Response of narrowband ultraviolet-B phototherapy combined with superoxide dismutase antioxidant cream in the management of non-segmental vitiligo
Abstract
Vitiligo is a skin depigmentation disorder characterized by the loss of melanocyte function. The oxidative stress theory plays a role in the occurrence of vitiligo. Narrow band ultraviolet B (NB-UVB) phototherapy can be combined with other therapies to accelerate skin repigmentation. A 47 yo woman presented to the dermatology and venereology outpatient clinic in Dr. Sardjito General Hospital, Yogyakarta with a chief complaint of white patches on her face, neck, chest, and hands that had persisted for 11 yr. The patient had previously received NB-UVB phototherapy and a calcineurin inhibitor cream, but the symptoms persisted. Significant repigmentation of the lesion area was achieved after NB-UVB phototherapy combined with superoxide dismutase (SOD) antioxidant cream. NB-UVB phototherapy plays a role in immunomodulation, biostimulation, and reducing oxidative stress. The SOD helps clear superoxide radicals, preventing damage to melanocytes. The combination of NB-UVB phototherapy and antioxidant cream can be considered a treatment option for vitiligo.
References
Bergqvist C, Ezzedine K. Vitiligo : a review. Dermatology, 2020;236(6):571-92.
https://doi.org/10.1159/000506103
Anna MLD, Pase A De, Eleftheriadou V, Ezzedine K, Gauthier Y, Taieb A, et al. Guidelines for the management of vitiligo : The European Dermatology Forum consensus. Br J Dermatol, 2013;168(1):5-19.
https://doi.org/10.1111/j.1365-2133.2012.11197.x
Whitton ME, Pinart M, Batchelor J, Leonardi-Bee J, Gonzalez U, Jiyad Z, et al. Interventions for vitiligo (review). Cochrane Database Syst Rev, 2015;2015(2):1-49.
https://doi.org/10.1002/14651858.CD003263.pub5
Zenedin H, César C, Castro S De, Medeiros V, Hitomi P, Dellatorre G, et al. Update on the pathogenesis of vitiligo. An Bras Dermatol, 2022;97(4):478-90.
https://doi.org/10.1016/j.abd.2021.09.008
Shi M, Wu Y, Li L, Cai Y, Liu M, Gao X, et al. Meta-analysis of the association between vitiligo and the level of superoxide dismutase or malondialdehyde. Clin Exp Dermatol, 2017;42(1):21-9.
https://doi.org/10.1111/ced.12950
Mohammad TF, Al-jamal M, Hamzavi IH. The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo. J Am Acad Dermatol, 2017;76(5):879-88.
https://doi.org/10.1016/j.jaad.2016.12.041
Białczyk A, Wełniak A, Kamińska B, Czajkowski R. Oxidative stress and potential antioxidant therapies in vitiligo: a narrative review. Mol Diagn Ther, 2023;27(6):723-39.
https://doi.org/10.1007/s40291-023-00672-z
Soliman M, Samy NA, Eittah MA, Hegazy M. Comparative study between excimer light and topical antioxidant versus excimer light alone for treatment of vitiligo. J Cosmet Laser Ther, 2016;18(1):7-11.
https://doi.org/10.3109/14764172.2015.1052510
Kostović K, Paštar Z, Pašic A, Čeović R. Treatment of vitiligo with narrow-band UVB and topical gel containing catalase and superoxide dismutase. Acta Dermatovenerologica Croat, 2007;15(1):10-4.
Esmat S, Hegazy RA, Shalaby S, Chu-Sung Hu S, Lan CCE. Phototherapy and combination therapies for vitiligo. Dermatol Clin, 2017;35(2):171-92.
https://doi.org/10.1016/j.det.2016.11.008
Wang E, Rodrigues M. An update and review of narrowband ultraviolet B phototherapy for vitiligo. Dermatol Rev, 2022;3:326-35.
https://doi.org/10.1002/der2.142
Luisa A, Pereira T, Menezes JG De, Beltrame ML, Veronese B, Lima DF, et al. Effectiveness of narrowband ultraviolet on vitiligo : a systematic review. Dermato, 2024;4(4):187-97.
https://doi.org/10.3390/dermato4040016
Chang WL, Ko CH. The role of oxidative stress in vitiligo : an update on its pathogenesis and therapeutic implications. Cells, 2023;12(936):1-17.
https://doi.org/10.3390/cells12060936
He S, Xu J, Wu J. The promising role of chemokines in vitiligo: from oxidative stress to the autoimmune response. Oxid Med Cell Longev, 2022;2022(6):1-10.
https://doi.org/10.1155/2022/879735
Diehl C. A novel efficient and safe treatment for atopic dermatitis: topical superoxide dismutase (SOD). J Dermatol Res Skin Care, 2017;1(1):1-7.
Fontas E, Montaudie H, Passeron T. Oral gliadin-protected superoxide dismutase in addition to phototherapy for treating non-segmental vitiligo : a 24-week prospective randomized placebo-controlled study. J Eur Acad Dermatol Venereol, 2021;35(8):1725-9.
https://doi.org/10.1111/jdv.17331
Whitton M, Pinart M, Batchelor JM, Gonzalez U, Jiyad Z, Eleftheriadou V. Evidence-based management of vitiligo : summary of a Cochrane systematic review. Br J Dermatol, 2016;174(5):962-9.
https://doi.org/10.1111/bjd.14356
Yuksel E pancar, Aydin F, Sentrurk N, Canturk T, Turanli AY. Comparison of the efficacy of narrow band ultraviolet B and narrow band ultraviolet B plus topical catalase-superoxide dismutase treatment in vitiligo patients. Eur J Dermatol, 2009;19(4):341-4.
https://doi.org/10.1684/ejd.2009.0699
El-Zawahry BM, Elmasry MF, Ragab A. The role of long‐wavelength ultraviolet A1 (UVA1) in acral vitiligo. J Cosmet Derm, 2019;18(4):1155-60.
https://doi.org/10.1111/jocd.12808
Rodrigues M, Hons M, Ezzedine K, Hamzavi I. Current and emerging treatments for vitiligo. J Am Acad Dermatol, 2020;77(1):17-29.
