BackgroundThe treatment of vitiligo is a persistent challenge in dermatology. New treatments are being offered and studied in this field for those resistant to or intolerant of classical therapies.AimsIn this systematic review, we study the use of prostaglandin analogues (PGAs) and phosphodiesterase inhibitors (PDEIs) in the treatment of vitiligo, as they are known for their pigmentation inducing effects through activating melanocytes.MethodsWe searched four main online databases with the keywords “Vitiligo”, “Prostaglandin analogue” and “Phosphodiesterase inhibitor”.ResultsA total of 42 articles were included, with 1027 cases, studying drugs like bimatoprost, latanoprost, travoprost, dinoprostone, apremilast, crisaborole, etc. Among the included studies, the treatment regimens are commonly once or twice daily for 12–48 weeks, with a mean of 20.61 weeks, and the routes of administration are mainly topical gels or ophthalmic solutions and oral tablets. Side effects are mild and tolerable, namely erythema, itching or burning sensations at application site for topicals, or gastrointestinal problems with apremilast. Repigmentation results are significant in both adult and pediatric patients and progressive or stable vitiligo. PGAs and PDEIs outperform many classical therapies, for example, narrowband ultraviolet B phototherapy (NB‐UVB), tacrolimus, mometasone or methylprednisolone mini‐pulse. PGAs or PDEIs are usually used in combination therapies to either cause synergism or increase drug delivery, and almost always enhance repigmentation, for example, with NB‐UVB, fractional CO2 laser, microneedling, and mometasone.ConclusionMonotherapy or add‐on PGAs and PDEIs can be considered effective treatments for vitiligo and promising last resorts for those resistant to other therapies.

中文翻译：

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前列腺素类似物和磷酸二酯酶抑制剂作为治疗白癜风的有前途的最后手段的用途：系统评价，从作用机制到单一、联合和比较疗法


背景白癜风的治疗是皮肤病学的一个持续挑战。该领域正在为那些对经典疗法耐药或不耐受的人提供和研究新的治疗方法。目的在本系统综述中，我们研究了前列腺素类似物 （PGA） 和磷酸二酯酶抑制剂 （PDEI） 在治疗白癜风中的应用，因为它们以其通过激活黑色素细胞诱导色素沉着的作用而闻名。方法我们用关键词 “Vitiligo” 、 “Prostaglandin analogue” 和 “Phosphodiesterase inhibitor” 检索了四个主要的在线数据库。结果共纳入 42 篇文献，涉及 1027 例，研究比马前列素、拉坦前列素、曲伏前列素、地诺前列酮、阿普斯特、crisaborole 等药物。在纳入的研究中，治疗方案通常为每天一次或两次，持续 12-48 周，平均为 20.61 周，给药途径主要是局部凝胶或滴眼液和口服片剂。副作用轻微且可耐受，即外用药物应用部位出现红斑、瘙痒或烧灼感，或阿普斯特的胃肠道问题。成人和儿童患者以及进行性或稳定型白斑患者的色素沉着结果均显著。PGA 和 PDEI 优于许多经典疗法，例如窄带紫外线 B 光疗 （NB-UVB）、他克莫司、莫米松或甲泼尼龙迷你脉冲。PGA 或 PDEI 通常用于联合疗法中，以引起协同作用或增加药物输送，并且几乎总是增强色素沉着，例如，使用 NB-UVB、点阵 CO2 激光、微针和莫米松。结论单药治疗或附加 PGA 和 PDEI 可被认为是治疗白癜风的有效方法，对于对其他疗法有抵抗力的人来说，这是有希望的最后手段。