Clinical and pathogenetic assessment of cyclosporine efficacy in the complex therapy of non-segmental vitiligo patients
- Authors: Nikulina A.S.1, Lomonosov K.M.1
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Affiliations:
- The First Sechenov Moscow State Medical University (Sechenov University)
- Issue: Vol 27, No 2 (2024)
- Pages: 189-199
- Section: DERMATOLOGY
- URL: https://journal-vniispk.ru/1560-9588/article/view/262158
- DOI: https://doi.org/10.17816/dv625411
- ID: 262158
Cite item
Abstract
BACKGROUND: Vitiligo is a chronic disease of unknown etiology, characterized by the appearance of depigmented spots on various areas of the skin, rarely on mucous membranes, and discolored hair due to destruction and reduction of melanocytes. While not life-threatening, vitiligo significantly impacts the psychoemotional aspect. Studies assessing the quality of life of vitiligo patients reveal the presence of depression in these individuals. In addition to depression, a high susceptibility to anxiety, stigmatization, sleep disturbances, adaptation, and problems in personal relationships have been identified. The prevalence of depression and anxiety among vitiligo patients is comparable to other dermatological conditions such as atopic dermatitis, acne, psoriasis, and urticaria. This underscores the need to seek new means and methods for treating this condition.
AIM: Clinical assessment of the effectiveness of using cyclosporine in combination with UVB 311 nm and monotherapy with UVB 311 nm for vitiligo.
MATERIALS AND METHODS: The study involved 40 patients with progressive vitiligo. All patients were randomly divided into two groups. Group 1 (20 individuals) underwent a course of cyclosporine therapy in combination with UVB therapy, while Group 2 (20 individuals) received monotherapy with UVB 311 nm. The duration of the treatment was 6 months. The extent of the affected area relative to the body surface area was evaluated using the VES index (Vitiligo extent score) on a vitiligo calculator. The impact of the disease on the quality of life was assessed using the VitiQoL scale (vitiligo-specific quality-of-life instrument).
RESULTS: All patients included in the study completed the full course of treatment. Group 1 (20 individuals) underwent a course of cyclosporine therapy in combination with UVB therapy, while Group 2 (20 individuals) received monotherapy with UVB 311 nm. Patients in the combined therapy group experienced earlier stabilization of the skin process compared to those receiving monotherapy with UVB 311 nm. Additionally, Group 1 demonstrated more pronounced repigmentation of vitiligo lesions and significant improvement in quality of life compared to Group 2.
CONCLUSION: Cyclosporine in combination with narrowband phototherapy at 311 nm demonstrated good clinical efficacy and significant improvement in quality of life for non-segmental vitiligo patients. Cyclosporine is well-tolerated, has a low spectrum of side effects, and can be used long-term for patients with active vitiligo.
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##article.viewOnOriginalSite##About the authors
Alena S. Nikulina
The First Sechenov Moscow State Medical University (Sechenov University)
Author for correspondence.
Email: a.niku@mail.ru
ORCID iD: 0000-0002-0736-8022
SPIN-code: 8652-3101
Russian Federation, Moscow
Konstantin M. Lomonosov
The First Sechenov Moscow State Medical University (Sechenov University)
Email: lamclinic@yandex.ru
ORCID iD: 0000-0002-4580-6193
SPIN-code: 4784-9730
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowReferences
- Clinical recommendations. The Vitiligo. L80. Adults and children. Russian Society of Dermatovenerologists and Cosmetologists; 2020. 37 р. (In Russ).
- Alikhan A, Felsten LM, Daly M, et al. Vitiligo: A comprehensive overview. Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up. J Am Acad Dermatol. 2011;65(3):473–491. doi: 10.1016/j.jaad.2010.11.061
- Bae JM, Lee SC, Kim TH, et al. Factors affecting quality of life in patients with vitiligo: A nationwide study. Br J Dermatol. 2018;178(1):238–244. doi: 10.1111/bjd.15560
- Bergqvist C, Ezzedine K. Vitiligo: A review. Dermatology. 2020;236(6):571–592. doi: 10.1159/000506103
- Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol. 2012;51(10):1206–1212. doi: 10.1111/j.1365-4632.2011.05377.x
- Homan MW, Spuls PI, de Korte J, et al. The burden of vitiligo: Patient characteristics associated with quality of life. J Am Acad Dermatol. 2009;61(3):411–420. doi: 10.1016/j.jaad.2009.03.022
- Elbuluk N, Ezzedine K. Quality of life, burden of disease, co-morbidities, and systemic effects in vitiligo patients. Dermatol Clin. 2017;35(2):117–128. doi: 10.1016/j.det.2016.11.002
- Varzhapetyan AA, Dorozhenok IYu, Lomonosov KM. Vitiligo and comorbid psychosomatic disordes. Russ J Skin Venereal Diseases. 2019;22(1-2):33–38. EDN: BATEUP
- Lekayon M, Lomonosov KM. Features of the quality of life of patients suffering from vitiligo. Russ J Skin Venereal Diseases. 2022;25(2):119–125. EDN: TKAWCK doi: 10.17816/dv106940
- Grimes PE, Miller MM. Vitiligo: Patient stories, self-esteem, and the psychological burden of disease. Int J Womens Dermatol. 2018;4(1):32–37. doi: 10.1016/j.ijwd.2017.11.005
- Bibeau K, Ezzedine K, Harris JE, et al. Mental health and psychosocial quality-of-life burden among patients with vitiligo: Findings from the global VALIANT study. JAMA Dermatol. 2023;159(10):1124–1128. doi: 10.1001/jamadermatol.2023.2787
- Rashighi M, Harris JE. Vitiligo pathogenesis and emerging treatments. Dermatol Clin. 2017;35(2):257–265. doi: 10.1016/j.det.2016.11.014
- Frisoli ML, Essien K, Harris JE. Vitiligo: Mechanisms of pathogenesis and treatment. Annu Rev Immunol. 2020;(38):621–648. doi: 10.1146/annurev-immunol-100919-023531
- Buchman AL. Side effects of corticosteroid therapy. J Clin Gastroenterol. 2001;33(4):289–294. doi: 10.1097/00004836-200110000-00006
- Doumeizel PM, Robin F, Ballerie A, et al. [Side effects of longterm oral corticosteroid therapy. (French).] Rev Prat. 2021;71(6):587–596.
- Tapia C, Nessel TA, Zito PM. Cyclosporine. [2023 Aug 28]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
- Jin XH, Chen X, Mou Y, Xia JX. Effects of cyclosporine on palmoplantar pustulosis and serum expression of IL-17, IL-23, and TNF-α. Dermatol Ther (Heidelb). 2019;9(3):547–552. doi: 10.1007/s13555-019-0308-z
- Taneja A, Kumari A, Vyas K, et al. Cyclosporine in treatment of progressive vitiligo: An open-label, single-arm interventional study. Indian J Dermatol Venereol Leprol. 2019;85(5):528–531. doi: 10.4103/ijdvl.IJDVL_656_18
- Mehta H, Kumar S, Parsad D, et al. Oral cyclosporine is effective in stabilizing active vitiligo: Results of a randomized controlled trial. Dermatol Ther. 2021;34(5):e15033. doi: 10.1111/dth.15033
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