Systemic Corticosteroids in Vitiligo

The document from 2011 reviewed the use of systemic corticosteroids in treating vitiligo, particularly focusing on their effectiveness in stopping the progression of rapidly spreading vitiligo and encouraging repigmentation. It traced the history of corticosteroid use in vitiligo treatment, noting the shift to oral mini-pulse (OMP) therapy with drugs like betamethasone or dexamethasone to reduce long-term side effects. The mechanism by which corticosteroids work involves suppressing the formation of autoantibodies and inducing apoptosis in cytotoxic T cells that destroy melanocytes. The document underscored the need for careful patient selection, dosing, and monitoring due to the potential side effects, which can be both reversible and irreversible. It concluded that while systemic corticosteroids are beneficial, especially for rapidly progressing vitiligo, more research is needed to solidify their role in treatment, with OMP therapy being the preferred method for its reduced side effects.