Vitiligo is an ever-increasing condition that affects people of all ages around the world. Sun exposure, UVR, oral and topical psoralens are all used in different regimens. NEEDLING is paired with narrow band UVB radiation in our study, which is an innovative effort with a novel concept. The Melanocytes in the normal skin around the vitiligo patch can be pushed into the vitiligo patch, and subsequent UVB induced melanogenesis heals vitiligo, according to our hypothesis.
Methods: A 30-G needle with a short stem is gently placed parallel to the skin through the normal skin edge into the vitiligo patch at the level of the D-E junction. NEEDLING pulls epidermal cells, including melanocytes, as a micro inoculation, resulting in several small populations of melanocytes in the vitiligo area, which are subsequently exposed to narrow band UVB, causing melanogenesis and thereby repigmentation of the area. One centimetre apart, many needle pushes are conducted through the edge into the vitiligo patch. Needling is done once a week for all patients, and UVB is done three times a week.
From July 2009 through July 2016, a study of this combination was conducted on 300 patients of both sexes in various age groups, with follow-up continuing. In several of these individuals, a comparison with UVB alone (without needling) was made at some patches. It was decided on inclusion and exclusion criteria, as well as a result criteria and a study Performa with follow-up information. All of the patients' photos were taken in the beginning and then every three weeks after that. A few patients were biopsied to see how the needling affected them.
In comparison to UVB alone, this combined treatment has proven to be quite safe and effective against vitiligo in all age groups. All of the patients saw rapid repigmentation. The face has the best outcomes, with more than 90% repigmentation in all age categories. Repigmentation is still good, but it is slower in the periphery. Repigmentation was observed to begin at the periphery of the vitiligo patch (where needling begins) as little black dots, with subsequent needling through these spots eventually repigmenting the centre portions. Because needling employs melanocytes from the skin around the vitiligo patch rather than follicular cells, repigmentation is also possible over areas with grey hair. This bolstered the case for needling as an effective adjunct to UVB therapy.Author(S) Details
M. I. Sheikh
Consultant Dermatologist, Alhamd Skin Clinic, Pakistan.
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