Therapeutic Effect of the Combination of High-dose Methylprednisolone Pulse Therapy and PUVA in Vitiligo Patients

Lee, Young; Seo, Young Joon; Lee, Jeung Hoon; Park, Jang Kyu

Abstract

BACKGROUND: It is well known that topical and systemic corticosteroids can arrest the progress of vitiligo and lead to repigmentation. However, it may also produce unacceptable side effects. To minimize the side effects of systemic corticosteroids, there have been some reports of using high-dose methylprednisolone pulse therapy in vitiligo. But, there has been no report on the effectiveness of the combined treatment with phototherapy.
OBJECTIVE
We evaluated the efficacy, safety, and tolerability of combination therapy of intravenous methylprednisolone pulse therapy and PUVA.
METHODS
A study was performed on 31 patients with vitiligo who could undergo follow up study for at least 6 months. After intravenous administration of methylprednisolone 25 mg/kg/day for 3 consecutive days, PUVA phototherapy was given once or twice a week for the next 6 months.
RESULTS
After 6 months, vitiligo lesions on the face showed 60.7% improvement, and the upper extremities showed 34.5% improvement. The trunk and lower extremities showed 25.1% and 25.8% improvement respectively. Compared with other sites, lesions on the feet (13.2%) and periungal area (0%) showed poor improvement. The overall improvement in 12 patients (38.7%) showed more than 50% repigmentation. Side effects occurred in a small number of patients and were transient.
CONCLUSION
Combination treatment of high-dose methylprednisolone pulse therapy and PUVA may provide a therapeutic option for generalized vitiligo, with high effectiveness and low side effects.