[What is new in the treatment of vitiligo]

ABSTRACT

Vitiligo is a frequent hypomelanosis that affects 1% of the world population, and 0,95% of the Tunisian population. The objective of our study is to describe through a recent review of the literature, the different therapeutic modalities, now used in vitiligo. We have used a clinical approach to guide therapeutic indications. We have performed a review of the articles, dealing with the treatment of vitiligo and published during the 10 previous years. We have used a Medline research with these key-words "vitiligo and treatment". Randomized studies were privileged and 29 articles were analysed. We have initially presented all validated therapeutic means now used in vitiligo. We have then proposed, according to this recent review of the literature, clinical indications according to vitiligo type, extension of lesions and if vitiligo involves adults or children. We dispose of multiple chemical, physical and surgical treatments of vitiligo. Vitiligo with partial melanocyte defect can be treated especially by the different modalities of phototherapy [PUVA therapy, PUVASOL, UVB therapy TL01, Laser excimer]. Surgical treatments were also described, with there principal indications. Ethiopathgenic treatments [local steroids, Tacrolimus, Calcipotriol, Vitix] were especially indicated in vitiligo with complete epidermic and follicular achromy. Finally, different therapeutic associadons were reported in the litterature, showing synergic effect of some treatments. Phototherapy remains the best treatment of vitiligo type I. In vitiligo type II and III, ethiopathogenic treatments may be efficient, alone or associated with phototherapy