Aravindakshan Rajeev, Gopinath Hima, Kaimal Sowmya, Pentapati Siva Santosh, Marimuthu Yamini
All India Institute of Medical Sciences Mangalagiri, India.
St Johns Medical College and Hospital, Bengaluru, India.
Clin Exp Dermatol. 2025 Aug 22;50(9):1741-1747. doi: 10.1093/ced/llaf134.
Idiopathic guttate hypomelanosis (IGH) is a common benign leucoderma, the incidence of which increases with age. Treatment is often sought for cosmetic reasons. However, there is a paucity of information regarding effective treatments for this condition.
To evaluate and compile the effects of interventions for IGH.
MEDLINE (through PubMed), Web of Science and Scopus databases were searched for articles reporting interventions for IGH, from inception up to November 2023. Reference lists of identified articles were searched for additional articles. Eligibility criteria included human randomized controlled trials (RCTs), clinical studies (non-RCTs) and case series studies (n > 5 patients) of topical treatments, light-based or energy-based devices and procedural interventions for IGH. Repigmentation was the primary outcome of interest. At least two reviewers were involved in article screening, selection, data extraction and quality assessment.
Our search returned 522 articles, of which 20 met the eligibility criteria: 9 randomized studies and 11 quasi-experimental studies. The number of patients per study ranged from 6 to 240, and the maximum number of macules included was 2129. Thirteen studies used a quartile grading score to report outcomes. Half of the randomized studies had a high risk of bias, and the outcome measures were heterogeneous across studies. The treatment modalities were well-tolerated.
A wide range of interventions are effective in treating IGH. Most treatment modalities involve some form of therapeutic wounding. However, study design and methodology limitations must be considered for each intervention that has been evaluated. There is a paucity of large RCTs with standardized outcome measures and follow-up data regarding the longevity of repigmentation in patients with IGH.
特发性点滴状色素减退症（IGH）是一种常见的良性白斑病，其发病率随年龄增长而增加。人们常因美容原因寻求治疗。然而，关于这种疾病的有效治疗方法的信息却很少。
评估并汇总IGH干预措施的效果。
检索MEDLINE（通过PubMed）、科学网和Scopus数据库，查找自数据库建立至2023年11月期间报告IGH干预措施的文章。在已识别文章的参考文献列表中查找其他文章。纳入标准包括关于IGH局部治疗、光基或能量基设备及程序性干预的人体随机对照试验（RCT）、临床研究（非RCT）和病例系列研究（n>5例患者）。色素再沉着是主要关注的结局。至少两名评审员参与文章筛选、选择、数据提取和质量评估。
我们的检索共返回522篇文章，其中20篇符合纳入标准：9项随机研究和11项准实验研究。每项研究的患者数量从6例至240例不等，纳入的最大斑疹数量为2129个。13项研究使用四分位数分级评分来报告结局。一半的随机研究存在高偏倚风险，且各研究的结局测量方法不一致。这些治疗方式耐受性良好。
多种干预措施对治疗IGH有效。大多数治疗方式都涉及某种形式的治疗性损伤。然而，对于每项已评估的干预措施，都必须考虑研究设计和方法的局限性。目前缺乏关于IGH患者色素再沉着持续时间的标准化结局测量和随访数据的大型RCT。
