LAUSR

Vitiligo is a common acquired disorder that is characterized by depigmented patches on the skin. Although many factors have been proposed for its pathogenesis, all direct and indirect evidence support an immune-mediated pathogenesis for this disorder (Grimes, 2016). Topical and oral corticosteroids, calcineurin inhibitors, calcipotriol, and phototherapy have been administered for treating vitiligo with some success. Studies have shown that release of prostaglandins (PGs), mainly PGE2 and PGF2a, is responsible for the increase in size and number of the melanocytes and in the number of melanosomes transferred to keratinocytes during the process of phototherapy. Hence, it seems that PGs effectively play a central role in the reversal of vitiligo (Grimes, 2016). Bimatoprost is a synthetic prostamide F2a analog that is approved for the treatment of glaucoma and eyelash hypotrichosis. Cutaneous hyperpigmention of the treated sites has been reported with this agent. In the current study, Grimes assessed the efficacy of 0.03% bimatoprost solution for treating vitiligo. She recruited 32 subjects with nonfacial vitiligo and divided them into three groups: (1) bimatoprost as monotherapy; (2) bimatoprost plus mometasone; and (3) mometasone with placebo. This study showed that bimatoprost both as a monotherapy and in combination with mometason is more effective than mometasone alone in the treatment of non-facial vitiligo (Grimes, 2016). Before Grimes, in a small open-label study, the efficacy of bimtoprost had been revealed in treating recalcitrant focal vitiligo particularly on the face (Narung, Jain, & Sing, 2011). Additionally, in another study, the efficacy of topical PGE2 in managing stable localized vitiligo was demonstrated (Kapoor, Phiske, & Jerajani, 2009). However, more robust controlled studies with a high number of subjects and long evaluation periods are required to confirm the precise efficacy of bimatoprost and other PG analogs in the treatment of vitiligo. Commentary: Bimatoprost and other prostaglandin analogs seem to be effective in the treatment of vitiligo. More robust clinical trials are needed to evaluate their precise efficacy.