Awad Sherif S, Abdel-Raof Hamza, Hosam El-Din Wael, El-Domyati Moetaz
Department of Dermatology and Venereology, Faculty of Medicine, Minya University, Minia, Egypt.
J Cosmet Dermatol. 2007 Jun;6(2):119-24. doi: 10.1111/j.1473-2165.2007.00307.x.
Phototherapeutic techniques were introduced into medical practice by the ancient Egyptians. It is considered a cornerstone in the management of resistant vitiligo; yet, failures are very well known. Recently, the introduction of surgical techniques provided a major development in the management of vitiligo and replaced other conventional unsuccessful therapies.
The aim of this work is to find out if phototherapy, which failed to resolve the vitiligo problem in patients, is still required in the treatment strategy after epithelial grafting of the same cases.
Twenty-five vitiligo patients, nonresponding to classic phototherapy, were treated surgically. Ultrathin Thiersch grafts and suction blister grafts were used. Phototherapy using ultraviolet A (UVA) bulbs in combination with psoralen or khellin was used postoperatively immediately after take of grafts onto recipient sites.
In spite of reactivation of depigmentary effects at grafted areas, phototherapy acted as a stimulator for melanocytic proliferation and function and as an immunosuppressant, halting the melanocytic destructive process. The application of UVA phototherapy resulted in successful treatment in the patients receiving it.
The success of epithelial grafting in patients with vitiligo can be increased by UVA phototherapy.
光疗技术由古埃及人引入医学实践。它被认为是顽固性白癜风治疗的基石；然而，治疗失败的情况也很常见。最近，手术技术的引入为白癜风的治疗带来了重大进展，并取代了其他传统的无效治疗方法。
本研究旨在探讨在同一病例进行上皮移植后，对于光疗未能解决白癜风问题的患者，其治疗策略中是否仍需要光疗。
对25例对经典光疗无反应的白癜风患者进行手术治疗。采用超薄蒂尔施移植片和吸引水疱移植片。在移植片移植到受区后立即使用紫外线A（UVA）灯结合补骨脂素或凯林进行术后光疗。
尽管移植区域色素脱失效应重新激活，但光疗起到了刺激黑素细胞增殖和功能的作用，并作为一种免疫抑制剂，阻止黑素细胞的破坏过程。接受UVA光疗的患者治疗成功。
UVA光疗可提高白癜风患者上皮移植的成功率。
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