白斑内服PUVA、人工光で転帰良好

Comparison of efficacy and side-effect profile of oral PUVA vs. oral PUVA sol in the treatment of vitiligo: a 36-week prospective study.

Singh S et al.

J Eur Acad Dermatol Venereol. 2013 Nov;27(11):1344-51.

　白斑で内服PUVA治療を受けた患者35人を対象に、人工光（18人）／太陽光（17人）の有効性と副作用を前向き比較臨床研究で比較。治療後36週でLund & Browderスコアによる罹患体表面積の減少（人工光46.4％、太陽光26.1％、P＝0.06）、患者／医師による総合評価（P＝0.13／P＝0.11）、Tjioeらの質問票によるQOL（P＝0.04）で人工光が有意に良かった。光毒性副作用は人工光が有意に多かった。

Comparison of efficacy and side-effect profile

of oral PUVA vs. oral PUVA sol in the treatment of vitiligo:

a 36-week prospective study.

Singh S, Khandpur S, Sharma VK, Ramam M.

J Eur Acad Dermatol Venereol. 2013 Nov;27(11):1344-51. doi: 10.1111/jdv.12002. Epub 2012 Oct 16.

https://pubmed.ncbi.nlm.nih.gov/23066663/#

Source

Department of Dermatology & Venerology, All India Institute of Medical Sciences, New Delhi, India.

Abstract

BACKGROUND:

Both Oral PUVA and PUVA sol have been successfully used in vitiligo treatment.

However, there is paucity of studies comparing the two therapies,

especially under subtropical conditions of abundant sunlight where PUVA sol is more feasible.

OBJECTIVES:

To compare the efficacy and side effects

of oral PUVA versus oral PUVA sol therapy in generalized vitiligo.

METHODS:

Comparative prospective clinical trial conducted on consecutive patients of generalized vitiligo. Response to treatment was assessed using change in Lund & Browder (L & B) score for assessment of reduction in body surface area of involvement, patient global assessment (PGA) of improvement in vitiligo, investigator's global assessment (IGA) of extent of repigmentation, and quality of life (QOL) assessment using Tjioe et al questionnaire.

RESULTS:

Thirty five patients were recruited- 18 in PUVA and 17 in PUVA sol group. Mean percentage change in L & B score at 36 weeks was 46.4% in PUVA and 26.1% in PUVA sol group (P = 0.06), mean PGA score in PUVA was 4.58 ± 2.23 and in PUVA sol group was 6 ± 2.08 (P = 0.13), mean IGA score was 3.08 ± 1.68 in PUVA and 1.79 ± 0.57 in PUVA sol group (P = 0.11). QOL scores were significantly higher in PUVA group as compared to the PUVA sol group (P = 0.04). Side effects were comparable in two groups except for phototoxic side effects which were significantly more in PUVA group.

CONCLUSIONS:

PUVA is more efficacious than PUVA sol and also provides greater psychological benefit in treatment of generalized vitiligo but is associated with more phototoxic adverse effects.