Cases reported "Vitiligo"

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1/3. Successful treatment of progressive vitiligo with high-dose intravenous methylprednisolone 'pulse' therapy.

    We report on the successful therapy of rapid progressive generalized vitiligo in a 24-year-old woman. After intravenous injection of 500 mg of methylprednisolone on 3 consecutive days, the disease progression was stopped and repigmentation was induced. The treatment was repeated monthly and after 6 cycles, repigmentation was achieved on vast parts of most vitiligo lesions. The treatment was well tolerated by the patient, and no side effects were noted. We conclude that high-dose glucocorticoid pulse therapy may represent a therapeutic alternative in selected patients with generalized rapid progressive vitiligo.
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2/3. Treatment of localized vitiligo by autologous minigrafting.

    Autologous minigrafting has been reported as an effective method for repigmenting diverse types of stable leukoderma. A group of 22 patients with localized vitiligo, 17 segmental and five focal, who are under treatment with this method, are described. Thirteen patients attained a 90% to 100% repigmentation, two others achieved a partial improvement, and five patients had a positive test area indicating the possibility of repigmentation by means of this procedure. Only two patients had a negative test with minigrafts and, consequently, they were left untreated. Autologous minigrafting is suggested as an alternative for treating localized vitiligo, particularly when other medical therapeutic attempts have failed in repigmenting this often refractory condition.
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3/3. Suplatast tosilate (IPD), a new immunoregulator, is effective in vitiligo treatment.

    The major type of vitiligo is considered to be an autoimmune disorder. Anti-melanocyte antibodies are frequently detected in sera of patients with this disease. Interleukin (IL)-4 released from th2 cells is an important factor in stimulating autoantibody production by B-cells. In this study, seven patients with vitiligo treated with suplatast tosilate (IPD), three showed repigmentation and improvement of their lesions after administration of the drug. IPD halted the continuous spread of the lesions in three of the other patients, and, in two of them, also reduced microsome test and thyroid test titers. The efficacy of IPD in treating vitiligo was thought to be due to the suppressive effect of this drug on IL-4 production. No side effect was observed. Thus IPD may represent a new alternative in vitiligo treatment due to its inhibition of autoimmunity by the suppression of IL-4.
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