title: Noninvasive cutaneous blood flow as a response predictor for visible light therapy on segmental vitiligo: a prospective pilot study.
abstract: BACKGROUND
  Visible light is a treatment option for segmental vitiligo (SV), and visible light-induced repigmentation is associated with normalization of sympathetic dysfunction. Currently, it is difficult to predict individual patients' response to visible light therapy.
  
  
  OBJECTIVE
  To test whether cutaneous blood flow can serve as a response predictor for visible light on treating SV.
  
  
  METHODS
  Fourteen patients with SV were recruited in this prospective pilot study. Laser Doppler flowmetry was used to evaluate the cutaneous blood flow over SV lesions and contralateral normal skin. The pretreatment blood flow evaluation consisted of two stages: stage 1, following cold stress without prior visible light irradiation, and stage 2, following cold stress with prior visible light irradiation. Subsequently, the patients received regular visible light treatment for 3months, and a comparison of the pretreatment blood flow patterns between the visible light responding and nonresponding groups was carried out at the end of the study period.
  
  
  RESULTS
  The SV lesions showed different blood flow profiles as compared with the contralateral normal skin. At the end of the 3-month study period, seven (50%) patients showed clinical repigmentation of >25%. The visible light responding group showed a more consistent occurrence of increased blood flow after stage 2 of the pretreatment evaluation while the nonresponding counterpart showed no significant changes.
  
  
  CONCLUSIONS
  Normalization of sympathetic dysfunction may account for the efficacy of visible light in treating SV. Evaluation of cutaneous blood flow with and without prior visible light irradiation on cold-stressed SV lesions may serve as a treatment response predictor.
authors.affiliation: Department of Dermatology, Kaohsiung Medical University Hospital and Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan.
authors.forename: W-T
authors.initials: WT
authors.lastname: Yu
authors.forename: H S
authors.initials: HS
authors.lastname: Yu
authors.forename: C-S
authors.initials: CS
authors.lastname: Wu
authors.forename: C-H
authors.initials: CH
authors.lastname: Lee
authors.forename: Y-C
authors.initials: YC
authors.lastname: Cheng
authors.forename: W-T
authors.initials: WT
authors.lastname: Lin
authors.forename: G-S
authors.initials: GS
authors.lastname: Chen
authors.forename: C-C E
authors.initials: CC
authors.lastname: Lan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology / Q000528:radiation effects; D008875:Middle Aged; D010789:Phototherapy / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology / Q000528:radiation effects; D012867:Skin / Q000098:blood supply*; D013312:Stress, Physiological / Q000502:physiology; D014820:Vitiligo / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult