Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand.
Dermatol Ther. 2021 Mar;34(2):e14886. doi: 10.1111/dth.14886. Epub 2021 Feb 25.
Excimer light, topical vitamin D analogues, and topical steroids have been reported to be effective treatments for vitiligo. However, monotherapy often demonstrates unfavorable results for acral vitiligo. This study aimed to evaluate the efficacy and safety of combination treatment with 308-nm excimer light and topical calcipotriol or topical clobetasol ointment for acral vitiligo. A prospective, randomized, double-blind, and intraindividual study was conducted. Combination treatment (excimer light and topical medication) was applied in the first 12 weeks, and monotherapy (topical medication alone) was used in the later 12 weeks. Both hands were irradiated with excimer light three times a week for 12 weeks. Calcipotriol ointment was randomly assigned to one hand, whereas clobetasol ointment was assigned to the other hand. The ointments were applied twice daily for a total of 24 weeks. Repigmentation, clinical improvement, and adverse reactions were assessed. A total of 26 hands completed the study. Of the hands treated with excimer light and calcipotriol, approximately 8% achieved excellent repigmentation at the end of the combination treatment period and 23% achieved good to excellent improvement after 12 weeks of calcipotriol monotherapy. More than 85% and 77% of the hands treated with calcipotriol-based and clobetasol-based regimens showed some repigmentation at the end of the study, respectively (P < .05). Nevertheless, no significant difference was found between the treatments. No serious adverse reactions were observed. In conclusion, the combination of excimer light and topical calcipotriol followed by topical calcipotriol alone is effective and might be a promising treatment regimen for acral vitiligo.
准分子光、局部维生素 D 类似物和局部皮质类固醇已被报道为治疗白癜风的有效方法。然而,单一疗法常常对肢端型白癜风效果不佳。本研究旨在评估 308nm 准分子光联合外用钙泊三醇或卤米松软膏治疗肢端型白癜风的疗效和安全性。采用前瞻性、随机、双盲、个体内研究。前 12 周采用联合治疗(准分子光和局部药物治疗),后 12 周采用单一疗法(单独使用局部药物)。双手每周接受准分子光照射 3 次,共 12 周。将钙泊三醇软膏随机分配到一只手上,而将卤米松软膏分配到另一只手上。两种软膏均每日两次使用,共 24 周。评估复色、临床改善和不良反应。共有 26 只手完成了研究。在接受准分子光和钙泊三醇治疗的手中,大约 8%在联合治疗结束时达到极好的复色,23%在钙泊三醇单一治疗 12 周后达到良好至极好的改善。在研究结束时,钙泊三醇组和卤米松组分别有超过 85%和 77%的手出现一些复色(P<0.05)。然而,两种治疗方法之间没有发现显著差异。没有观察到严重的不良反应。总之,准分子光联合外用钙泊三醇随后单独使用钙泊三醇是有效的,可能是肢端型白癜风的一种有前途的治疗方案。