Pasricha J S, Khera V
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi.
Int J Dermatol. 1994 Aug;33(8):584-7. doi: 10.1111/j.1365-4362.1994.tb02903.x.
For an effective treatment of vitiligo, it is as important to arrest the progression of the disease (if it is still active) as it is to induce repigmentation in existing lesions. In patients having limited and slow-spreading vitiligo, we evaluated the efficacy of levamisole to control the activity of the disease process and to induce repigmentation of the vitiliginous areas.
Levamisole was given to 64 patients in an oral dose of 150 mg on two consecutive days every week for periods varying from 4-48 months. In 14 patients levamisole was used alone, in 38 patients it was combined with topical 0.1% fluocinolone acetonide acetate ointment massaged on the lesions once a day, and in 12 patients it was combined with topical 0.05% clobetasol propionate used in the same way. There was no other adjuvant therapy.
In 34 of the 36 patients (94%) having active disease, the progression of the disease could be arrested within 2-4 months. A variable degree of spontaneous repigmentation of the vitiliginous areas was seen in 9 patients (64%) treated with levamisole alone, 33 patients (87%) treated with levamisole and topical fluocinolone, and all the 12 patients treated with levamisole and topical clobetasol. The side effects with levamisole were minimal except in two cases where treatment had to be discontinued. Topical fluocinolone was fairly safe in the Indian patients, but clobetasol frequently produced atrophy and telangiectasia.
Levamisole seems to be a simple, safe, and fairly effective remedy for controlling the activity of the disease process in vitiligo patients who have limited and slow-spreading disease. Some patients develop spontaneous repigmentation as well. To achieve a faster rate of repigmentation, levamisole can be combined with other treatment methods such as topical corticosteroids.
对于白癜风的有效治疗，阻止疾病进展（如果疾病仍处于活动期）与诱导现有皮损处色素再生同样重要。在患有局限性、缓慢进展性白癜风的患者中，我们评估了左旋咪唑控制疾病进程活动及诱导白癜风区域色素再生的疗效。
64例患者口服左旋咪唑，每周连续两天，每次150mg，疗程4 - 48个月。14例患者单独使用左旋咪唑，38例患者将其与0.1%醋酸氟轻松软膏联合使用，每天在皮损处按摩一次，12例患者将其与0.05%丙酸氯倍他索以同样方式联合使用。未进行其他辅助治疗。
在36例活动期疾病患者中的34例（94%），疾病进展可在2 - 4个月内得到控制。单独使用左旋咪唑治疗的9例患者（64%）、左旋咪唑与外用氟轻松联合治疗的33例患者（87%）以及左旋咪唑与外用氯倍他索联合治疗的所有12例患者中，均可见不同程度的白癜风区域自发色素再生。除两例必须停药的情况外，左旋咪唑的副作用极小。外用氟轻松在印度患者中相当安全，但氯倍他索经常导致萎缩和毛细血管扩张。
对于患有局限性、缓慢进展性疾病的白癜风患者，左旋咪唑似乎是一种简单、安全且相当有效的控制疾病进程活动的药物。一些患者也会出现自发色素再生。为了实现更快的色素再生速度，左旋咪唑可与其他治疗方法如外用皮质类固醇联合使用。
