|Institution:||Universiteit van Amsterdam|
|Full text PDF:||http://hdl.handle.net/11245/1.469684|
Pigmentary disorders are disturbances of human skin color. Minor changes in the cellular physiology of the skin can dramatically affect pigment production in positive or negative manner. In this these, associated diseases, therapeutical options and disease parameters for the pigmentation disorder vitiligo, melasma, postinflammatory hyperpigmentation and erythema dyschromicum perstans, are investigated. Vitiligo is often associated with autoimmune thyroid diseases. In chapter 2 a systematic review and meta-analysis was performed to summarize and critically appraise current evidence of the prevalence of thyroid diseases in patients with vitiligo. In Chapter 3 and 4, the prevalence of thyroid dysfunction and thyroid peroxidase-specific (TPO) antibodies was investigated in a large cohort of adults and children with vitiligo in order to help decide whether routine screening is justified. In chapter 5 we investigated the relationship between melanocyte antigen-specific antibodies and recent disease activity in patients with vitiligo. In chapter 6 we conducted a randomized controlled trial to compare the efficacy of phototherapy alone or in combination with a topical corticosteroid in the treatment of patients with vitiligo. In chapter 7, 8 and 9, studies were conducted to assess the efficacy and safety of non-ablative fractional laser therapy in the treatment of the pigmentary disorders erythema dyschromicum perstans, postinflammatory hyperpigmentation and melasma. Non-ablative fractional laser therapy was not effective for the treatment of erythema dyschromicum perstans and post-inflammatory hyperpigmentation. Fractional laser therapy at 10 mJ/microbeam may be a useful alternative treatment option for melasma when topical bleaching is ineffective or not tolerated.