Gupta Divya, Kumari Rashmi, Thappa Devinder Mohan
Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Indian J Dermatol Venereol Leprol. 2012 Jan-Feb;78(1):49-58. doi: 10.4103/0378-6323.90946.
Depigmentation therapy in vitiligo is an option in those with extensive vitiligo who have failed to respond to medical therapy and have obvious cosmetic disfigurement due to intervening patchy pigmented areas. Various aspects of this therapy such as the cost, treatment time, course, permanency of depigmentation, side effects, and the possibility of repigmentation should first be discussed with the patient. At present, there is no ideal depigmenting therapy available, but many agents in the market have been in use for many years. Monobenzyl ether of hydroquinone (MBEH) is the mainstay and Food and Drug Administration (FDA) approved in USA but takes many months to depigment and is associated with local side effects and risk of repigmentation. Other agents which are also used are 4-methoxy phenol and 88% phenol. Physical therapies for depigmentation include Q-switched ruby and alexandrite lasers and cryotherapy. Second-line agents which can be explored for depigmentation include imatinib mesylate, imiquimod, and diphencyprone. Many possible experimental agents are being explored like various phenol derivatives, melanoma vaccines, interferon gamma, busulfan, etc. A major lacuna still exists in this area and a lot more research is desirable to give satisfactory cosmesis to these patients with extensive vitiligo.
白癜风的脱色治疗适用于广泛性白癜风患者，这些患者对药物治疗无效，且因中间有色素沉着斑块而存在明显的美容缺陷。应首先与患者讨论这种治疗的各个方面，如费用、治疗时间、疗程、脱色的永久性、副作用以及复色的可能性。目前，尚无理想的脱色治疗方法，但市场上的许多药物已使用多年。对苯二酚单苄醚（MBEH）是主要药物，在美国获得食品药品监督管理局（FDA）批准，但需要数月才能脱色，且伴有局部副作用和复色风险。其他也使用的药物有4-甲氧基苯酚和88%苯酚。脱色的物理治疗方法包括Q开关红宝石激光和翠绿宝石激光以及冷冻疗法。可用于脱色探索的二线药物包括甲磺酸伊马替尼、咪喹莫特和二苯环丙烯酮。许多可能的实验性药物正在探索中，如各种苯酚衍生物、黑色素瘤疫苗、干扰素γ、白消安等。该领域仍存在一个主要空白，需要进行更多研究，以便为这些广泛性白癜风患者提供令人满意的美容效果。
