Majid Imran, Imran Saher
Department of Dermatology, Government Medical College Srinagar, India.
Indian J Dermatol. 2013 Mar;58(2):113-6. doi: 10.4103/0019-5154.108040.
Oral minipulse (OMP) therapy with methylprednisolone is presently one of the most common oral treatments used for progressive vitiligo in children. The treatment is usually given for a period of 6 months during which majority of patients are reported to go into remission. However, there are no follow-up studies to comment upon what happens to the disease after OMP therapy is withdrawn.
To document the incidence of relapse over a period of 1 year after OMP therapy is stopped in children with vitiligo.
The study was conducted in 180 patients of childhood vitiligo (<15 years of age) who had been on OMP therapy with oral methylprednisolone for at least 6 months and who had achieved a complete remission of their disease during the treatment period. The enrolled patients were followed up for a period of 1 year and examined clinically for any sign of reactivation of their disease over either the old lesions or at any new area of the body.
Forty-two patients were lost and could not complete the follow-up period of 1 year. Out of the 138 patients available at the end of 1 year, relapse was observed in 48 patients (34.8%). Rest of 90 patients remained in remission over the follow-up period of 1 year. Relapse was more common in patients below 10 years of age (47.4%) as compared with older children (25.9%).
Relapse after using methylprednisolone OMP therapy in children with vitiligo is quite common especially in younger age groups. Studies are needed to see whether these relapses could be avoided by giving the treatment for a period longer than 6 months.
口服小剂量脉冲式(OMP)甲基泼尼松龙治疗目前是儿童进展期白癜风最常用的口服治疗方法之一。该治疗通常持续6个月,在此期间,据报道大多数患者病情缓解。然而,尚无随访研究说明停用OMP治疗后疾病的转归情况。
记录白癜风患儿停用OMP治疗1年后复发的发生率。
该研究纳入180例儿童白癜风患者(年龄<15岁),这些患者接受口服甲基泼尼松龙OMP治疗至少6个月,且在治疗期间疾病完全缓解。对纳入的患者进行为期1年的随访,并进行临床检查,观察其原有皮损或身体任何新部位是否有疾病重新活动的迹象。
42例患者失访,未能完成1年的随访期。在1年末可获得随访结果的138例患者中,48例(34.8%)出现复发。其余90例患者在1年的随访期内病情持续缓解。与年龄较大的儿童(25.9%)相比,10岁以下患者的复发更为常见(47.4%)。
白癜风患儿使用甲基泼尼松龙OMP治疗后复发相当常见,尤其是在年龄较小的患者群体中。需要开展研究以确定延长治疗时间超过6个月是否可以避免这些复发情况。