Eleftheriadou Viktoria, Ezzedine Khaled
Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom.
Service de Dermatologie, Hôpital Henri Mondor, UPE-Université Paris-Est, Créteil, France.
Clin Dermatol. 2016 Sep-Oct;34(5):603-6. doi: 10.1016/j.clindermatol.2016.05.010. Epub 2016 May 20.
Vitiligo is the most common depigmentation disorder, affecting around 1% of population worldwide. There is no cure, and no firm clinical recommendations can be made for the treatment of vitiligo. A European guideline suggests early treatment of small lesions of recent onset and childhood vitiligo with combination of phototherapy and topical agents. Suitable facilities and equipment, such as hand-held portable phototherapy devices, are needed, if this new guideline is to be implemented. Hand-held units are suitable for small lesions, making phototherapy available for patients with limited and/or early vitiligo. Recently, a pilot randomized controlled multicenter trial study was conducted to develop an educational package for patients describing how to use phototherapy at home, adjust the dose, and manage short-term side effects. The pilot trial showed that vitiligo patients are very keen to participate in trials of home phototherapy. The study has successfully demonstrated willingness of participants to be randomized and very good treatment adherence and repigmentation rates, providing evidence of feasibility for a definitive trial. The mean post-trial outputs of hand-held phototherapy devices were lower than the pretrial values. Close collaboration with a local medical physics department is essential. Hand-held phototherapy devices might overcome the need to treat vitiligo in hospital-based phototherapy cabinets and allow early treatment at home that may enhance the likelihood of successful repigmentation.
白癜风是最常见的色素脱失性疾病，全球约1%的人口受其影响。目前尚无治愈方法，对于白癜风的治疗也没有确切的临床建议。一项欧洲指南建议，对于近期发病的小面积皮损及儿童白癜风，采用光疗与外用药物联合的早期治疗方法。若要实施这一新指南，需要合适的设施和设备，如手持式便携式光疗设备。手持式设备适用于小面积皮损，使光疗可用于局限性和/或早期白癜风患者。最近，开展了一项试点随机对照多中心试验研究，以制定一套针对患者的教育方案，内容包括如何在家中进行光疗、调整剂量以及处理短期副作用。试点试验表明，白癜风患者非常渴望参与家庭光疗试验。该研究成功证明了参与者愿意接受随机分组，且治疗依从性和色素恢复率都非常好，为确定性试验的可行性提供了证据。手持式光疗设备试验后的平均输出低于试验前的值。与当地医学物理部门密切合作至关重要。手持式光疗设备可能无需在医院的光疗箱中治疗白癜风，从而可在家中进行早期治疗，这可能会提高色素成功恢复的可能性。
