Appendix 1.
Key recommendations:
The main points of note.
Introduction: D.J. Gawkrodger
Includes method of guideline development, aims, scope, audience, process, funding, declaration of interests and review.
Symptoms and Signs: A.D. Ormerod
What symptoms and signs are suggestive of vitiligo?
Wood's Light: A.D. Ormerod
What is the accuracy of Wood's light compared with naked eye examination in the diagnosis of vitiligo?
Natural history: A.V. Anstey
What is the natural history of vitiligo?
Quality of Life: L. Shaw, I. Mauri-Sole
What is the quality of life in patients with vitiligo compared with other skin diseases?
Scoring indices: M.J. Watts, M.E. Whitton
In all patients with vitiligo, what is the accuracy of a scoring index in showing the outcome of common treatments compared with simple photography?
Topical treatments: D.J. Gawkrodger
Includes: In all patients with vitiligo, what is the efficacy of applying betamethasone, clobetasol, fluocinolone, fluticasone or mometasone vs. placebo or other active treatment in terms of condition progression, area reduction and quality of life score?
In all patients with vitiligo, what is the efficacy of applying calcipotriol or tacalcitol vs. placebo or an active treatment in terms of condition progression, area reduction and quality of life score?
In all patients with vitiligo, what is the efficacy of applying tacrolimus or pimecrolimus vs. placebo or an active treatment in terms of condition progression, area reduction and quality of life score?
In all patients with vitiligo, what is the efficacy of applying p-(benzyloxy)phenol (monobenzyl ether of hydroquinone) vs. placebo or an active treatment in terms of reducing areas of pigmentation?
Phototherapy: A.V. Anstey
Includes: In all patients with vitiligo, what is the efficacy of a course of narrowband UVB including high-intensity light sources compared with placebo in terms of condition progression, area reduction and quality of life score?
In all patients with vitiligo, what is the efficacy of a course of PUVA or PUVA-sol compared with placebo in terms of condition progression, area reduction and quality of life score?
In all patients with vitiligo, what is the efficacy of a course of khellin with sunlight UVA or UVB compared with PUVA or PUVA-sol in terms of progression, area reduction and quality of life score?
Late complications of PUVA or narrowband UVB therapy in patients with vitiligo: are patients who have received large doses of PUVA (more than 150 treatment sessions) or narrowband UVB (more than 150 treatment sessions) at increased risk of developing premalignant or malignant skin changes?
Combination Phototherapy: A.V. Anstey
Includes: In all patients with vitiligo, what is the efficacy of a course of narrowband UVB with a vitamin D analogue compared with narrowband UVB with placebo in terms of condition progression, area reduction and quality of life score?
In all patients with vitiligo, what is the efficacy of a course of PUVA with a vitamin D analogue compared with PUVA with placebo in terms of condition progression, area reduction and quality of life score?
Systemic Therapies: D.J. Gawkrodger
In all patients with vitiligo, what is the efficacy of systemic (i.e. orally and parenterally administered) treatments, including corticosteroids, ciclosporin and other immunosuppressive agents, in terms of condition progression, area reduction and quality of life score?
Surgical Treatments: A.D. Ormerod
In patients with vitiligo what is the efficacy of a skin graft and of various forms of placebo in terms of condition progression, area reduction and quality of life score? This may include punch grafts, full-thickness skin graft, split-thickness skin graft, autologous epidermal cell suspension, and autologous skin equivalent (commercial skin equivalent).
Psychological Treatments: L. Shaw, I. Mauri-Sole
In all patients with vitiligo, what is the efficacy of cognitive therapy vs. psychological support or no treatment in terms of condition progression, area reduction and quality of life score?
Research recommendations:
Areas for future research to improve treatment of vitiligo are suggested.
Final recommendations:
An approach to the overall management of vitiligo is outlined based on the evidence evaluated in this guideline.
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