engleski

VITILIGO TREATMENT IN 2017

Available treatment options for vitiligo are aimed first on stopping of the disease spreading, second on induction of repigmentation and third, but most important for the patient, on achieving of sufficient cosmetic results. Vitiligo is neither contagious nor life threatening disease so it is often widely assumed among the medical community and unfortunately also among dermatologists that problems which affect the patients just have a cosmetic nature. Due to this matter, vitiligo is worldwide considered as an orphan disease and unfortunately, many physicians (including dermatologists) still consider vitiligo to be an incurable disease and are not familiar with available therapeutic options. In this lecture we present five therapeutic algorithms for vitiligo treatment constituted from different worldwide working groups and organizations in the last decade. The following therapeutic options include mainly potent topical corticosteroids, topical calcineurin inhibitors, topical vitamin D3 analogues, combined topical therapies, phototherapy (PUVA and NBUVB), oral corticosteroids, oral antioxidants, and finally, laser and surgical therapy, microneedling and pigment transplantation being the most known. We point out here also to the new group of drugs, JAK 1 and JAK 3 inhibitors, with their representatives topical tofacitinib and topical ruxolitinib, two of the most promising new drugs in vitiligo treatment. British authors established algorithm for the management of vitiligo in adults and children by non- specialists in 2010. One year after, group of authors from USA suggests their algorithm for dermatologists. The European Dermatology Forum Consensus presented algorithms for the management of patients with nonsegmental or segmental vitiligo in 2013, the same year when Japanese dermatologists provided their proposal of the algorithm for the management of vitiligo in Japan. Considering available international guidelines for the management of vitiligo, both available and for the time being unavailable therapeutic options in Croatia, and our wide clinical experience, we have established our guidelines for the management of vitiligo in Croatia in 2014. This proposal and selection of specific therapeutic options in several lines are based on international up-to- date guidelines in accordance with evidence based medicine.

vitiligo ; therapy

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