Parsad D, Saini R, Verma N
Department of Dermatology, HIMS, Dehradun, India.
Dermatology. 1998;197(2):167-70. doi: 10.1159/000017991.
A large variety of therapeutic agents are being tried for the treatment of vitiligo, but psoralens continue to be mainstay of treatment although they are not uniformly effective. Recent advances in pathophysiology have established a perturbed calcium homeostasis in affected skin, and melanocytes were shown to express vitamin D3 receptors.
The purpose of present study was to determine the efficacy of the combination of PUVAsol with topical calcipotriol in the treatment of vitiligo.
Nineteen patients with essentially bilateral symmetrical lesions were enrolled in a randomized, double-blind, right/left comparative study of 18 months duration. An oral dose of 0.6 mg/kg 8-methoxypsoralen was given 2 h before exposure to sunlight thrice weekly to all patients. The patients were advised to apply calcipotriol (50 microgram/g) on one side of the body and placebo ointment over the lesions on the other side twice daily.
At the end of 6 months, 12 patients (70%) showed marked to complete improvement on calcipotriol-treated sides as compared to 6 patients (35%) showing similar improvement on placebo-treated sides (p <0.05). At the end of treatment, 13 patients (76%) showed marked improvement in calcipotriol-treated lesions whereas 9 patients (53%) showed moderate to marked improvement in placebo-treated lesions. The repigmentation of hands and feet was much better with the combination of PUVAsol and calcipotriol.
The combination of PUVA and calcipotriol is highly effective and works faster and may be used for shortening the therapy with PUVA in the treatment of vitiligo.
目前正在尝试多种治疗药物来治疗白癜风，尽管补骨脂素并非对所有患者都有效，但它仍然是治疗的主要药物。病理生理学的最新进展表明，白癜风患者皮肤中的钙稳态受到干扰，并且黑素细胞表达维生素D3受体。
本研究旨在确定补骨脂素光化学疗法（PUVAsol）联合外用卡泊三醇治疗白癜风的疗效。
19例双侧基本对称皮损的患者参与了一项为期18个月的随机、双盲、左右对照研究。所有患者每周接受3次日光照射，在照射前2小时口服0.6mg/kg的8-甲氧基补骨脂素。建议患者一侧身体涂抹卡泊三醇（50μg/g），另一侧皮损处涂抹安慰剂软膏，均为每日2次。
6个月结束时，卡泊三醇治疗侧有12例患者（70%）出现显著至完全改善，而安慰剂治疗侧有6例患者（35%）出现类似改善（p<0.05）。治疗结束时，卡泊三醇治疗的皮损中有13例患者（76%）出现显著改善，而安慰剂治疗的皮损中有9例患者（53%）出现中度至显著改善。补骨脂素光化学疗法联合卡泊三醇治疗时，手足的色素恢复情况更好。
补骨脂素光化学疗法联合卡泊三醇治疗白癜风疗效显著，起效更快，可用于缩短补骨脂素光化学疗法的治疗时间。
