회지

A 42-year-old Korean female patient with vitiligo universalis had depigmentation therapy with 20 monobenzyl ether of hydroquinone(MBEH). Noticeable lightening was observed 1 month after depigmentation therapy, three months later, complete depigmentation was achieved. As depigmentation induced by MBEH is generally irreversible, MBEH must be reserved for induction of complete depigmentation in severe cases of vitiligo in which the patients themselves do not want repigmentation and who can aecept the consequences of permanent non-tanning skin.