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Vitiligo treatment may repigment skin

In a dermatology research study dermatologists sought to evaluate the safety and effectiveness of a vitiligo treatment combination of Narrowband UVB phototherapy and afamelanotide, a drug that induces skin pigmentation. Dermatologist Dr Monika Saha describes the study results as “encouraging”.

Vitiligo is a skin condition where areas of skin lose their pigment and become white. It affects about 1% of the population and is unpredictable, varying from single small patches to total loss of skin colour. The cause is not fully understood however it is considered an autoimmune condition.

Dr Monika Saha explains that “we currently treat vitiligo with potent topical steroids, protopic 0.1% ointment or phototherapy but patients can have a variable response.”

In the study 55 patients were selected from men and women, over 18 years of age, with confirmed vitiligo involving 15% to 50% of their total body surface. The patients were randomly divided into two study groups. The 28 patients in group A received the combination therapy, while the 27 patients in group B received only narrowband UVB treatment. Both groups received phototherapy two to three times a week for six months for a total of 72 treatments. Patients in group A also received a dose of 16mg of afamelanotide in four monthly treatments, as an implant under the skin.

While both groups showed re-pigmentation of the skin, the response in group A was superior to group B by the 56th day of treatment, and even greater by the 168th day of treatment.

Afamelanotide is in the process of being submitted for approval from the U.S. Food and Drug Administration for use in treating vitiligo.

“This paper offers a novel treament combination for treatment refractory patients with vitiligo. Afamelanotide, a drug similar to melanocyte-stimulating hormone in combination with phototherapy may hasten repigmentation in vitiligo patients with darker skin types. This is not freely available as yet but is a promising treatment option, ” explains Dr Monika Saha .

The study Afamelanotide and Narrowband UV-B Phototherapy for the Treatment of Vitiligo is published in the Journal of the American Medical Association Dermatology.

Picture The effects of the combination treatment on skin re-pigmentation, from baseline (top), 66 days (middle) and 140 days (bottom) of the study. Credit: Henry Ford Hospital

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