Introduction: Vitiligo is an acquired idiopathic disorder characterized by hypochromic and achromic well-delimited macules.The 308 nm excimer laser can be used to treat this condition. Objective:To analyze studies published in indexed medical journals on the use of the 308 nm excimer laser in the treatment of vitiligo. Method: Adopting a qualitative approach, a survey of related articles from 2001 to 2009 was carried out using the Medline, Lilacs and Scielo databases. Results: According to the literature review, the 308 nm excimer laser achieved positive results in the treatment of vitiligo. Recent lesions and those located on the face responded better than those located elsewhere.The extremities of the body were more difficult to treat using this method.The patient’s age did not affect the outcome. On average, 11 sessions were necessary before the re-pigmentation started. Ideally, the laser application should be carried out from one to three times a week, with at least 48-hour intervals. Conclusion: The 308 nm excimer laser is effective and safe in the treatment of vitiligo when compared to other treatment modalities.The results depend on the location and the timeline of the disorder.

Keywords: VITILIGO, LASERS EXCIMER, SKIN

Introduction: Since patients with vitiligo are believed to be more susceptible to developing malignant neoplasias due to the lack of melanin in the affected skin, the use of sunscreens is critically important.
Objective: To evaluate the pattern of sunscreen usage in vitiligo patients.
Methods: A transverse study of vitiligo patients was conducted from August 2009 to April 2010. The following variables were studied using a questionnaire and physical examination: demographic data (gender, age, education level, and phototype); clinical characteristics of the condition (age at diagnosis, affected areas of the body, and clinical type); sunscreen use (frequency, protection factor, and duration of use); and habits of sun exposure.
Results: Of the 121 study subjects, 43 used sunscreen – mainly with sun protection factor 30 – on a daily basis.The variables associated with daily use were female gender (p = 0.001, OR = 4.76, 95% CI = 1.80-12.59) and recommendation by a dermatologist in the first medical visit (p = 0.047, OR=2.28, 95% CI = 1.01-5.28).
Conclusion: A pattern of sunscreen usage was determined for patients with vitiligo. In addition, it was verified that a dermatologist''''''''s recommendation to wear sunscreen had a statistically significant impact (p = 0.047, OR=2.28, 95% CI = 1.01-5.28).
Keywords: vitiligo; evaluation; sunscreening agents.

Keywords: VITILIGO, EVALUATION, SUNSCREENING AGENTS

Introduction: Vitiligo is cosmetically disfiguring and can cause significant psychological morbidity. Most therapies require protracted treatments and can lead to disappointing results. More recently, 308 nm Excimer laser has proven to be effective in treating vitiligo.
Objective: To analyze the effectiveness and patient satisfaction of 308 nm Excimer treat- ment for vitiligo patches in a variety of locations on the body.
Methods: Patients with generalized or localized vitiligo (n = 123, 321 lesions), were studied. The patients were treated at a private practice between 2007 and 2010. Two inde- pendent examiners analyzed the response to the therapy by comparing clinical and pho- tographic records before and after treatment.
Results: More than half (n = 77) of the patients presented repigmentation greater than 60%, 26 presented 40-59%, and 20% had levels less than 39%. Facial lesions responded better to treatment than those in other body parts. Elbows, hands and feet were the less sensitive areas. In general, the patients were satisfied with the treatment.
Conclusion: The use of Excimer laser for treating vitiligo was effective and safe, produc- ing satisfactory cosmetic results and improving patients'''''''' self esteem.

Keywords: VITILIGO, EXCIMER''S LASER, PHOTOTHERAPY

Introduction: The authors have carried out a retrospective analysis of data from 26 patients with developing vitiligo who were treated with oral mini-pulse of dexamethasone. Clinical response and side effects were evaluated at monthly intervals. Of the 26 patients included in the study, 12 (46.2%) presented a repigmentation of lesions, 11 (42.3%) stabilized, and 3 (11.5%) experienced a worsening of the condition. Ten patients (38.5%) had side effects, the most common of which was weight gain. There was a correlation between the duration of the treatment and the frequency of side effects.

Keywords: VITILIGO, PULSE THERAPY, DRUG, DEXAMETHASONE

Introduction: Vitiligo is a pigmentation disorder with great potential for cosmetic disfigurement and emotional impact on patients – especially during pregnancy. The prognosis of autoimmune diseases during pregnancy is variable, and no studies evaluating the prognosis of vitiligo during pregnancy was found in the literature review carried out by the authors. Objective: To evaluate the behavior of vitiligo during pregnancy and the postpartum period. Methods: A descriptive transversal investigation was carried out with a population of 86 women diagnosed with vitiligo, who answered a standardized questionnaire. Results: Among the women studied, only 28 patients (43.07%) had a diagnosis of vitiligo coinciding with pregnancy, totaling 57 pregnancies (33.92%) with vitiligo. Regarding the behavior of vitiligo during pregnancy, there was a worsening of vitiligo in 10 pregnancies (17.54%), stability in 38 (66.66%), and improvement in seven (12.28%). As for the evolution of vitiligo within 6 months postpartum, 16 patients (28.07%) had a worsening of the disease, 36 (63.15%) remained stable, and three (5.26%) improved. In two pregnancies (3.50%) the patient did not provide information about the behavior of the disease. Conclusion: In most patients, vitiligo remained stable during pregnancy, as well as in the 6 months postpartum.

Keywords: VITILIGO, PROGNOSIS, PREGNANCY

Introduction: UV light-induced photodamage is an acute precipitator of solar erythema, which is the phenomenon measured to assess the protection against the sun provided by a particular product. Objective: To investigate the ability of a dietary supplement containing antioxidants (carotenoids, trace elements/oligoelements, flaxseed oil, and vitamins E and C) to prevent photodamage, using as a parameter the minimum erythema dose level. Method: The minimum erythema dose level of 28 volunteers (Fitzpatrick skin types 2 and 3) was measured with a solar simulator, before and after 30 and 60 days of supplement use. Results: The daily use of the supplement was well tolerated. There was a significant increase in the minimum erythema dose level in the group evaluated (p = 0.017). Conclusion: The studied combination of antioxidants was demonstrated to increase the minimum erythema dose level with statistical significance, suggesting the presence of photoprotective activity.

Keywords: ULTRAVIOLET RAYS, ANTIOXIDANTS, CAROTENOIDS.

Introdução: Vitiligo is an acquired autoimmune form of hypopigmentation or depigmentation in which half of the cases begins in childhood. Objectives: To describe the clinical and epidemiological profile of childhood vitiligo in a referral center for dermatology. Methods: A cross-sectional, descriptive study was carried out based on the analysis of medical records of patients younger than 13 years diagnosed with vitiligo from 2004 to 2014. Results: Of the 113 cases identified, 54% were female and 46% male, the age ranged from 0 to 12 years, with most patients in the 4-8 years-old subgroup (54.8%). In 59% of the medical records there was no record of triggering factors of vitiligo; 31% of patients associated the onset of the illness to emotional stress, 3% to physical trauma and 7% did not associate it to any triggering factor. Conclusions: The discreet prevalence in women has also been reported in other studies. Vitiligo behavior in children is different from that observed in adults. The influence of psychological factors as triggers and potential lasting effects on self-esteem should be considered in the approach of the patient. Although studies on vitiligo in this age group are scarce in the literature, the results of the present study were similar to the reports already available in the literature.

Keywords: CHILD; EPIDEMIOLOGY; VITILIGO

Introduction: Photoprotectors are the active ingredients of sunscreens with the capability of protecting the skin against UV radiation. An increasing number of such photoprotection ingredients have been launched in the marketplace, causing sunscreens' formulas to become increasingly varied. Objective: To list the main active photoprotection ingredients contained in formulations commercially available in Brazil, as well as to document the presence of other ingredients contained in sunscreens. Methods: The authors inspected four drugstores in the city of Rio de Janeiro, Brazil, and analyzed the formulas of the SPF 30 sunscreens available. The active photoprotector substances found in all formulations were listed and the percentage of each of them was compared to those contained in all sunscreens evaluated. The presence of plant extracts and antioxidants was also documented. Results: Thirty commercially available SPF 30 sunscreens were found in different drugstores, having their formulas analyzed. Within this sample, there were 17 different active photoprotection principles, of which titanium dioxide was the most frequently found, followed by bis-ethylhexyloxyphenol methoxyphenyl triazine. Conclusion: The present study lists the profiles of photoprotection active principles found in the main sunscreens on sale in Brazil and provides data for further evaluation of changes in these profiles over time, as new sunscreens are launched in the marketplace.

Keywords: PHOTOPROTECTORS; SUNSCREENS; PHOTOPROTECTION; ULTRAVIOLET RAYS

Vitiligo is a hypopigmentation disorder that is characterized by macules and selective destruction of functional epidermal melanocytes. It is characterized by defilements and circumscribed depigmented patches. Vitiligo affects around 0,5% about 0.5% -2% of the general population worldwide, and is not observed preference for sex and ethnicity. The goals of treatment are repigmentation of vitiligo and stabilization of depigmentation process. We report the case of a 53-year-old female patient who underwent underwent experimental stem cell therapy with autologous biologically expanded stem cells isolated from hair follicle, holding three sessions with three months apart. The vitiligo affected area was relatively decreased in density with a rare repigmentation pattern.

Keywords: STEM CELLS; VITILIGO; THERAPEUTICS

Vitiligo is an acquired pigmentation disorder characterized by the development of well-defined achromic macules in the skin. It is deemed stable when no new lesion emerges or when pre-existing lesions do not undergo changes for at least one year. In these cases, surgical treatment is an important therapeutic option. Punch micrografting is the most commonly performed melanocyte transplantation technique, resulting in excellent repigmentation. The authors describe a variation of this technique using even smaller and finer grafts (consisting of epidermis and thin dermis), in order to achieve aesthetical outcomes that are better than those obtained with the traditional technique, especially when treating areas with significant aesthetic impairment.

Keywords: Melanocytes; Transplantation; Vitiligo

INTRODUCTION: Vitiligo is a hypopigmented disorder characterized by irregular loss of of the skin pigmentation. Current therapeutic modalities focus on increasing melanin production and modulating immune system responses. The use of some combined topical agents, in appropriate concentrations, is a possibility for the treatment of such hypopigmentation disorders.
OBJECTIVE: To follow-up patients who used a combination of creams in the experimental times of 6 and 14 months and to determine the effectiveness of the formulation.
METHODS: Forty-one patients with generalized stable vitiligo participated in the study. Patients applied a cream containing acetyl hexapeptide-1, mometazone furoate and dihydroxyacetone. The sites of the lesions included eyelids, forehead, face, neck, fingertips, hands, feet and legs. The variations in the treated patches were evaluated by dermatologists at each experimental visit. The percentage of repigmentation was evaluated after 6 months.
RESULTS: After 6 months of treatment, 8 patients (19.51%) had an excellent response to treatment, while a good response was observed in 19 patients (46.34%), moderate response in 10 (24.39%), and unsatisfactory in 4 (9.75%). Eyelids, face and forehead presented the best rate of repigmentation, while fingertips response was generally unsatisfactory.
CONCLUSIONS: The data support the efficacy of the new cream evaluated by the present study.

Keywords: Skin Pigmentation; Skin Cream; Vitiligo

INTRODUCTION: Vitiligo is a chronic acquired skin disease, which evolves with depigmentation. The control of disease activity is a therapeutic challenge. Systemic corticosteroids, in daily use or in pulse doses, are the most used treatment for the disease.
OBJECTIVE: To evaluate the effect of minocycline on the control over vitiligo activity compared with the corticosteroid therapy.
METHODS: Randomized clinical trial with 16 active vitiligo vulgaris patients, divided into two groups: MINO group: minocycline 100mg/day, orally, for three months; and CORT group: prednisolone 0.3mg/kg/day, orally, for two months, and 0.15 mg/kg/day in the third month. The patients were evaluated before and after the treatment by photographic records and evaluation of the scores obtained by the VIDA score (vitiligo disease activity score).
RESULTS: According to the photographic records, there was control of vitiligo activity in 100% of patients in the MINO group compared with 60% in the CORT group. In the comparison using the VIDA score, we noticed a statistically significant diference for both groups; however, we found that the reduction was greater in the MINO group, evidencing more effectiveness of minocycline in controlling the vitiligo activity.
CONCLUSION: This study demonstrated the efficacy of minocycline in the control of active vitiligo compared with a systemic corticosteroid regimen. Additional studies should be performed to confirm its efficacy.

Keywords: Vitiligo; Minocycline; Prednisolone

INTRODUCTION: Vitiligo is a pigmentation disorder characterized by white spots on the skin and mucous membranes. Wnt1 protein belongs to the Wnt signaling pathway. Wnt1 induction is linked with melanocyte stem cell differentiation in hair follicles on lentigo solaris, which is a hyperpigmentation skin disorder in sun-exposed area. This assumes the possibility of Wnt1 induction with NB-UVB therapy, which causes perifollicular repigmentation on vitiligo.
OBJECTIVES: To compare Wnt1 expressions in vitiligo repigmentation after NB-UVB treatment and to identify the relationship between Wnt1 expressions and vitiligo repigmentation area.
MATERIALS AND METHODS: The subjects of the study were 18 vitiligo patients. Immunohistochemical examination was conducted on vitiligo skin tissues pre- and post-phototherapy treatment twice a week for two months.
RESULTS: There were significant differences in the vitiligo lesion area between pre and post-therapy. Also, there were significant differences in Wnt1 expressions between pre and post-therapy. There was a correlation between the post-therapy Wnt1 expressions and the post-therapy vitiligo lesion area.
CONCLUSIONS: Wnt1 induction occurs in hair follicles post-NB-UVB therapy, causing pigmentation around hair follicles. Further studies are needed on the Wnt1 protein mechanism resulting in pigmentation around hair follicles.

Keywords: Hair Follicle; Melanocytes; Ultraviolet Therapy; Wnt1 Protein; Phototherapy; Vitiligo

Vitiligo is an acquired dyschromia that affects 0,1-3% of the world population and can cause significant psychosocial distress in patients. Surgical management became essential in the last years. Mini-punch grafting is one of the cheapest and most straightforward approaches to all surgical treatments available. A limitation of this technique is the possibility of cobblestone-like repigmentation. We describe a new technique with a dermoepidermal grafting obtained by shave excision of papule formed post punch grafting in vitiligo. It could improve the cobblestone pattern in the donor site and the repigmentation in both donor and recipient areas.

Keywords: Dermatology; Hypopigmentation; Vitiligo

INTRODUCTION: Vitiligo is an acquired skin dyschromia characterized by the physical and/or functional reduction of melanocytes. We present two surgical proposals for the treatment of vitiligo.
CASE REPORTS: 1) Implant of skin graft diluted in hyaluronic acid gel: We obtained the material through curettage, diluted it in hyaluronic acid gel, and applied it to receptor areas. 2) Epidermal suspension obtained through curettage and diluted in hyaluronic acid gel: After the curettage of the donor area, we treated the material with trypsin-EDTA, centrifuged it, and diluted it in hyaluronic acid gel. The receptor area received the graft.
CONCLUSION: These are safe, easy, and satisfactory surgical procedures for the presented cases.

Keywords: Vitiligo; Keratinocytes; Ambulatory surgical procedures