Vitiligo Medication

  • Author: Vlada Groysman, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Sep 29, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Corticosteroids

Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli. These drugs are used to stop spread of vitiligo and accomplish repigmentation. Data supporting the efficacy of such treatment is largely anecdotal. More study is needed to establish the safety and efficacy of systemic agents.

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Triamcinolone topical (Artistocort)

 

A medium potency topical steroid. Treats inflammatory dermatosis responsive to steroids. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing capillary permeability.

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Hydrocortisone topical (Westcort)

 

An adrenocorticosteroid derivative suitable for application to skin or external mucous membranes. Has mineralocorticoid and glucocorticoid effects resulting in relieve of pruritus.

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Clobetasol Propionate (Clobex, Temovate)

 

Class I superpotent topical steroid; suppresses mitosis and increases synthesis of proteins that decrease inflammation and cause vasoconstriction. Decreases inflammation by stabilizing lysosomal membranes, inhibiting PMN and mast cell degranulation.

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Psoralens

Class Summary

These agents are used with UV-A exposure for the treatment of localized or generalized vitiligo.

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Methoxsalen (8-MOP, Oxsoralen)

 

Inhibits mitosis by covalently binding to pyrimidine bases in DNA when photoactivated by UV-A. Effective in treating hyperkeratosis.

Trioxsalen (Trisoralen)

 

For treatment of hyperkeratosis. In UV-A radiation, inhibits mitosis by covalently binding to pyrimidine bases in DNA.

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Immunomodulator

Class Summary

Immunomodulators suppress the activity of the immune system.

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Tacrolimus ointment (Protopic)

 

The mechanism of action of tacrolimus in atopic dermatitis is not known. Reduces itching and inflammation by suppressing the release of cytokines from T cells. Also inhibits transcription for genes that encode IL-3, IL-4, IL-5, GM-CSF, and TNF-alpha, all of which are involved in the early stages of T-cell activation. Additionally, may inhibit release of pre-formed mediators from skin mast cells and basophils, and downregulate expression of FCeRI on Langerhans cells. Can be used in patients as young as 2 years old. Drugs of this class are more expensive than topical corticosteroids. It is available as an ointment in concentrations of 0.03 and 0.1%.

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Vitamins

Class Summary

Vitamin D analogs may regulate skin cell production and differentiation.

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Calcipotriene (Dovonex)

 

Synthetic vitamin D-3 analog that regulates skin cell production and development. Inhibits epidermal proliferation, promotes keratinocyte differentiation, and has immunosuppressive effects on lymphoid cells. Used in the treatment of moderate plaque psoriasis. Use 0.005% cream, ointment, or solution.

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Contributor Information and Disclosures
Author

Vlada Groysman, MD  Staff Physician, Department of Dermatology, University of Alabama School of Medicine

Vlada Groysman, MD is a member of the following medical societies: American Academy of Dermatology, Medical Dermatology Society, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Naveed Sami, MD, FAAD  Assistant Professor Department of Dermatology, University of Alabama School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mark G Lebwohl, MD  Chairman, Department of Dermatology, Mount Sinai School of Medicine

Mark G Lebwohl, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Amgen/Pfizer Honoraria Consulting; Centocor/Janssen Honoraria Consulting; DermiPsor Honoraria Consulting; GlaxoSmithKline Honoraria Consulting; HelixBioMedix Honoraria Consulting; Novartis Honoraria Consulting; Ranbaxy Lectures; Can-Fite Biopharma Honoraria Consulting; DermaGenoma Honoraria Consulting; Biosynexus Honoraria Consulting

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Edward F Chan, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Seung-Kyung Hann, MD, to the development and writing of this article.

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Trichrome vitiligo.
Marginal inflammatory vitiligo.
Segmental vitiligo.
Nonsegmental vitiligo.
 
 
 
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