ABSTRACT

Vitiligo is an acquired idiopathic pigmentary skin disorder characterized by sharply demarcated milky white macules with variable size and shape. It has an estimated worldwide incidence of 0.5-4% and occurs in half of the patients before the age of 20 years. Since exact pathogenic mechanism is unknown, several proposed hypotheses are alternation of cellular and humoral immunity, melanocyte damage stimulated by chemicals released from nerve endings, structural aberration of melanocytes, melanocytorrhagia, epidermal cytokines, metabolic dysregulations and convergence theory depended on combination of these etiologic factors. Treatment of vitiligo depends on viable melanocyte reservoirs which induce repigmentation during various therapies. Although melanocyte reservoir mainly shown as hair follicle unit, repigmentation arise from three main sources. These are hair follicle unit, melanocytes located at the edge of vitiligo lesion and unaffected melanocytes within areas of depigmented epidermis. Treatment modalities for vitiligo therapy divided in three main groups as medical therapy, phototherapy and surgical therapy. Vitiligo lesions should be initially treated with topical medical therapy or localized phototherapy. If depigmentation is larger than 10-20% of body surface area, systemic medical therapy or phototherapy should be sought. When depigmentations do not regress in spite of appropriate interventions, surgical therapies should be considered as the lesions become refrectory and stable. In this review, we discuss the literature and evidence base for phototherapy in vitiligo and summarized previous studies.