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Abstract：
BACKGROUND: Vitiligo is a muco-cutaneous, autoimmune, localized, or disseminated disease, which manifests through hypochromic or achromic macules, with loss in quality of life. The prevalence of vitiligo in Brazil was determined to be 0.54%. There is no on-label medication for its treatment. To date, no Brazilian consensus on the treatment of vitiligo had been written.
OBJECTIVE: The objective of this group of Brazilian dermatologists with experience in the treatment of this disease was to reach a consensus on the clinical and surgical treatment of vitiligo, based on articles with the best scientific evidence.
METHODS: Seven dermatologists were invited, and each was assigned two treatment modalities to review. Each treatment (topical, systemic, and phototherapy) was reviewed by three experts. Two experts reviewed the surgical treatment. Subsequently, the coordinator compiled the different versions and drafted a text about each type of treatment. The new version was returned to all experts, who expressed their opinions and made suggestions for clarity. The final text was written by the coordinator and sent to all participants to prepare the final consensus.
CONCLUSIONS: The experts defined the following as standard treatments of vitiligo: the use of topical corticosteroids and calcineurin inhibitors for localized and unstable cases; corticosteroid minipulse in progressive generalized vitiligo; narrowband UVB phototherapy for extensive forms of the disease. Surgical modalities should be indicated for segmental and stable generalized vitiligo. Topical and systemic anti-JAK drugs are being tested, with promising results.
OBJECTIVE: The objective of this group of Brazilian dermatologists with experience in the treatment of this disease was to reach a consensus on the clinical and surgical treatment of vitiligo, based on articles with the best scientific evidence.
METHODS: Seven dermatologists were invited, and each was assigned two treatment modalities to review. Each treatment (topical, systemic, and phototherapy) was reviewed by three experts. Two experts reviewed the surgical treatment. Subsequently, the coordinator compiled the different versions and drafted a text about each type of treatment. The new version was returned to all experts, who expressed their opinions and made suggestions for clarity. The final text was written by the coordinator and sent to all participants to prepare the final consensus.
CONCLUSIONS: The experts defined the following as standard treatments of vitiligo: the use of topical corticosteroids and calcineurin inhibitors for localized and unstable cases; corticosteroid minipulse in progressive generalized vitiligo; narrowband UVB phototherapy for extensive forms of the disease. Surgical modalities should be indicated for segmental and stable generalized vitiligo. Topical and systemic anti-JAK drugs are being tested, with promising results.
摘要：
背景：白癜风是一种粘膜皮肤，自身免疫，局部化,或传播疾病，表现为低色斑或无色斑，生活质量的损失。巴西白癜风的患病率确定为0.54％。没有用于治疗的标签药物。迄今为止,巴西尚未就白癜风的治疗达成共识.
目的：本组有治疗本病经验的巴西皮肤科医生的目的是就白癜风的临床和外科治疗达成共识，基于最好的科学证据的文章。
方法：邀请了7位皮肤科医生，每个患者被分配两种治疗模式进行审查.每次治疗（局部，系统性，和光疗）由三位专家进行了审查。两位专家回顾了手术治疗。随后，协调员编写了不同的版本，并起草了关于每种治疗类型的文本。新版本已返回给所有专家，他们表达了他们的意见，并提出了澄清的建议。最后文本由协调员撰写，并发送给所有参与者，以准备最终共识。
结论：专家将以下定义为白癜风的标准治疗：局部和不稳定病例使用局部皮质类固醇和钙调磷酸酶抑制剂；进行性全身白癜风的皮质类固醇小脉冲；窄带UVB光疗治疗广泛形式的疾病。对于节段性和稳定性的全身性白癜风，应采用手术方式。正在测试局部和全身抗JAK药物，有希望的结果。
目的：本组有治疗本病经验的巴西皮肤科医生的目的是就白癜风的临床和外科治疗达成共识，基于最好的科学证据的文章。
方法：邀请了7位皮肤科医生，每个患者被分配两种治疗模式进行审查.每次治疗（局部，系统性，和光疗）由三位专家进行了审查。两位专家回顾了手术治疗。随后，协调员编写了不同的版本，并起草了关于每种治疗类型的文本。新版本已返回给所有专家，他们表达了他们的意见，并提出了澄清的建议。最后文本由协调员撰写，并发送给所有参与者，以准备最终共识。
结论：专家将以下定义为白癜风的标准治疗：局部和不稳定病例使用局部皮质类固醇和钙调磷酸酶抑制剂；进行性全身白癜风的皮质类固醇小脉冲；窄带UVB光疗治疗广泛形式的疾病。对于节段性和稳定性的全身性白癜风，应采用手术方式。正在测试局部和全身抗JAK药物，有希望的结果。
