Vitiligo Clinical Trial
Official title:
The Reflection of Skin Color on the Efficacy of Narrow Band UVB in Stabilization of Active Cases of Vitiligo
Vitiligo is a disease in which autoimmunity plays a major role. Multiple treatment options
are available, of which narrow-band UVB is a cornerstone, acting through immunosuppression
and repigmentation by stimulating reservoir melanocytes.
It's expected that this immunsupression is lower in darker skin types, where increased basal
melanin might act as a barrier.
Vitiligo is acquired depigmentation disorder. Several theories were hypothesized for causing
vitiligo, of which the autoimmune theory is the most accepted.
The main targets of therapy are stabilization of the disease activity through
immunosuppression, and repigmentation through stimulation of reservoir melanocytes
proliferation and migration.
Narrow band ultraviolet phototherapy (NB-UVB) remains the cornerstone treatment of vitiligo.
NB-UVB can induce both immunosuppression and repigmentation. Several factors can modulate the
efficacy of NB-UVB therapy in treatment of vitiligo cases, including patient's age, lesion
site, duration of the disease, and duration of the therapy.
The immunosuppressive function of NB-UVB was first detected in 1963 by Hanisko and Suskind,
who observed that the contact hypersensitivity response in skin sensitized to
dinitrochlorobenzene (DNCB) was reduced if skin was previously exposed to suberythemal doses
of UVB.
Present evidence suggests that UVB suppress immune system through generation of T-suppressor
cells, which inhibit the effector cells of Th1 type. It appears that UV-induced
immunosuppression depresses the function of Th1 cells and enhances the activity of Th2 cells
via cytokines such as Interleukin 10.
It's expected that this immunsupression is lower in darker skin types, where increased basal
melanin might act as a barrier. However, skin was previously divided to UVB-resistant and
UVB-sensitive (UVB-R and UVB-S) based on the contact hypersensitivity testing, regardless of
the skin type. Moreover, A study on NB-UVB phototherapy for psoriasis revealed that
photoadaptation during NB-UVB therapy Is Independent of skin type.
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