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ISSN 1405-1710 (Print)

2018, Number 2

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Rev Cent Dermatol Pascua 2018; 27 (2)

Topical psoralene for night-time versus daytime use to reduce adverse events in patients with vitiligo

Domínguez-Gómez MA, Jurado-Santa CF, Martínez-Zavala M, Peralta-Pedrero ML, Morales-Sánchez MA

Language: Spanish
References: 16
Page: 45-50
PDF size: 227.43 Kb.


Text Extraction

Introduction: Vitiligo is an acquired disorder of melanocytes that affects 2% of the population. The treatment with topical psoralens promotes the repigmentation of the skin but with the risk of phototoxicity. Objective: To determine the safety and affectiveness of the nocturnal compared with the diurnal application of 8-methoxypsoralen in vitiligo patients. Material and methods: A randomized, single-blind clinical trial was conducted in patiens with vitiligo, who received 8-methoxypsoralen topically every 24 hours for 12 weeks. Group 1 applied it at night, with daytime solar exposure after cleaning the affected skin; while group 2 applied it in the morning and 30 minutes later the skin was exposed to sunlight between 10 and 16 hours for one minute, the exposure time was increased according to patients' tolerance. Results: 37 patients with vitiligo were included. Phototoxicity was seen in a patient of group 1 (5.3%) and in eight patients (44.4%) of group 2. Partial repigmentation was similar in both groups; no patient achieved total repigmentation. Conclusions: The present study shows that the nocturnal application of 8-methoxypsoralen decreases the risk of adverse events without compromising the efficacy of the treatment.


REFERENCES

  1. Matin R. Vitiligo in adults and children. BMJ Clin Evid. 2011; 2011: 1717.

  2. Whitton ME, Pinart M, Batchelor J, Leonardi-Bee J, González U, Jiyad Z et al. Interventions for vitiligo. Cochrane Database Syst Rev. 2015; 24: CD003263.

  3. Herr H, Cho HJ, Yu S. Burns caused by accidental overdose of photochemotherapy (PUVA). Burns. 2007; 33: 372-375.

  4. Poletti ED, Muñoz-Sandoval R, Escobedo-Terrones GS, Alcalá-Dávila EI. PUVASOL: ¿la fuerza de la costumbre? Reflexiones y propuestas en consideración a tres casos iatrógenos. Dermatol Rev Mex. 2010; 54: 222-227.

  5. Grimes PE. Psoralen photochemotherapy for vitiligo. Clin Dermatol. 1997; 15: 921-926.

  6. Grundmann-Kollmann M, Tegeder I, Ochsendorf FR, Zollner TM, Ludwig R, Kaufmann R et al. Kinetics and dose-response of photosensitivity in cream psoralen plus ultraviolet A photochemotherapy: comparative in vivo studies after topical application of three standard preparations. Br J Dermatol. 2001; 144: 991-995.

  7. Grundmann-Kollmann M, Podda M, Bräutigam L, Hardt-Weinelt K, Ludwig RJ, Geisslinger G et al. Spatial distribution of 8-methoxypsoralen penetration into human skin after systemic or topical administration. Br J Clin Pharmacol. 2002; 54: 535-539.

  8. Falabella R, Barona MI. Update on skin repigmentation therapies in vitiligo. Pigment Cell Melanoma Res. 2008; 22: 42-65.

  9. Wu CS, Lan CC, Wang LF, Chen GS, Wu CS, Yu HS. Effects of psoralen plus ultraviolet A irradiation on cultured epidermal cells in vitro and patients with vitiligo in vivo. Br J Dermatol. 2007; 156: 122-129.

  10. Stüttgen G. The risk of photochemotherapy. Int J Dermatol.1982; 21: 198-202.

  11. Balasaraswathy P, Kumar U, Srinivas CR, Nair S. UVA and UVB in sunlight. Optimal utilization of UV rays in sunlight for phototherapy. Indian J Dermatol Venereol Leprol. 2002; 68: 198-201.

  12. Ezzedine K, Whitton M, Pinart M. Interventions for vitiligo. JAMA. 2016; 316: 1708-1709.

  13. Khalid M, Mujtaba G, Haroon TS. Comparison of 0.05% clobetasol propionate cream and topical Puvasol in childhood vitiligo. Int J Dermatol. 1995; 34: 203-205.

  14. Farah FS, Kurban AK, Chaglassian HT. The treatment of vitiligo with psoralens and triamcinolone by mouth. Br J Dermatol. 1967; 79: 89-91.

  15. Taieb A, Alomar A, Böhm M, Dell’anna ML, De Pase A, Eleftheriadou V et al. Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol. 2013; 168: 5-19.

  16. Tien Guan ST, Theng C, Chang A. Randomized, parallel group trial comparing home-based phototherapy with institution-based 308 excimer lamp for the treatment of focal vitiligo vulgaris. J Am Acad Dermatol. 2015; 72: 733-735.




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