问题 11. 如何治疗白癜风?

Question11. How can I treat vitiligo?

问题 11. 如何治疗白癜风?

•Key points

•要点

•Many different methods may be used to treat vitiligo.

•许多不同的方法可用于治疗白癜风。

•   Treatment should always start with efficacious and safe approaches and at the same time with less aggressive and cost/effective methods.

•治疗通常多首选安全有效、同时创伤小、 花费低的方法。

•A targeted UVB therapy (308 or 311 nm) alone or associated with topical steroids or with topical calcineurine inhibitors represents the most efficacious and safe approach if less than 15% of the skin is affected.

•如果皮肤受累面积少于 15%，靶向 UVB(308 或 311nm)单独或联合外用激素/外用钙调 神经磷酸酶抑制剂是最为安全有效的方 法。

• Second-, third- and fourth-line therapies must be discussed by the dermatologist and vitiligo-affected subject in an open and constructive way, keeping in mind that the less aggressive and the most cost/effective modalities are always the first choice.

•二、三和四线的治疗必须由皮肤科医师和 白癜风患者以开放和建设性的方式共同探 讨,需要记住的是创伤小、花费小的治疗方 法永远是首选。

•Don’t feel frustrated if you don’t achieve the goal with the first-line treatment: discuss other options with your dermatologist and go on according to your new treatments.

•如果一线治疗方案没达到令你满意的目 标，不要沮丧，和你的皮肤科医生讨论其 他选择并按照新的治疗方案进行治疗。

•Be always optimistic: you have very many chances to find the right treatment for your vitiligo!

•保持乐观：你有很多机会找到治疗白癜风 的合适的治疗方案！

• Answer

•解答

Choosing a treatment for vitiligo can be difficult, sometimes overwhelming.  In general, first-line therapy should be safe, effective, minimally invasive, and cost efficient. More complex, invasive, and time- consuming options should be reserved for subjects with recalcitrant disease. Each therapeutic modality should be tried for a sufficient period of time because the initiation of pigmentation varies and is in general rather slow. An effective therapy should  be continued as long as there is an improvement or the lesions repigment completely.

选择白癜风的治疗方案存在一定的困难，有 些时候难度巨大。一般来说，一线治疗方案 安全、有效，创伤小、花费低。较复杂，侵 入性的、费时的治疗方案通常应用于疾病顽 固的患者。因为色素恢复相当缓慢，每一种 治疗模式都应该用足够长时间，有效的治疗 应该持续到皮损改善或完全复色。

We are in need of consistent data on maintenance regimens or the long-term persistence of pigmentation with any of the recommended therapies.

无论应用哪种推荐的治疗方案，关于维持治 疗方案或长期保持色素沉着方面的一致的 数据目前仍有欠缺。

How to treat vitiligo:

如何治疗白癜风：

First-line. There are many topical and some oral agents that are inexpensive, easy to use, and effective at halting disease  progression and inducing repigmentation. Corticosteroids (CSs) are consistently reported as the most effective single topical agent, with Calcineurine Inhibitors (CIs) being always a close second. Due to the possibility of local side effects of CSs, scheduled drug holidays are recommended.