Department of Dermatology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand.
Department of Preventive and Social Medicine, Srinakharinwirot University, Bangkok, Thailand.
Dermatol Ther. 2022 Aug;35(8):e15596. doi: 10.1111/dth.15596. Epub 2022 Jun 1.
Narrowband ultraviolet B (NBUVB) phototherapy is an effective therapeutic option for generalized vitiligo. Previous reports showed the potential benefit of minocycline to stop disease progression in vitiligo. Meanwhile, minocycline has antioxidative, anti-inflammatory, and immunomodulating properties. There is no clinical study combining oral minocycline and NBUVB for treating generalized vitiligo. This study aims to compare the efficacy and safety of the combination treatment of NBUVB plus oral minocycline with NBUVB alone in generalized vitiligo. A randomized, double-blinded, placebo-controlled pilot study was conducted. Patients were randomly treated with either combined oral minocycline 100 mg per day plus NBUVB phototherapy or placebo plus NBUVB. All patients recieved NBUVB two times per week, for 12 weeks. The outcomes were assessed using Vitiligo Area Scoring Index score (VASI) percent change, quartile grading scale (QGS) of repigmentation, and Vitiligo Disease Activity Index (VIDA) score. Fourteen generalized vitiligo patients were included, and seven cases were assigned in each group. At week 12, the mean VASI score was decreased by 28.87% (24.15) in the minocycline group compared to 27.26% (7.98) in placebo group (p = 0.886). No significant difference was observed between both treatment modalities in QGS of repigmentation and mean VIDA score change. Two of the seven patients (29%) receiving minocycline developed hyperpigmentation, dark-brown and muddy brown discoloration, which was only confined to some vitiliginous patches. In conclusion, combination therapy with oral minocycline does not enhance the efficacy of NBUVB in generalized vitiligo. Due to the high incidence of drug-induced skin hyperpigmentation, minocycline plus NBUVB should be avoided.
窄谱中波紫外线（NBUVB）光疗是一种治疗泛发性白癜风的有效治疗选择。先前的报告显示米诺环素可能有助于阻止白癜风的疾病进展。同时，米诺环素有抗氧化、抗炎和免疫调节作用。目前尚无将口服米诺环素与 NBUVB 联合用于治疗泛发性白癜风的临床研究。本研究旨在比较 NBUVB 联合口服米诺环素与 NBUVB 单一疗法治疗泛发性白癜风的疗效和安全性。进行了一项随机、双盲、安慰剂对照的初步研究。患者随机接受联合口服米诺环素 100mg/天加 NBUVB 光疗或安慰剂加 NBUVB 治疗。所有患者每周接受两次 NBUVB 治疗，共 12 周。使用白癜风面积评分指数（VASI）百分比变化、复色四分位等级量表（QGS）和白癜风疾病活动指数（VIDA）评分评估结果。纳入了 14 例泛发性白癜风患者，每组 7 例。在第 12 周，米诺环素组的 VASI 评分平均下降 28.87%（24.15），而安慰剂组下降 27.26%（7.98）（p=0.886）。两种治疗方法在复色 QGS 和平均 VIDA 评分变化方面无显著差异。接受米诺环素治疗的 7 例患者中有 2 例（29%）出现色素沉着过度，表现为棕褐色和泥褐色变色，仅局限于一些白癜风斑块。总之，口服米诺环素联合治疗不能增强 NBUVB 治疗泛发性白癜风的疗效。由于药物引起的皮肤色素沉着过度发生率较高，应避免米诺环素加 NBUVB 治疗。
