Discussion
vitiligo, hyperpigmentation, non-segmental vitiligo, non-segmental or segmental vitiligo, tissue damage
VITILIGO, LOCALIZED HYPERTRICHOSIS, HYPERPIGMENTATION, INFLAMMATION, DISEASE, INFECTIOUS PROCESS
Bimatoprost is a synthetic prostamide (prostaglandin-ethanolamides) F2α analogues. Prostaglandins are groups of lipid compounds that are produced from cells involved in inflammation, tissue damage, or infectious process. Previous studies showed that both PGE2 and PGF2α induced hyperpigmentation via the mechanism of melanocytic activationThis randomized single-blind controlled clinical trial evaluated the efficacy of 0.01% topical bimatoprost ophthalmic solutions plus NB-UVB or bimatoprost 0.01% monotherapy compared to placebo in stable non-segmental or segmental vitiligo patients over an 8-month period. The VASI score was significantly improved in the combination therapy group compared to the placebo group at all 8 monthly time points, and repigmentation onset was observed as early as the 1-month. Although both the monotherapy and the combination therapy groups yielded better VASI score outcomes than placebo, the combination group outperformed the monotherapy group. There was, however, no statistically significant difference between the improvement in the VASI score compared between monotherapy and combination therapy at any time point in the study.Previous studies of both latanoprostComparing bimatoprost with other treatment, Kanokrungsee, et al., found a similar repigmentation result between bimatoprost 0.01% and tacrolimus 0.1% ointment in non-segmented facial vitiligoRegarding type of vitiligo, the results of our study demonstrated non-segmental vitiligo and non-face/neck lesions to be significant predictors of good response to combination therapy. Similarly, Kapoor, et al. conducted a study in different types of vitiligo (vulgaris, focal, segmental, and lip) using PGE2 (0.25 mg gConcerning the location of vitiligo, Kapur, et al. reported that facial and scalp lesions responded earliest to vitiligo treatment with a mean onset of repigmentation of 1 to 1.5 monthsThe median duration of disease was 4 years, which is lower than the median disease duration reported from other studies, and this may result in earlier response to treatment. In addition to the overall efficacy of bimatoprost therapy demonstrated in the present study, our finding of significant response to treatment in the non-segmental vitiligo group is consistent with previously reported findingsRegarding the safety of bimatoprost ophthalmic solution for treating vitiligo, Jha, et al., reported localized hypertrichosis after 6 weeks of treatment at the periorbital area