Katayama Ichiro, Ashida Miwa, Maeda Aki, Eishi Kumiko, Murota Hiroyuki, Bae Sang Jae
Department of Dermatology, Nagasaki University School of Medicine, 1-7-1, Sakamoto, Nagasaki, Japan.
Eur J Dermatol. 2003 Jul-Aug;13(4):372-6.
Vitiligo vulgaris is a common skin disease, however some cases show poor clinical responses to topical steroid ointment or PUVA therapy. Such regimens are generally avoided in the treatment of facial lesions or in pediatric cases because of the undesirable side effects. To confirm the excellent response to combination therapy with topical vitamin D3 ointment and solar irradiation for vitiligo achieved in the initial patients, we conducted an open trial on other patients, most of whom had poor clinical responses to the prior therapies. Fifteen patients (9 men and 6 women) with vitiligo vulgaris were enrolled in this study. Each patient was instructed to sunbathe for 30 minutes within 1 hour after topical application of the tacalcitol [1 alpha 24(OH)(2)D(3)] ointment or cream to the skin lesions every day. Six of 15 patients showed a fair and excellent clinical response to the combination therapy (more than 30% clearance of the vitiligo). The clinical effect was more apparent in patients with a history of less than 5 years of vitiligo (4 of 6 cases) in contrast to those with a history of more than 5 years (2 of 9 cases). In vitro experiments revealed that tacalcitol upregulated the expression of c-Kit mRNA by melanocytes irradiated with linear polarized infrared, UVA or short period solar irradiation. These results suggest that combination therapy with topical vitamin D(3) ointment and solar irradiation can be used as an alternate therapy for vitiligo vulgaris.
寻常型白癜风是一种常见的皮肤病，然而一些病例对局部用类固醇软膏或补骨脂素加紫外线A（PUVA）疗法的临床反应不佳。由于存在不良副作用，在治疗面部病变或儿科病例时通常避免使用此类疗法。为了证实最初的患者使用局部维生素D3软膏和日光照射联合治疗白癜风取得了良好效果，我们对其他患者进行了一项开放性试验，这些患者大多数对先前的治疗临床反应不佳。15例寻常型白癜风患者（9例男性和6例女性）参与了本研究。指导每位患者每天在局部将他卡西醇[1α,24(OH)₂D₃]软膏或乳膏涂抹于皮肤病变后1小时内日光浴30分钟。15例患者中有6例对联合治疗表现出良好及优秀的临床反应（白癜风清除率超过30%）。与白癜风病史超过5年的患者（9例中的2例）相比，白癜风病史少于5年的患者（6例中的4例）临床效果更明显。体外实验显示，他卡西醇上调了经线性偏振红外线、紫外线A或短时间日光照射的黑素细胞中c-Kit mRNA的表达。这些结果表明，局部维生素D₃软膏和日光照射联合治疗可作为寻常型白癜风的一种替代疗法。
