Zohdy Hatem Abo-El-Wafa, Hussein Mohamed Saber
Faculty of Medicine, Benha University, Benha, Egypt.
J Cosmet Dermatol. 2019 Oct;18(5):1430-1434. doi: 10.1111/jocd.12820. Epub 2018 Nov 15.
Vitiligo is an autoimmune disease with a prevalence of 1.22% in Egypt. Intralesional steroids use in localized vitiligo treatment still a matter of debate. Fluorouracil was tried in vitiligo treatment after lesion dermabrasion, ablative laser, or micro-needling. The study aimed to compare the efficacy of intradermal fluorouracil and triamcinolone acetonide without any adjuvant therapy in localized vitiligo treatment.
Sixty patients with localized non-segmental stable vitiligo were assigned randomly and equally into groups. Patients subjected to intradermal injection of either fluorouracil (50 mg/mL), triamcinolone acetonide (3 mg/mL) or an equal mixture of both drugs. All patients had four treatment sessions every 2 weeks were followed up for 6 months.
Intradermal fluorouracil showed the best overall improvement (median 52.27, IQR 36.25-68.18) when compared with triamcinolone (median 13.86, IQR 3.83-33.32) and the drug mixture (median 17.15, IQR 7.48-41.67). During follow-up, the vitiliginous patches continued to repigment for 6 months in fluorouracil and the drug mixture groups. The improvement stopped 1 month after the last session in the triamcinolone group.
The intradermal fluorouracil injection is an effective treatment of localized vitiligo. The intradermal steroid has a short-acting therapeutic effect, but the mixture of drugs added no therapeutic effect.
白癜风是一种自身免疫性疾病,在埃及的患病率为1.22%。皮损内注射类固醇用于局限性白癜风的治疗仍存在争议。氟尿嘧啶已被尝试用于白癜风治疗,可在皮损磨皮、剥脱性激光治疗或微针治疗后使用。本研究旨在比较在局限性白癜风治疗中,皮内注射氟尿嘧啶和曲安奈德在无任何辅助治疗情况下的疗效。
60例局限性非节段性稳定期白癜风患者被随机且平均分为三组。患者接受皮内注射氟尿嘧啶(50mg/mL)、曲安奈德(3mg/mL)或两种药物的等量混合物。所有患者每2周进行4次治疗,随访6个月。
与曲安奈德(中位数13.86,四分位数间距3.83 - 33.32)和药物混合物(中位数17.15,四分位数间距7.48 - 41.67)相比,皮内注射氟尿嘧啶显示出最佳的总体改善效果(中位数52.27,四分位数间距36.25 - 68.18)。在随访期间,氟尿嘧啶组和药物混合物组的白癜风斑块在6个月内持续复色。曲安奈德组在最后一次治疗后1个月改善停止。
皮内注射氟尿嘧啶是局限性白癜风的有效治疗方法。皮内注射类固醇具有短效治疗效果,但药物混合物未增加治疗效果。