الفهرس 
Microdermabrasion
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Abstract
Vitiligo is the most common depigmenting disorder affecting around 0.5 -2% of the population worldwide. Vitiligo is characterized by the destruction of melanocytes in the skin, resulting in the appearance of well-circumscribed white macules. It is particularly distressing for people with darker skin types, especially if vitiligo occurs on highly visible sites such as the face and the hands. The exact pathophysiological mechanism of vitiligo remains elusive. Vitiligo is considered to be a multifactorial and polygenic disease that is associated with the loss of epidermal melanocytes. Loss of melanocytes in vitiligo appears to occur through a combination of several mechanisms (Genetic, immunological, neurochemical, melanocytorrhagy and oxidative stress) that act in concert. Medical therapy has been the mainstay of vitiligo treatment. There exists a variety of medical treatments for vitiligo including corticosteroids, tacrolimus, immunomodulators, NB-UVB and PUVA (using oral psoralen). Currently, phototherapy is the “gold standard” of vitiligo therapy, but it is time consuming for the patient, with months of twice weekly visits needed to yield results. Other treatments include phenylalanine, vitamin D-3 analogues, Khellin, 5-flourouracil, pseudocatalase, antioxidant therapy, as well as human placental extracts. Many patients remain refractory to the vast array of non-invasive treatments. Since 1964 various surgical techniques for the treatment of vitiligo have emerged including mini-punch grafting, suction blister epidermal grafting, split thickness skin grafting, cultured autologous melanocyte grafting and non-cultured melanocyte-keratinocyte transplantation. Recently, lasers have been introduced into the therapeutic armamentarium for vitiligo, specifically the helium-neon and excimer laser as solotherapy.