Sahu Priyadarshini, Jain Vijay Kumar, Aggarwal Kamal, Kaur Sarabjit, Dayal Surabhi
Department of Dermatology, Venereology and Leprology, Pt B D Sharma University of Health Sciences, Rohtak, Haryana, India.
Photodermatol Photoimmunol Photomed. 2016 Sep;32(5-6):262-268. doi: 10.1111/phpp.12265. Epub 2016 Sep 12.
Phototherapy especially narrow-band UV-B (NBUVB) has been considered as mainstay of therapy in nonsegmental vitiligo (generalized type). Topical tacalcitol has also been claimed to be effective, either as monotherapy or as combination therapy.
Comparison of clinical efficacy and safety of NBUVB in combination with topical tacalcitol vs. NBUVB alone in vitiligo.
MATERIAL & METHODS: Thirty patients with symmetrical vitiliginous lesions were enrolled for 24 weeks. Patients were instructed to apply tacalcitol ointment on right side of body once daily. In addition, the whole body was irradiated with NBUVB thrice weekly. All the patients were examined, and lesional photography was done. Patients were also followed up for 6 months post-treatment.
Our study resulted in two key findings: (1) There was a statistically significant difference in mean percentage of repigmentation at 8, 16 and 24 weeks between combination therapy and NBUVB. (2) The mean cumulative dose and number of treatment sessions for initial repigmentation were significantly lower with combination therapy. No serious adverse effects were observed during the study period.
Topical tacalcitol potentiates efficacy of NBUVB as it enhances extent of pigmentation, decrease time to repigmentation and lowers the cumulative doses of NBUVB, thereby leading to greater patient satisfaction and improved compliance.
光疗尤其是窄谱中波紫外线(NBUVB)被认为是非节段性白癜风(泛发型)治疗的主要手段。外用他卡西醇也被宣称有效,可作为单一疗法或联合疗法。
比较NBUVB联合外用他卡西醇与单独使用NBUVB治疗白癜风的临床疗效和安全性。
30例有对称性白癜风皮损的患者入选,治疗24周。患者被要求每天在身体右侧涂抹一次他卡西醇软膏。此外,全身每周接受3次NBUVB照射。对所有患者进行检查并拍摄皮损照片。治疗后还对患者进行了6个月的随访。
我们的研究得出两个关键发现:(1)联合疗法与NBUVB治疗在8周、16周和24周时的平均色素恢复百分比有统计学显著差异。(2)联合疗法使色素最初恢复的平均累积剂量和治疗次数显著降低。研究期间未观察到严重不良反应。
外用他卡西醇可增强NBUVB的疗效,因为它能提高色素沉着程度、缩短色素恢复时间并降低NBUVB的累积剂量,从而提高患者满意度并改善依从性。