Title: Needle sheikhing treatment of vitiligo

Biography:

Iftikhar Sheikh Mohammad is currently working as consultant dermatologist at Alhamd skin clinic. He received his Doctoral degree from the University of Punjab, Lahore. He completed his Diploma from the University of Wales, Cardiff. He then worked at Alhamd skin clinic, Lahore, served as Consultant Dermatologist. He has authored several publications in various journals. His publications reflect his research interests in dermatology. He is also an Associate Editor of the Journal of Cosmetology, medwin publishers. He is serving as a member of Pakistan Association of Dermatology (PAD). He is awarded many times in national and international conferences for presentation of his research papers, including Best Poster Bronze Award during world congress of dermatology, 2011- Seoul Korea.

Abstract

Introduction: Vitiligo is an ever increasing problem in all age groups. Different regimens in practice are sun exposure, UVR and psoralens. My paper presents an original study where NEEDLING is combined with narrow band UVB.

Our hypothesis is that epidermal cells in the skin around the vitiligo patch can be pushed from normal skin into the vitiligo patch and subsequent UVB induced melanogenesis treats vitiligo.

Methods: A 31G needle is softly pushed through the normal skin in to the vitiligo patch at level of dermo-epidermal junction parallel to skin. This needle push called NEEDLING pushes epidermal cells including melanocytes into the vitiligo patch as micro inoculation to produce multiple small populations of melanocytes, which is then exposed to increasing doses of UVB to cause melanogenesis and hence repigmentation of the area.

Multiple needle pushes are made through the edge one centimeter apart. All patients having needling once weekly and UVB 3 times a week.

This study was done over 170 patients in both sexes in different age groups from July 2009 to July 2013.A comparison was also done with UVB alone. Photos of all patients taken at the start and then after every 3 weeks. Biopsy of few patients performed to observe the effects of needling.

Results: This combination treatment has proved very safe and effective against vitiligo as compared to UVB alone in all age groups. All patients had fast repigmentation. The best results are on face with more than 90% repigmentation. Repigmentation is good but slower towards peripheral parts. Repigmentation specially noted to start from edge of vitiligo patch (where needling is done) as tiny black dots and further needling through these dots gradually repigmented the central areas. Repigmentation is also good over areas with grey hair with this technique as needling uses melanocytes of the surrounding skin rather than the follicular cells. This further strengthened the idea of needling.