RSUSSH 2020

IN20-298 Efficacy of platelet-rich plasma in combination therapy for vitiligo

Presenter: Kyi Mar Tun, M.D
Thammasat University/Chulabhorn International College of Medicine, Thailand

Abstract

          Vitiligo is a recalcitrant, disfiguring autoimmune disorder resulting from the loss of epidermal melanocytes. Many therapeutic approaches have been used with various outcomes. Platelet-rich plasma has recently been an alternative treatment in numerous skin disorders, including vitiligo. This study aims to evaluate the efficacy of platelet-rich plasma modality as an adjunctive therapy for vitiligo.  A search of clinical studies in human was conducted in the PubMed, Cochrane and Scopus databases with specific MeSH term (Medical Section Heading) terms. All data analyzing and grouping are performed with STATA version 14.0 (Stata Corp LP, College Station, TX).  Total seven manuscripts met with the study inclusion criteria and were included in this study. Combination therapies rather than treating with monotherapy were proved for getting better repigmentation and outcomes. In vitiligo, platelet-rich plasma (PRP) used as an adjunct therapy related with other standard modalities compared with PRP alone or other control group, there was clinically as well as statistically significant in repigmentation. PRP therapy is generally considered as safe apart from minimal side effects like pain, erythema and minor complications for short duration immediately after procedure. In conclusion, a novel autologous therapeutic modality, PRP therapy with high concentration of growth factors tends to skin repigmentation in vitiligo as adjunct therapy for standard vitiligo treatment. However, larger population with longer duration clinical trials are necessary to measure the exact efficacy and mechanism of PRP on vitiliginous skin.

Keywords: Vitiligo; Platelet-rich Plasma; Combination Therapy

Citation format:

Tun, K., & Juntongjin, P.. (2020). Efficacy of platelet-rich plasma in combination therapy for vitiligo. Proceeding in RSU International Research Conference, May 1, 2020. Pathum Thani, Thailand.

QUESTIONS & ANSWERS

Suparuj Lueangarun (Visitor)

What are the mechanisms of PRP in the treatment of vitiligo ?

 

Suparuj Lueangarun (Visitor)

Which vitiligo case that you will recommend the PRP treatment as the combination or adjunct therapy?

เปรมจิต จันทองจีน (Visitor)

Is there any difference in the type of PRP affecting on the outcomes?

Kyi Mar Tun, M.D (Presenter)

First of all, thank you, everyone, for interesting my research topic. 

@SUPARUJ LUEANGARUN, 

Q1. What are the mechanisms of PRP in the treatment of vitiligo?

A: Current and emerging treatments address 3 major goals in vitiligo treatment, first, to reduce melanocyte stress, second, to reduce autoimmunity and thrid to enhance melanocyte regeneration.

Even though the exact mechanism of PRP on depigmented skin is still unknown, there are some facts that growth factors involved in PRP have effect on melanocyte regeneration and migration of melanoblasts from the outer root sheath of hair follicles especially from the border area of vitiligo lesions into the depigmented epidermis. 

Reference: 

Rashighi, M., & Harris, J. E. (2017). Vitiligo Pathogenesis and Emerging Treatments. Dermatol Clin, 35(2), 257-265. doi:10.1016/j.det.2016.11.014

Kadry, M., Tawfik, A., Abdallah, N., Badawi, A., & Shokeir, H. (2018). Platelet-rich plasma versus combined fractional carbon dioxide laser with platelet-rich plasma in the treatment of vitiligo: a comparative study. Clin Cosmet Investig Dermatol, 11, 551-559. doi:10.2147/ccid.S178817

Q2: Which vitiligo case that you will recommend the PRP treatment as the combination or adjunct therapy?

A: Based on my present study, the most favourable outcome in clinical improvement (>75% repigmentation) is achieved for PRP treatment as a combination therapy in clinical studies that recruited non-segmental vitiligo patients as inclusion participants. 

 

@เปรมจิต จันทองจีน 

Q: Is there any difference in the type of PRP affecting on the outcomes?

A: Regards to my included studies, most studies did not mention the exact subtype of PRP (amount of platelet concentrate and leukocyte involvement) usage in their clinical trials but we can emphasize to analyze in their method of PRP preparation, most studies used double spins (Hard and soft spins) technique in centrifugation and used sodium citrate as anticoagulants. 

 

For your more information, please download my manuscript and more question are warmly welcome. 

Thank you so much.