title: Advanced treatment modalities for vitiligo.
abstract: BACKGROUND
  Vitiligo is an acquired multifocal and polygenic dyschromia that affects 1% to 3% of the world and presents as multiple depigmented macules and patches. Traditionally, the treatment of vitiligo has focused on pharmacologic interventions, but nearly half of all treated patients fail to respond successfully.
  
  
  OBJECTIVE
  Several advanced techniques exist that can aid dermatologists in treating vitiligo in patients who do not respond favorably to traditional pharmacologic treatments. These advanced interventions include the use of the 308-nm excimer laser, total body depigmentation therapy with monobenzyl ether of hydroquinone, microdermabrasion, micropigmentation, khellin-UVA therapy, and surgical management using miniature punch grafting, suction blister grafting, and epidermal cultures.
  
  
  METHODS
  This article reviews the current literature on these advanced treatment modalities for vitiligo and provides a practical guide for application of these techniques.
  
  
  CONCLUSIONS
  Our ability to treat vitiligo may be imperfect, but through appropriate patient selection and careful application of one or more of these advanced therapies, successful treatment of vitiligo, even in patients refractory to treatment, can be achieved.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida, USA. npatel85@gmail.com
authors.forename: Nishit S
authors.initials: NS
authors.lastname: Patel
authors.forename: Kapila V
authors.initials: KV
authors.lastname: Paghdal
authors.forename: George F
authors.initials: GF
authors.lastname: Cohen
mesh_terms: D003869:Dermabrasion / Q000379:methods; D006801:Humans; D006873:Hydroquinones / Q000627:therapeutic use; D007666:Khellin / Q000627:therapeutic use; D054018:Lasers, Excimer; D028022:Low-Level Light Therapy / Q000379:methods; D008544:Melanocytes / Q000637:transplantation; D011701:PUVA Therapy / Q000379:methods; D018579:Patient Selection; D016038:Skin Transplantation / Q000379:methods; D014820:Vitiligo / Q000628:therapy*
chemical_list: D006873:Hydroquinones; D007666:Khellin; C031927:hydroquinone