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：

---

前列腺素类似物和磷酸二酯酶抑制剂作为治疗白癜风的最后手段的应用：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中持续存在的挑战。该领域正在为那些对经典疗法耐药或不耐受的患者提供和研究新的治疗方法。 目的在这篇系统综述中，我们研究了前列腺素类似物 (PGA) 和磷酸二酯酶抑制剂 (PDEI) 在白癜风治疗中的用途，因为它们方法以“白癜风”、“前列腺素类似物”和“磷酸二酯酶抑制剂”为关键词检索四个主要在线数据库。结果共纳入 42 篇文章，1027 例，研究药物如比马前列素、拉坦前列素、曲伏前列素、地诺前列酮、阿普斯特、克立硼罗等。纳入研究中，治疗方案一般为每日一次或两次，持续12~48周，平均20.61周，给药途径主要为外用凝胶或眼用溶液和口服片剂。副作用轻微且可以忍受，即局部用药部位出现红斑、瘙痒或烧灼感，或阿普斯特的胃肠道问题。色素沉着结果对于成人和儿童患者以及进行性或稳定性白癜风患者均具有显着意义。 PGA 和 PDEI 的效果优于许多经典疗法，例如窄带 UVB 光疗 (NB-UVB)、他克莫司、莫米松或甲泼尼龙微脉冲。 PGA 或 PDEI 通常用于联合治疗，以引起协同作用或增加药物输送，并且几乎总是增强再色素沉着，例如与 NB-UVB、分数 CO 一起使用2激光、微针和莫米松。结论单一疗法或附加 PGA 和 PDEI 可以被认为是白癜风的有效治疗方法，并且是对其他疗法耐药的患者的最后手段。