الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Vitiligo is one of the common pigmentary disorders, of significant sociomedical importance, affecting about 1–2% of the people. It is defined clinically as sharply defined, acquired, progressive, depigmentation of skin &hair, and is characterized by totally absent functional melanocytes microscopically.
The goal of vitiligo treatment is controlling the destruction of melanocytes and stimulation of their migration from the nearby skin and adnexal reservoirs, thus stops depigmentation and stimulates repigmentation. For stopping depigmentation, besides UV therapies, systemic CSs may help arrest disease progression. Commonly used repigmentation treatments for vitiligo are UV light, and immunomodulatory drugs as CSs, calcineurin inhibitors, and calcipotriol.
Patients not respond to these lines are indicated for surgical treatment. Surgical treatments used in vitiligo are classified into either tissue grafts or cellular grafts. The tissue grafts are simpler and used to achieve good repigmentary outcome without needing laboratory and infrastructure, but the disadvantage is that only limited vitiligo lesions can be treated at a time. The commonest used tissue graft is full-thickness PG, whereas the miniature grafts serve as islands of melanocyte reservoir, inducing pigment spread around the graft. The cellular grafts include cultured as well as non-cultured melanocytes and hope to cover wide vitiligino areas in one session with limited donor site.
Needling is a recent emerging approach which is simple and easy , it might augment repigmentation in non-responding or poorly responding stable vitiligo alone or as an adjuvant to other treatments.it induce trauma-trigerred inflammation stimulating migration of keratinocytes & melanocytes during healing phase, cytokine release resulting in induction of melanocytes in the peripheral parts of the patch or outer root sheath of pigmented hair in addition to mechanical migration of melanocytes from pigmented margins to depigmented sites.NB-UVB therapy and OMP can be used in vitiligo in order to halt disease progression and stimulate repigmentation when used as adjuvant therapy to surgical procedures.