Vitiligo is characterized by depigmented patches of skin due to loss of cutaneous melanocytes. Many recent studies have demonstrated defects in the melanocortin system in patients with vitiligo, including decreased circulating and lesional skin levels of α-melanocyte-stimulating hormone (α-MSH). Afamelanotide is a potent and longer-lasting synthetic analogue of naturally occurring α-MSH.
We describe the preliminary results of 4 patients with generalized vitiligo who developed repigmentation using afamelanotide in combination with narrowband UV-B (NB-UV-B) phototherapy. Patients were treated 3 times weekly with NB-UV-B and starting in the second month received a series of 4 monthly implants containing 16 mg of afamelanotide. Afamelanotide induced faster and deeper repigmentation in each case. All patients experienced follicular and confluent areas of repigmentation within 2 days to 4 weeks after the initial implant, which progressed significantly throughout treatment. All patients experienced diffuse hyperpigmentation.
We propose that afamelanotide represents a novel and potentially effective treatment for vitiligo. The combined therapy of NB-UV-B and afamelanotide appears to promote melanoblast differentiation, proliferation, and eumelanogenesis. Further studies are necessary to confirm these observations.
"In a preliminary result, 4 cases of vitiligo treated with NBUVB combined with
melanotrophic hormone synthetic analog afamelanotide obtained diffuse and fast
repigmentation, although more studies are needed.38 "
[Show abstract][Hide abstract] ABSTRACT: In an unprecedented effort in the field of vitiligo, a global consensus resulted on a
suggested new classification protocol for the disease. The main histopathological
finding in vitiligo is the total absence of functioning melanocytes in the lesions,
while the inflammatory cells most commonly found on the edges of the lesions are CD4+
and CD8+ T lymphocytes. Physical and pharmacological treatment strategies aim to
control the autoimmune damage and stimulate melanocyte migration from the unaffected
edges of lesions and the outer hair follicle root sheath to the affected skin;
moreover, surgical treatments can be combined with topical and physical
[Show abstract][Hide abstract] ABSTRACT: The Evidence Based Update (EBU) meetings are annual one day meetings held by the Centre of Evidence-Based Dermatology (CEBD) at the University of Nottingham. The aim of the meeting is to discuss high quality evidence, mainly in the form of systematic reviews and randomised controlled trials (RCTs), on a different topic each year. The meetings are designed to be interactive with a panel discussion between international experts and delegates forming a key part of the meeting. The 11(th) EBU meeting was on vitiligo and took place on 23(rd) May 2013 in Loughborough, UK. The most recent research including new and unpublished studies was presented on the classification of vitiligo, the evidence behind different treatment options and current guidelines for vitiligo. This article is protected by copyright. All rights reserved.
British Journal of Dermatology 10/2013; 170(3). DOI:10.1111/bjd.12669 · 4.28 Impact Factor
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