Department of Dermatology, Kaohsiung Medical University Hospital and Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan.
Br J Dermatol. 2011 Apr;164(4):759-64. doi: 10.1111/j.1365-2133.2010.10148.x.
Visible light is a treatment option for segmental vitiligo (SV), and visible light-induced repigmentation is associated with normalization of sympathetic dysfunction. Currently, it is difficult to predict individual patients' response to visible light therapy.
To test whether cutaneous blood flow can serve as a response predictor for visible light on treating SV.
Fourteen patients with SV were recruited in this prospective pilot study. Laser Doppler flowmetry was used to evaluate the cutaneous blood flow over SV lesions and contralateral normal skin. The pretreatment blood flow evaluation consisted of two stages: stage 1, following cold stress without prior visible light irradiation, and stage 2, following cold stress with prior visible light irradiation. Subsequently, the patients received regular visible light treatment for 3months, and a comparison of the pretreatment blood flow patterns between the visible light responding and nonresponding groups was carried out at the end of the study period.
The SV lesions showed different blood flow profiles as compared with the contralateral normal skin. At the end of the 3-month study period, seven (50%) patients showed clinical repigmentation of >25%. The visible light responding group showed a more consistent occurrence of increased blood flow after stage 2 of the pretreatment evaluation while the nonresponding counterpart showed no significant changes.
Normalization of sympathetic dysfunction may account for the efficacy of visible light in treating SV. Evaluation of cutaneous blood flow with and without prior visible light irradiation on cold-stressed SV lesions may serve as a treatment response predictor.
可见光疗法是治疗节段性白癜风（SV）的一种方法，可见光诱导的复色与交感神经功能障碍的正常化有关。目前，很难预测个体患者对可见光治疗的反应。
测试皮肤血流量是否可以作为预测可见光治疗 SV 的反应指标。
本前瞻性初步研究纳入了 14 名 SV 患者。激光多普勒血流仪用于评估 SV 病变和对侧正常皮肤的皮肤血流量。预处理血流评估包括两个阶段：阶段 1，在没有预先进行可见光照射的冷应激下进行，阶段 2，在预先进行可见光照射的冷应激下进行。随后，患者接受了 3 个月的常规可见光治疗，在研究结束时比较了可见光反应组和非反应组之间预处理血流模式的差异。
SV 病变的血流模式与对侧正常皮肤不同。在 3 个月的研究结束时，7 名（50%）患者的临床复色>25%。可见光反应组在预处理评估的第 2 阶段后血流增加更为一致，而非反应组则没有明显变化。
交感神经功能障碍的正常化可能是可见光治疗 SV 有效的原因。评估冷应激下 SV 病变在有和没有预先进行可见光照射时的皮肤血流量，可能作为治疗反应的预测指标。
