title: In vivo vitiligo induction and therapy model: double-blind, randomized clinical trial.
abstract: In this study, we developed an in vivo vitiligo induction model to explore the underlying mechanisms leading to Koebner's phenomenon and to evaluate the efficacy of therapeutic strategies. The model consisted of 12 pigmented test regions on the back of generalized vitiligo patients that were exposed to three Koebner induction methods: cryotherapy, 755 nm laser therapy, and epidermal abrasion. In addition, four cream treatments (pimecrolimus, tacrolimus, steroid and placebo) were randomly applied. Koebnerization was efficiently induced by all three induction methods. In general, cryotherapy was the best method of Koebner induction, followed by 755 nm laser therapy and epidermal abrasion. Reproducible results were obtained, which showed enhanced depigmented surface areas and higher amounts of T lymphocytes in placebo-treated test zones compared to active treated areas. Tacrolimus and local steroids were better inhibitors of Koebner's process (P < 0.05) compared to pimecrolimus. Our in vivo vitiligo induction model is very informative to investigate vitiligo induction and to determine the efficacy of topical treatments in vitiligo. This proof of concept confirms the efficient comparison of head-to-head therapeutic strategies intra-individually in a standardized, specific and better timed way.
authors: Department of Dermatology, Ghent University Hospital, De Pintelaan, Ghent, Belgium. Nanja.vangeel@UGent.be
authors: Nanja
authors: N
authors: van Geel
authors: Reinhart
authors: R
authors: Speeckaert
authors: Ilse
authors: I
authors: Mollet
authors: Sofie
authors: S
authors: De Schepper
authors: Julie
authors: J
authors: De Wolf
authors: Esther P M
authors: EP
authors: Tjin
authors: Rosalie M
authors: RM
authors: Luiten
authors: Jo
authors: J
authors: Lambert
authors: Lieve
authors: L
authors: Brochez
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D017679:Cryotherapy / Q000009:adverse effects*; D003869:Dermabrasion / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007801:Langerhans Cells / Q000473:pathology; D028022:Low-Level Light Therapy / Q000009:adverse effects*; D058965:MART-1 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D009824:Ointments; D011244:Pregnadienediols / Q000008:administration & dosage / Q000627:therapeutic use; D015203:Reproducibility of Results; D016176:T-Lymphocyte Subsets / Q000473:pathology; D016559:Tacrolimus / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use; D014820:Vitiligo / Q000188:drug therapy* / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D058951:gp100 Melanoma Antigen / Q000032:analysis
chemical_list: D007166:Immunosuppressive Agents; D058965:MART-1 Antigen; D009824:Ointments; D011244:Pregnadienediols; D058951:gp100 Melanoma Antigen; D000068656:Mometasone Furoate; C117268:pimecrolimus; D014222:Triamcinolone Acetonide; D016559:Tacrolimus