Where Need to Pay Attention to in Photochemotherapy for Vitiligo?

Photochemotherapy is a method of treating skin diseases by using light or by using light in combination with drugs. The PUVA is to stimulate the melanocytes to divide, multiply, and increase their activity to accelerate the formation of melanin. It can promote the melanocytes remaining in the white patches area from the reduced type to the oxidized type, and promote the proliferation of melanin; It could cause the local skin inflammatory reaction, destroy the Sulfhydryl compounds in the skin, unblock its inhibitory effect on tyrosinase, activating tyrosinase activity and catalyzing melanin synthesis. And it can also inhibit the local immune response by suppressing pathological T lymphocytes; or inhibiting the value-added of Langerhans cells in the skin to reduce their number and function.

Vitiligo occurs due to the destruction of melanin in the epidermis, but often the melanin in the hair follicles is spared. Therefore, after UVA irradiation, the regeneration of melanin, mostly from the melanocytes in the hair follicles starts to increase their number and then moves along the hair follicle to the infundibulum of the hair follicle

, and finally spreads telecentric in the adjacent keratinocytes. It is also often seen clinically that after PUVA treatment, the appearance of pigment is first around the hair follicle.

In addition, the use of photochemotherapy for vitiligo patients should pay attention to the following aspects:

1. Pay attention to eye protection, in the light room must wear anti-ultraviolet glasses.

2. Treatment for non-lesion parts should be covered with opaque objects.

3. Protection of exposed parts of the skin from sun exposure, at least 8 hours after taking psoralen should be protected from sun exposure with clothing or broad-spectrum shading agents such as phenyl ketone.

4. Regularly do three major Routines—liver, kidney function, and eye examination.

5. Avoid the simultaneous use of other photosensitive drugs, such as sulfonamide, sulfonylurea, chlorothiazide, phenothiazine, tetracycline derivatives, etc.