Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
J Dermatol. 2021 Jul;48(7):1090-1093. doi: 10.1111/1346-8138.15858. Epub 2021 Mar 25.
Systemic corticosteroid is indicated for vitiligo, especially for generalized and progressive vitiligo. However, no consensus exists yet for the dosages and modalities of systemic corticosteroid treatments for vitiligo. The purpose of this study is to validate the efficacy and safety of i.v. methylprednisolone pulse therapy (IVMP) for patients with progressive generalized vitiligo. We retrospectively reviewed the medical records of vitiligo patients treated in our institute for 10 years between January 2010 and December 2019. Among 525 vitiligo patients treated in 10 years, 33 vitiligo patients (aged, 8-78 years; 18 female and 15 males) received IVMP, a single course of daily 500 mg methylprednisolone application (8 mg/kg/day for children) for 3 consecutive days. We observed that 14 of 25 (56%) achieved stable condition without lesion progression, and 12 of 19 (63%) had more than 25% repigmentation at 6 months after IVMP. A group of Vitiligo Area Scoring Index over 10 included more patients with Vitiligo Disease Activity Score of +3 and +4 disease progression at 6 months after the IVMP. We did not observe any severe adverse events relating to the IVMP procedures. In conclusion, IVMP is a safe and effective treatment for progressive generalized vitiligo.
全身皮质类固醇适用于白癜风，特别是泛发性和进展性白癜风。然而，对于白癜风的全身皮质类固醇治疗剂量和方式尚未达成共识。本研究旨在验证静脉注射甲基强的松龙脉冲疗法（IVMP）治疗进展性泛发性白癜风患者的疗效和安全性。我们回顾性分析了 2010 年 1 月至 2019 年 12 月我院 10 年间治疗的白癜风患者的病历。在 10 年间治疗的 525 例白癜风患者中，33 例白癜风患者（年龄 8-78 岁；女性 18 例，男性 15 例）接受 IVMP，即连续 3 天每天应用 500mg 甲基强的松龙（儿童 8mg/kg/天）。我们观察到，25 例中有 14 例（56%）病情稳定，无病变进展，19 例中有 12 例（63%）在 IVMP 后 6 个月时色素恢复超过 25%。在 IVMP 后 6 个月，VASI 评分超过 10 的患者中，VASI 评分+3 和+4 的疾病进展患者更多。我们未观察到与 IVMP 相关的任何严重不良事件。总之，IVMP 是治疗进展性泛发性白癜风的一种安全有效的方法。
