Determination of melanin levels in patients with vitiligo

BACKGROUND: Vitiligo is an urgent problem for both patients and the scientific community of dermatologists. In this regard, there are many studies aimed at finding new methods of therapy for this disease, providing repigmentation of foci and stabilization of the process, as well as available methods of treatment control to objectify the results in dynamics.

AIM: To assess the melanin level in hypopigmentation foci in vitiligo patients before and during treatment using mexametry, as well as on the surrounding healthy skin, to study the possibility of using this method as a control of response to therapy.

MATERIALS AND METHODS: 17 vitiligo patients (10 female, 7 males, mean age 37.9±2.9, disease duration 16.5±2.3 years) participated in the dynamic follow-up. Patients were measured melanin level in depigmentation foci and on the surrounding healthy skin in 19 localizations by mexametry before treatment and after 3 months of therapy. The study was carried out on the Soft plus device. The degree of repigmentation was also assessed clinically using the visual analog scale of repigmentation (G0–G4).

RESULTS: According to mexametry data, the most significant differences between the melanin level in vitiligo foci and on the surrounding healthy skin of the upper and lower extremities, on the skin of the trunk (p <0.001). In 3 months after therapy a significant increase of melanin in vitiligo foci according to mexametry data was observed in the elbows ― from 2 u to 13 u, shoulders ― from 2 u to 17 u and knees ― from 5 u to 18 u. Increased melanin levels according to mexametry correlated with the clinical picture. Thus, these areas showed a G4 excellent (repigmentation over 75%) and G3 very good response (repigmentation 50–75%) on the visual analog scale of repigmentation. There were no correlations between skin melanin levels and age, sex.

CONCLUSION: In the course of treatment there was an increase in melanin level in vitiligo foci according to mexametry, which correlated with the clinical picture, and testified to the effectiveness of therapy. On the basis of the obtained results we can conclude that mexametry is a good objective method of monitoring the effectiveness of therapy in patients with vitiligo in dynamics.