Successful Treatment of Vitiligo Vietnamese Patients with VitilinexÂ® Herbal Bio-Actives in Combination with Phototherapy
Keywords:Vitiligo, Bio-actives, UVB narrow band (311 nm), Phototherapy, Re-pigmentation
BACKGROUND: Vitiligo is an acquired pigmentary disease, that causes progressive loss of melanocytes, resulting in hypopigmented skin patches. Current treatments aim at stopping the disease progression and achieving repigmentation of the amelanotic areas. Corticosteroids, surgery, topical immunomodulators, total depigmentation of normal pigmented skin and phototherapy are current treatment options for vitiligo although phototherapy remains the treatment of choice. There is no documented evidence that herbal bio-active products may also be effective treatment options for vitiligo.
AIM: This study aimed to investigate the efficacy and safety of VitilinexÂ® (herbal bio- actives) alone and in combination with UVB narrowband (311 nm) phototherapy, in the treatment of localised stable or active forms of vitiligo.
MATERIAL AND METHODS: Sixty two subjects with mean age 34.5 years (range: 18-58 years) with mild to moderate vitiligo, consisting of 36 females and 26 males were randomly divided into three treatment groups â€“ Group A (13 females, 10 males ) treated with VitilinexÂ® alone; Group B (12 females, 11 males) were treated with VitilinexÂ® in combination with narrowband UVB (311 nm) phototherapy for 15 seconds, using a handheld lamp and Group C (8 females, 8 males ) were treated with nbUVB (311 nm) phototherapy alone, for 15 seconds over a 12-week period.
RESULTS: In Group A, 9 patients (39%) achieved outstanding improvement with a re-pigmentation rate higher than 75%, with 2 patients experiencing total repigmentation. 6 patients (26%) had marked improvement with a repigmentation rate between 50-75% while 5 patients (22%) showed a moderate response between 25-50% re-pigmentation rate. 3 patients (13%) had minimal or no improvement. In Group B, 16 patients (69.5%) achieved outstanding improvement with a re-pigmentation rate higher than 75%, with 12 patients experiencing total re-pigmentation. 4 patients (17.5 %) achieved a marked improvement with a re-pigmentation rate between 50-75%; 2 patients (8.7%) showed a moderate response with a re-pigmentation rate between 25-50%. 1 (4.3%) patient had minimal or no improvement. In Group C, 6 patients (37.5%) achieved a re-pigmentation rate higher than 75%, with 2 patients experiencing total re-pigmentation. 4 patients (25%) achieved marked improvement with a re-pigmentation rate between 50-75% while 3 patients (18.75%) had a re-pigmentation rate between 25-50%. 3 patients (18.75%) had minimal or no improvement.
CONCLUSION: VitilinexÂ® herbal bio-actives in combination with nbUVB is a more effective treatment option for vitiligo with 87% of the patients achieving a re-pigmentation rate higher than 50%, compared to VitilinexÂ® alone (65%) or nbUVB alone (62.5%).
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Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: a comprehensive overview: part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, aetiology, and work-up. Journal of the American Academy of Dermatology. 2011; 65(3):473-91. https://doi.org/10.1016/j.jaad.2010.11.061 PMid:21839315
Lotti T, Hautmann G, HercogovÃ J. Vitiligo: disease or symptom? From the confusion of the past to current doubts. In: Lotti T, HercogovÃ J, eds. Vitiligo. Problems and solutions. New York, NY, Basel: Marcel Dekker, Inc, 2004:1-14. PMid:15063608
Shah AA, Sinha AA. Oxidative stress and autoimmune skin disease. Eur J Dermatol. 2013; 23(1):5-13. PMid:23420016
Palermo B, Campanelli R, Garbelli S et al. Specific cytotoxic T lymphocyte responses against Melan-A/MART1, tyrosinase and gp100 in vitiligo by the use of major histocompatibility complex/peptide tetramers: the role of cellular immunity in the etiopathogenesis of vitiligo. J Invest Dermatol. 2001. https://doi.org/10.1046/j.1523-1747.2001.01408.x PMid:11511311
Choice D, et al. Vitiligo: a review of the pathogenesis. Egyptian Women's Dermatologic Society, 2014:1687-1537.
Sehgal VN, Srivastava G. Vitiligo: a compendium of clinico-epidemiological features. Indian Journal of Dermatology, Venereology, and Leprology. 2007; 73(3):149-56. https://doi.org/10.4103/0378-6323.32708
Ojojarumi EP, et al. Clinical Characteristics of Vitiligo among Adult Patients at the Obafemi Awolowo University Teaching Hospitals' Complex (OAUTHC), Ile-Ife, Osun State, Nigeria British Journal of Medicine & Medical Research. 2017; 20(4):1-8. https://doi.org/10.9734/BJMMR/2017/32026
Gawkrodger DJ, Ormerod AD, Shaw L, Mauri-Sole I, Whitton ME, Watts MJ, Anstey AV, Ingham J, Young K. Vitiligo: concise evidence based guidelines on diagnosis and management. Postgraduate medical journal. 2010; 86(1018):466-71. https://doi.org/10.1136/pgmj.2009.093278 PMid:20709768
Gianfaldoni S, Wollina U, Tirant M, Tchernev G, Lotti J, Satolli F, Rovesti M, FranÃ§a K, Lotti T. Herbal Compounds for the Treatment of Vitiligo: A Review. Open Access Maced J Med Sci. 2018.
Lotti T, Wollina U, Tchernev G, Valle Y, Lotti J, FranÃ§a K, Satolli F, Rovesti M, Tirant M, Lozev I, Pidakev I, Gianfaldoni S. An Innovative Therapeutic Protocol for Vitiligo: Experience with the Use of Fraxel Herbium Laser, Topical Latanoprost and Successive Irradiation with UVA - 1 Laser. Open Access Maced J Med Sci. 2018; 6(1):49-51. https://doi.org/10.3889/oamjms.2018.059 PMid:29483980 PMCid:PMC5816313
Gianfaldoni S, Tchernev G, Wollina U, Roccia MG, Fioranelli M, Lotti J, Rovesti M, Satolli F, Valle Y, Goren A, Tirant M, Situm M, Kovacevic M, FranÃ§a K, Lotti T. Micro - Focused Phototherapy Associated To Janus Kinase Inhibitor: A Promising Valid Therapeutic Option for Patients with Localized Vitiligo. Open Access Maced J Med Sci. 2018; 6(1):46-48. https://doi.org/10.3889/oamjms.2018.042 PMid:29483979 PMCid:PMC5816312
Dorni AC, Amalraj A, Gopi S, Varma K, Anjana SN. Novel cosmeceuticals from plantsâ€”An industry guided review. Journal of applied research on medicinal and aromatic plants. 2017; 7:1-26. https://doi.org/10.1016/j.jarmap.2017.05.003
Hart PH, Brand C, Carson CF, Riley TV, Prager RH, Finlay-Jones JJ. Terpinen-4-ol, the main component of the essential oil of Melaleuca alternifolia (tea tree oil), suppresses inflammatory mediator production by activated human monocytes. Inflammation Research. 2000; 49(11):619-26. https://doi.org/10.1007/s000110050639 PMid:11131302
Farris PK. Cosmeceutical vitamins: vitamin C. Cosmeceuticals E-Book: Procedures in Cosmetic Dermatology Series. 2014:37.
Kim JM, Noh EM, Kwon KB, Hwang BM, Hwang JK, You YO, Kim MS, Lee W, Lee JH, Kim HJ, Kim JS, Lee YR. Dihydroavenanthramide D prevents UV-irradiated generation of reactive oxygen species and expression of matrix metalloproteinase-1 and -3 in human dermal fibroblasts. Exp Dermatol. 2013; 22(11):759-61. https://doi.org/10.1111/exd.12243 PMid:24103002 PMCid:PMC4251632
Alamgir AN. Secondary Metabolites: Secondary Metabolic Products Consisting of C and H; C, H, and O; N, S, and P Elements; and O/N Heterocycles. Therapeutic Use of Medicinal Plants and their Extracts. 2018; 2:165-309. https://doi.org/10.1007/978-3-319-92387-1_3
Faas L, Venkatasamy R, Hider RC, Young AR, Soumyanath A. In vivo evaluation of piperine and synthetic analogues as potential treatments for vitiligo using a sparsely pigmented mouse model. British Journal of Dermatology. 2008; 158(5):941-50. https://doi.org/10.1111/j.1365-2133.2008.08464.x PMid:18284389
Lin Z, Liao Y, Venkatasamy R, Hider RC, Soumyanath A. Amides from Piper nigrum L. with dissimilar effects on melanocyte proliferation inâ€vitro. Journal of pharmacy and pharmacology. 2007; 59(4):529-36. https://doi.org/10.1211/jpp.59.4.0007 PMid:17430636
Bezerra DP, Pessoa C, de Moraes MO, Saker-Neto N, Silveira ER, Costa-Lotufo LV. Overview of the therapeutic potential of piplartine (piperlongumine). European Journal of Pharmaceutical Sciences. 2013; 48(3):453-63. https://doi.org/10.1016/j.ejps.2012.12.003 PMid:23238172
Barygina V, Becatti M, Lotti T, Moretti S, Taddei N, Fiorillo C. Treatment with low-dose cytokines reduces oxidative-mediated injury in perilesional keratinocytes from vitiligo skin. Journal of dermatological science. 2015; 79(2):163-70. https://doi.org/10.1016/j.jdermsci.2015.05.003 PMid:26051876
Gianfaldoni S, Tchernev G, Wollina U, et al. Vitiligo in Children: What's New in Treatment? Open Access Maced J Med Sci. 2018;6(1):221-225. https://doi.org/10.3889/oamjms.2018.060
Gianfaldoni S, Wollina U, Tchernev G, Lotti J, FranÃ§a K, Lotti T. Vitiligo in Children: A Review of Conventional Treatments. Open Access Maced J Med Sci. 2018;6(1):213-217. https://doi.org/10.3889/oamjms.2018.054
Gianfaldoni S, Wollina U, Tirant M, et al. Herbal Compounds for the Treatment of Vitiligo: A Review. Open Access Maced J Med Sci. 2018;6(1):203-207. https://doi.org/10.3889/oamjms.2018.048
Gianfaldoni S, Tchernev G, Wollina U, et al. Vitiligo in Children: A Better Understanding of the Disease. Open Access Maced J Med Sci. 2018;6(1):181-184. https://doi.org/10.3889/oamjms.2018.040 PMid:29484022 PMCid:PMC5816297
Gianfaldoni S, Tchernev G, Lotti J, et al. Unconventional Treatments for Vitiligo: Are They (Un) Satisfactory?. Open Access Maced J Med Sci. 2018;6(1):170-175. https://doi.org/10.3889/oamjms.2018.038 PMid:29484020 PMCid:PMC5816295
Lotti T, Wollina U, Tchernev G, et al. An Innovative Therapeutic Protocol for Vitiligo: Experience with the Use of Fraxel Herbium Laser, Topical Latanoprost and Successive Irradiation with UVA - 1 Laser. Open Access Maced J Med Sci. 2018;6(1):49-51. https://doi.org/10.3889/oamjms.2018.059 PMid:29483980 PMCid:PMC5816313
Gianfaldoni S, Tchernev G, Wollina U, et al. Micro - Focused Phototherapy Associated To Janus Kinase Inhibitor: A Promising Valid Therapeutic Option for Patients with Localized Vitiligo. Open Access Maced J Med Sci. 2018;6(1):46-48. https://doi.org/10.3889/oamjms.2018.042 PMid:29483979 PMCid:PMC5816312
Lotti T, Tchernev G, Wollina U, et al. Successful Treatment with UVA 1 Laser of Non - Responder Vitiligo Patients. Open Access Maced J Med Sci. 2018;6(1):43-45. https://doi.org/10.3889/oamjms.2018.047 PMid:29483978 PMCid:PMC5816311
Stanimirovic A, Kovacevic M, Korobko I, Å itum M, Lotti, T. Combined therapy for resistant vitiligo lesions: NBâ€UVB, microneedling, and topical latanoprost, showed no enhanced efficacy compared to topical latanoprost and NBâ€UVB. Dermatologic Therapy. 2016; 29:312-316. https://doi.org/10.1111/dth.12363 PMid:27356486
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Copyright (c) 2019 Trang Trinh Minh, Doanh Le Huu, Thuong Nguyen Van, Sau Nguyen Huu, Tung Vu Thanh, Nghi Dinh Huu, Van Tran Cam, My Le Huyen, Khang Tran Hau, Hao Nguyen Trong, Marco Gandolfi, Francesca Satolli, Claudio Feliciani, Michael Tirant, Aleksandra Vojvodic, Torello Lotti
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