Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Department of Dermatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Australas J Dermatol. 2023 Aug;64(3):e207-e211. doi: 10.1111/ajd.14071. Epub 2023 May 11.
BACKGROUND/OBJECTIVES: Vitiligo is an immune-mediated skin disorder that targets epidermal melanocytes leading to the appearance of depigmented skin patches. Different treatment modalities have been reported with varied efficacy. We tried to evaluate the safety and efficacy of intralesional methotrexate in treating localized areas of vitiligo.
Thirty participants with localized patches of vitiligo were recruited. They were treated with intralesional injections of methotrexate every 2 weeks for a maximum of six sessions. At the end of the study, the degree of repigmentation was categorized into: excellent improvement (>75% repigmentation), good improvement (50%-75% repigmentation), fair improvement (25%-50% repigmentation) and poor improvement (<25% repigmentation).
We included 7 males (23.3%) and 23 females (76.7%). Their mean age was 33.6 ± 8.6 years. The duration of the disease ranged from 1 to 22 years. Four patients had a family history of vitiligo. At the end of the study, there was a highly statistically significant improvement (p < 0.001) after treatment regarding repigmentation.
This study showed that intralesional methotrexate is a safe and effective treatment option for patients with localized vitiligo lesions. Further studies on a larger scale are needed to evaluate the long-term effects of treatment and detect the ideal dose to be injected.
背景/目的：白癜风是一种免疫介导的皮肤疾病，会攻击表皮中的黑色素细胞，导致皮肤出现色素脱失斑块。已经报道了多种不同的治疗方法，其疗效也有所不同。我们尝试评估局部皮损内注射甲氨蝶呤治疗白癜风的安全性和疗效。
招募了 30 名患有局限性白癜风斑块的参与者。他们接受了每 2 周一次的皮损内注射甲氨蝶呤治疗，最多进行 6 次。在研究结束时，根据复色程度将疗效分为：极好改善（＞75%复色）、良好改善（50%-75%复色）、中等改善（25%-50%复色）和较差改善（＜25%复色）。
我们纳入了 7 名男性（23.3%）和 23 名女性（76.7%）。他们的平均年龄为 33.6±8.6 岁。疾病持续时间从 1 年到 22 年不等。有 4 名患者有白癜风家族史。在研究结束时，治疗后复色有高度显著的改善（p<0.001）。
本研究表明，皮损内注射甲氨蝶呤是治疗局限性白癜风皮损的安全有效选择。需要进一步开展更大规模的研究来评估治疗的长期效果，并确定理想的注射剂量。
