Menke H E, van Everdingen J J E
Sint Franciscus Gasthuis, afd. Dermatologie, Rotterdam.
Ned Tijdschr Geneeskd. 2006 Sep 9;150(36):1976-81.
A working group of the Dutch Society for Dermatology and Venereology (NVDV), in collaboration with the Dutch Institute for Health Care Improvement (CBO), has written an evidence-based guideline for the treatment of vitiligo. A distinction is made between generalised or non-segmental vitiligo and localised, including segmental, vitiligo. In patients with generalised vitiligo phototherapy (especially narrow-band ultraviolet B) is the treatment of first choice while in localised vitiligo, this is surgery, particularly autologous skin transplantation (Thiersch grafting, the use of blister epidermis and cell suspensions). However, on the basis of the results of the treatments proposed in the guideline, the working group cannot advise dermatologists to propose a particular treatment to each vitiligo patient they see. On the other hand, the working group is of the opinion that, based on a proper medical examination and an assessment of the disease burden, well-considered advice--and in some cases therapy--should be given to every vitiligo patient who requests it. The benefit of the guideline is that it provides clarity to dermatologists, general practitioners and patients regarding the therapeutic possibilities and limitations.
荷兰皮肤病与性病学会(NVDV)的一个工作组与荷兰医疗保健改善研究所(CBO)合作,编写了一份关于白癜风治疗的循证指南。指南区分了泛发型或非节段型白癜风与局限性白癜风(包括节段型白癜风)。对于泛发型白癜风患者,光疗(尤其是窄谱中波紫外线)是首选治疗方法;而对于局限性白癜风患者,首选治疗方法是手术,特别是自体皮肤移植(蒂尔施移植法、水疱表皮的使用和细胞悬液)。然而,根据该指南中提出的治疗结果,该工作组无法建议皮肤科医生对他们所诊治的每一位白癜风患者都推荐特定的治疗方法。另一方面,该工作组认为,基于适当的医学检查和对疾病负担的评估,应该为每一位有需求的白癜风患者提供经过深思熟虑的建议,在某些情况下还应提供治疗。该指南的益处在于,它为皮肤科医生、全科医生和患者在治疗可能性和局限性方面提供了清晰的指导。