{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T01:58:06Z","timestamp":1782611886592,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The current therapies for vitiligo require long duration with often disappointing outcomes. 5\u2010Fluorouracil (5\u2010FU) is a chemotherapeutic agent approved for topical use in the treatment of several dermatologic conditions. Matrix metalloproteinase 2 (MMP2) is synthesized by keratinocytes during the epidermal remodeling process and has been found to help in melanocyte migration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the efficacy and safety of flexible microneedling followed by application of 5\u2010FU in vitiligo treatment and to evaluate the immunohistochemical expression of MMP2 in involved skin in vitiligo patients before and after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty patients presented with vitiligo were planned to receive one session every 2\u00a0weeks for 12\u00a0weeks of microneedling followed by 5\u2010FU application. Clinical response to therapy was evaluated by VASI score. Pre\u2010 and post\u2010treatment biopsies were taken from vitiliginous patches for MMP2 immunostaining.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen patients (75%) responded to therapy with observed side effects such as pain, erythema, and hyperpigmentation of margins. The clinical response was more in young patients and those who have short disease duration. MMP2 was significantly increased in post\u2010treatment biopsy compared with the pretreatment one.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>5\u2010Fluorouracil application after microneedling is effective in the treatment of vitiligo with 75% response, 60% patient satisfaction, and tolerable side effects. The improvement in vitiligo patients by microneedling and 5\u2010fluorouracil could be due to upregulation of MMP2 in affected vitiligo specimens.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14388","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T19:17:56Z","timestamp":1629487076000},"page":"2153-2161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The clinical and pathological effectiveness of microneedling and topical 5\u2010fluorouracil in vitiligo treatment: An association with matrix metalloproteinase 2 immunohistochemical expression"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5095-2937","authenticated-orcid":false,"given":"Asmaa Gaber","family":"Abdou","sequence":"first","affiliation":[{"name":"Pathology Department Faculty of Medicine Menoufia University  Shebein Elkom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azza Gaber Antar","family":"Farag","sequence":"additional","affiliation":[{"name":"Dermatology, Andrology and STDs Department Faculty of Medicine Menoufia University  Shebein Elkom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manal","family":"Rashwan","sequence":"additional","affiliation":[{"name":"Dermatology, Andrology and STDs Department Faculty of Medicine Menoufia University  Shebein Elkom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa Ahmed","family":"Shehata","sequence":"additional","affiliation":[{"name":"Dermatology, Andrology and STDs Department Faculty of Medicine Menoufia University  Shebein Elkom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-020-00447-y"},{"issue":"5","key":"e_1_2_9_3_1","first-page":"855","article-title":"Understanding the symptoms of vitiligo","volume":"27","author":"Luo E","year":"2017","journal-title":"Exp Dermatol"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2016.11.013"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdermsci.2015.09.003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2017.0002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2003.10.023"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14106"},{"key":"e_1_2_9_9_1","first-page":"1473","article-title":"Evaluation of the additional effect of topical 5\u2010fluorouracil to needling in the treatment of localized vitiligo","volume":"19","author":"Attwa E","year":"2020","journal-title":"JCD"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4172\/2376-0427.1000242"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2005.01849.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1983.01650330014006"},{"key":"e_1_2_9_13_1","first-page":"125","article-title":"Treatment of vitiligo with 5\u2010 fluorouracil after microneedling of the lesion","volume":"5","author":"Santosh S","year":"2018","journal-title":"Int J Sci Stud"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"187","article-title":"Efficacy of topical 5% 5\u2010fluorouracil with needling versus 5% 5\u2010fluorouracil alone in stable vitiligo: a randomized controlled study","volume":"12","author":"Zahra F","year":"2020","journal-title":"JCAS"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12440"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2011.02127.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijdvl.IJDVL_386_16"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.14750"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-148X.2012.00997.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.140.6.677"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/15321819.2017.1344129"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.160482"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0749.2000.130103.x"},{"key":"e_1_2_9_24_1","first-page":"149","article-title":"Needling: an adjunct to NB\u2010UVB therapy in localized fixed vitiligo","volume":"18","author":"Ahmad T","year":"2008","journal-title":"J Pak Assoc Dermatol"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.12.054"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12480997"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1997.18011894.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2007.03226.x"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S225881"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2007.02278.x"},{"issue":"6","key":"e_1_2_9_31_1","first-page":"15","article-title":"Vitiligo in children: a review of classification, hypotheses of pathogenesis and treatment","volume":"80","author":"Bellet J","year":"2005","journal-title":"An Bras Dermatol"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAI.0b013e318246c793"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9896(2000)9999:9999<::AID-PATH659>3.0.CO;2-D"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10324.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0749.2002.02044.x"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07584.x"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0906-6705.2004.00221.x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14890"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0625.1999.tb00373.x"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.277.5323.225"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.14388","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.14388","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.14388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T23:40:52Z","timestamp":1692661252000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.14388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,20]]},"references-count":39,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1111\/jocd.14388"],"URL":"https:\/\/doi.org\/10.1111\/jocd.14388","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,20]]},"assertion":[{"value":"2021-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}